Magnetic Stimulation for Monitoring of Motor Pathways in Spinal Procedures
Magnetic Stimulation for Monitoring of Motor Pathways in Spinal Procedures
复制标题
磁刺激用于监测脊柱手术中的运动通路
DOI：
10.1097/00007632-199304000-00006
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发表时间：
1993
期刊：
影响因子：
3
通讯作者：
Klaus O. W. Huse
中科院分区：
文献类型：
--
作者：
J. Herdmann;C. Lumenta;Klaus O. W. Huse
对13例脊髓内、髓外和硬膜外肿瘤患者术中应用经颅磁刺激进行运动诱发电位监测。麻醉以依托咪酯为基础。磁刺激运动诱发电位监测成功10例，其中12例为神经功能损害。运动诱发电位记录来自四肢肌肉或马尾神经纤维。基线记录(麻醉诱导后获得的初始记录)的波幅较术前降低±34%(平均值±SD)，基线潜伏期较术前延长7±8%。与基线相比，分析随后的记录的幅度和潜伏期的变化。与基线相比，波幅变化超过50%和潜伏期变化超过3ms正确地预示着术后肢体瘫痪增加的运动通路即将发生的损害。在运动诱发电位监测成功的情况下，对术后短期运动结果的预测总是正确的。没有“假阴性”或“假阳性”。
Transcranial magnetic stimulation was used for intraoperative motor evoked potential monitoring during surgery of intramedullar, extramedullar, and extradural spinal tumors in 13 patients. Anesthesia was based on etomidate. Magnetic stimulation for motor evoked potential monitoring was successful in 10 of 13 patients, 12 of whom were neurologically impaired. Motor evoked potentials were recorded from limb muscles or from the fibers of the cauda equina. Amplitudes of baseline recordings (the initial recording obtained after induction of anesthesia) were decreased by 64 ± 34% (mean ± SD) and baseline latencies were increased by 7 ± 8% compared with the preoperative recordings. Subsequent recordings were analyzed for amplitude and latency changes in comparison to baseline. Amplitude changes exceeding 50% and latency changes higher than 3 ms compared with the baseline correctly indicated an impending lesion of motor pathways with increased paresis postoperatively. In cases where motor evoked potential monitoring was successful prediction of short-term postoperative motor outcome was always correct. There were no “false-negatives” or “false-positives.”