Usefulness of multi-channels in intraoperative spinal cord monitoring: multi-center study by the monitoring committee of the Japanese Society for Spine Surgery and related research
Usefulness of multi-channels in intraoperative spinal cord monitoring: multi-center study by the monitoring committee of the Japanese Society for Spine Surgery and related research
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DOI：
10.1007/s00586-013-2722-8
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发表时间：
2013-08-01
影响因子：
2.8
通讯作者：
Tani, Toshikazu
中科院分区：
文献类型：
--
作者：
Ito, Zenya;Matsuyama, Yukihiro;Tani, Toshikazu
本研究的目的是从通道数量方面分析数据，以检查多通道在术中脊髓监测中的有用性，纳入基线数据的前提条件如下：（1）仅进行CMAP监测的病例;（2）在相同刺激条件和记录条件下进行监测的病例。使用吸入麻醉或肌松剂作为维持麻醉的病例从基线数据中排除。在6，887例病例中，884例符合标准。每种不同通道数的检查项目为敏感性和特异性、假阳性率、假阴性率和术后运动缺陷肌肉覆盖率，以通道数检查这两个项目，4通道组的敏感性和特异性评分低于8通道组和16通道组（4个通道73/93%，8个通道100/97%，16个通道100/95%）。这些病例仅获得4个通道，术后运动缺陷肌肉的覆盖率为38%，总共80块术后运动缺陷肌肉中仅30块得到监测。在8通道组中，20个术后运动缺陷肌肉中有12个被监测，为60%。16通道组对术后运动功能障碍肌肉的覆盖率为100%，我们建议术中脊髓监护最好采用至少8个通道的多通道监测。
The purpose of this study is to analyze the data in terms of the number of channels employed to examine the usefulness of multi-channels in intraoperative spinal cord monitoring.The prerequisites for inclusion in the baseline data were as follows: (1) cases in which only CMAP monitoring was conducted; (2) cases in which monitoring was conducted under the same stimulation condition and the recording condition. Cases where inhalation anesthesia was used or muscle relaxants were used as maintenance anesthesia was excluded from the baseline data. Of the 6,887 cases, 884 cases met the criteria. The items examined for each of the different numbers of channels were the sensitivity and specificity, the false positive rate, the false negative rate, and the coverage rate of postoperative motor deficit muscles.To examine these two items in terms of the number of channels, the 4-channel group had lower sensitivity and specificity scores compared with the 8- and 16-channel groups (4 channels 73/93 %, 8 channels 100/97 %, 16 channels 100/95 %). Only four channels were derived for these cases and the coverage of postoperative motor deficit muscles was 38 % with only 30 out of the 80 postoperative motor deficit muscles in total being monitored. In the 8-channel group, it was 60 % with 12 of the 20 postoperative motor deficit muscles being monitored. The 16-channel group had 100 % coverage rate of postoperative motor deficit muscles.We suggest that multi-channel monitoring of at least eight channels is desirable for intraoperative spinal cord monitoring.