[Application of intraoperative neurophysiological monitoring in spinal cord surgery].
OBJECTIVE
To study application of intraoperative neurophysiological monitoring(IONM) in spinal cord surgery.


METHODS
In the study, 24 patients with spinal cord tumors were divided into 4 groups according to the method of monitoring. Group A (ventral tumors) underwent somatosensory evoked potential (SEP) + motor evoked potential (MEP) + electromyography (EMG) monitoring, group B (intramedullary tumors) underwent SEP + MEP monitoring, group C (subdural extramedullary tumors) underwent SEP + EMG monitoring, group D (conus medullary and cauda equina lesions) underwent EMG monitoring. The relationship between changes of IONM and postoperative neurological function was analyzed.


RESULTS
All of the 3 patients in group A had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group B had IONM alteration, of whom 5 recovered before the end of surgery, and 1 did not recover and neurological function deteriorated in this case. Seven of the nine patients in group C had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group D had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case.


CONCLUSIONS
IONM is useful to reduce postoperative neurological deterioration. However, IONM neurophysiological monitoring needs further improvement.
Department of Neurosurgery, Peking University Third Hospital, Beijing, China.
Guo-zhong
GZ
Lin
Zhen-yu
ZY
Wang
Bin
B
Liu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D013118:Spinal Cord Diseases / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D055815:Young Adult