Comparison of intraoperative neurophysiological monitoring methods for lumbosacral lipoma surgery in infants
Comparison of intraoperative neurophysiological monitoring methods for lumbosacral lipoma surgery in infants
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DOI：
10.1007/s00381-023-05900-9
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发表时间：
2023-03-04
影响因子：
1.4
通讯作者：
Asai，Akio
中科院分区：
文献类型：
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作者：
Nonaka，Masahiro;Itakura，Takeshi;Asai，Akio
婴儿，尤其是非常小的婴儿，术中稳定的神经生理监测是具有挑战性的。在这项研究中，运动诱发电位（MEP），球海绵体肌反射（BCR），体感诱发电位（SEP）同时监测婴儿腰骶部脂肪瘤，这些方法进行了比较retrospectively.MethodsA共21例手术腰骶部脂肪瘤的患者不到1岁进行了研究。手术时平均年龄为133.8天（范围21-287天; ≤ 120天：9例，> 120天：12例）。在肛门括约肌和腓肠肌中测量经颅MEP，并根据需要添加胫骨前肌和其他肌肉。结果9例BCR均在≤ 120日龄时记录到稳定电位，BCR与SEP分别为：（1）BCR与SEP;（2）BCR与SEP。9例MEP中仅4例记录到稳定电位（p< 0.05）。对于> 120日龄的所有患者，MEP和BCR是可测量的。结论在≤ 120日龄的腰骶部脂肪瘤患儿中，BCR比MEP测量更为一致。
BackgroundStable intraoperative neurophysiology monitoring of infants, especially very young infants, is challenging. In this study, motor evoked potentials (MEPs), the bulbocavernosus reflex (BCR), and somatosensory evoked potentials (SEPs) were simultaneously monitored in infants with lumbosacral lipomas, and these methods were compared retrospectively.MethodsA total of 21 surgeries performed for lumbosacral lipoma in patients less than 1 year old were studied. The mean age at surgery was 133.8 days (range 21–287 days; ≤ 120 days: 9 cases, > 120 days: 12 cases). Transcranial MEPs were measured in the anal sphincter and gastrocnemius, and tibialis anterior and other muscles were added as needed. The BCR was measured by the electromyogram of the anal sphincter muscle with stimulation of the pubic region, and SEPs were measured from the waveforms of stimulation of the posterior tibial nerves.ResultsFor the BCR, stable potentials could be recorded for all 9 cases at ≤ 120 days of age. In contrast, for MEPs, stable potentials could be recorded in only 4 of 9 cases (p< 0.05). For all patients > 120 days of age, MEPs and the BCR were measurable. SEPs were undetectable in some patients regardless of age.ConclusionThe BCR could be more consistently measured than MEPs in infant patients with lumbosacral lipoma at ≤ 120 days of age.