Preliminary application of intraoperative neurophysiological monitoring in spinal cord surgery

Lin Guozhong, Wang Zhenyu, Liu Bin. Dept of neurosurgery, Peking University Third Hospital, Beijing 100191,China 【Abstract】 Objective: To study application of intraoperative neurophysiological monitoring in spinal cord surgery. Methods: 24 patients with spinal cord tumors were divided into 4 groups according to the method of monitoring. Group A (ventral tumors) were underwent SEP + MEP + EMG monitoring, Group B (intramedullary tumors) were underwent SEP + MEP monitoring, Group C (subdural extramedullary tumors) were underwent SEP + EMG monitoring, Group D (conus medullary and cauda equina lesions) were underwent EMG monitoring. The relationship between changes of intraoperative monitoring and postoperative neurological function was analysised. Results: All of the 3 patients in group A had intraoperative warning which recovered before the end of surgery. But neurological function was deteriorated in 1 case. All of the 6 patients in group B had intraoperative warning. 5 of these cases recovered before the end of surgery, 1 of these cases did not recover and neurological function was deteriorated in this case. 7 of the 9 patients in group C had intraoperative warning which recovered before the end of surgery. But neurological function was deteriorated in 1 case. All of the 6 patients in group D had intraoperative warning which recovered before the end of surgery. But neurological function was deteriorated in 1 case. Conclusions: Intraoperative neurophysiological monitoring was useful to reduce postoperative neurological deterioration. However, intraoperative neurophysiological monitoring need further improvement.

【Key words】: spinal cord; intraoperative neurophysiological monitoring; nerve root