Transcranial motor evoked potentials electrically elicited by multi-train stimulation can reflect isolated nerve root injury more precisely than those by conventional multi-pulse stimulation: an experimental study in rats
Transcranial motor evoked potentials electrically elicited by multi-train stimulation can reflect isolated nerve root injury more precisely than those by conventional multi-pulse stimulation: an experimental study in rats
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多列刺激电诱发的经颅运动诱发电位比传统多脉冲刺激更准确地反映孤立神经根损伤：大鼠实验研究
DOI：
10.1007/s10877-019-00296-x
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发表时间：
2019
影响因子：
2.2
通讯作者：
H. Yamada
中科院分区：
文献类型：
--
作者：
Takuhei Kozaki;S. Tsutsui;H. Yamada
神经根损伤可发生在复杂的脊柱手术中。记录经颅运动诱发电位（TcMEPs）是手术中监测运动功能最常用的方法。然而，TcMEPs不能很好地检测单个神经根损伤。最近，多列刺激（MTS）被证明可以有效地提高TcMEPs。本研究的目的是探讨MTS诱导的TcMEPs在术中神经根监测中的应用。记录20只大鼠后肢股四头肌（QF）和腓肠肌（GC）在L6神经根（支配GC的优势根）横断前后的tcmep。对于MTS，以5hz的频率反复传递多脉冲（训练）刺激。比较MTS与常规单列刺激（STS）在神经根横断后的振幅变化率。MTS和STS分别为97.8±12.2%和100.1±7.2% (p = 0.496)，而MTS和STS分别为40.6±11.5%和64.8±8.8% （p < 0.001）。MTS可提高术中TcMEP监测中孤立性神经根损伤的检测能力。
Nerve root injury can occur in complex spine surgeries. Recording transcranial motor-evoked potentials (TcMEPs) has been the most popular method to monitor motor function during surgery. However, TcMEPs cannot detect single nerve root injury satisfactorily. Recently, multi-train stimulation (MTS) was demonstrated to effectively enhance TcMEPs. The aim of this study was to investigate the utility of TcMEPs elicited by MTS for intraoperative nerve root monitoring. TcMEPs were recorded from the quadriceps femoris (QF) and gastrocnemius (GC) muscles in the hindlimbs of 20 rats before and after transection of the nerve root at L6 (dominant root innervating the GC). For MTS, a multipulse (train) stimulus was delivered repeatedly at 5 Hz. The change ratio of the amplitude after transection of the nerve root was compared between MTS and conventional single-train stimulation (STS). The change in TcMEP amplitudes for QF after transection of the nerve root at L6 was 97.8 ± 12.2% with MTS and 100.1 ± 7.2% with STS (p = 0.496), whereas that for GC was 40.6 ± 11.5% with MTS and 64.8 ± 8.8% with STS (p < 0.001). MTS could improve the ability to detect isolated nerve root injury in intraoperative TcMEP monitoring.