[The application value of neuroelectrophysiological monitoring in posterior spinal corrective surgery for patients with osteochondrodysplasia complicated by kyphoscoliosis].

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	[The application value of neuroelectrophysiological monitoring in posterior spinal corrective surgery for patients with osteochondrodysplasia complicated by kyphoscoliosis].
Συγγραφείς:	Liu WY; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Qiu JY; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Liu S; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China., Cai ZP; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China., Wang P; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China., Shi BL; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Mao SH; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Liu Z; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Sun X; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Zhu ZZ; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China., Qiu Y; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
Πηγή:	Zhonghua yi xue za zhi [Zhonghua Yi Xue Za Zhi] 2026 Sep 29; Vol. 106 (36), pp. 3906-3909.
Τύπος έκδοσης:	English Abstract; Journal Article
Γλώσσα:	Chinese
Στοιχεία περιοδικού:	Publisher: Zhonghua yi xue hui Country of Publication: China NLM ID: 7511141 Publication Model: Print Cited Medium: Print ISSN: 0376-2491 (Print) Linking ISSN: 03762491 NLM ISO Abbreviation: Zhonghua Yi Xue Za Zhi Subsets: MEDLINE
Imprint Name(s):	Publication: Beijing : Zhonghua yi xue hui Original Publication: Beijing : Zhonghua yi xue hui.
Ιατρικοί όροι (MeSH):	Kyphosis/surgery , Kyphosis/complications , Scoliosis/surgery , Scoliosis/complications , Osteochondrodysplasias/complications , Intraoperative Neurophysiological Monitoring, Humans ; Female ; Retrospective Studies ; Child ; Male ; Evoked Potentials, Somatosensory ; Adolescent ; Spinal Fusion ; Achondroplasia
Περίληψη:	This study retrospectively analyzed the feasibility and influencing factors of intraoperative neurophysiological monitoring (IONM) during posterior corrective surgery in patients with achondroplasia (ACH) and kyphoscoliosis. A total of 22 ACH patients (10 males, 12 females) with kyphoscoliosis who underwent one-stage posterior spinal fusion at a single center from February 2010 to June 2023 were enrolled, with a mean age of (11.7±4.0) years. IONM parameters included latency and amplitude of somatosensory evoked potentials (SEP) from bilateral lower limbs, as well as latency and maximum amplitude of transcranial electric motor evoked potentials (MEP); side-to-side differences and the incidence of asymmetric SEP were calculated. Results showed that kyphosis was the most common deformity type (14 cases, 63.7%), and the apex vertebra was most frequently located at the thoracolumbar junction (15 cases, 68.2%); the mean preoperative maximum coronal Cobb angle was (71.9±26.3)°, and the mean maximum sagittal Cobb angle was (84.3±27.0)°. Baseline acquisition rates were 81.8% (18/22) for SEP and 72.7% (16/22) for MEP; intraoperative alerts occurred in 4 cases for SEP and 2 cases for MEP, with postoperative new neurological deficits in 2 cases. Sensitivity and specificity were 100.0% and 87.5% for SEP, and 100.0% and 92.8% for MEP, respectively. The mean side-to-side differences were (1.7±1.6) ms for SEP-P37 latency, (2.5±2.3) ms for SEP-N45 latency, (0.7±0.7) μV for SEP amplitude, (2.2±2.4) ms for MEP latency, and (174.7±150.3) μV for MEP amplitude; the incidence of abnormal SEP was 55.5% (10/18). It is concluded that IONM provides reliable monitoring value in deformity correction surgery for ACH patients with kyphoscoliosis; however, these patients commonly exhibit side-to-side asymmetry of IONM parameters and carry a higher risk of intraoperative positive events, which is closely associated with their inherent spinal stenosis, potential chronic spinal cord compression, and abnormal preoperative spinal cord morphology.
Competing Interests:	所有作者声明不存在利益冲突
Grant Information:	82302685 National Natural Science Foundation of China
Contributed Indexing:	Local Abstract: [Publisher, Chinese] 该研究中对骨软骨发育不全（ACH）伴脊柱侧后凸畸形患者行后路矫形术中神经电生理监测（IONM）的可行性与影响因素进行了回顾性分析。共纳入2010年2月至2023年6月于单一中心行后路矫形内固定术的ACH伴脊柱侧后凸畸形患者22例（男10例，女12例），年龄（11.7±4.0）岁，IONM测量参数为双下肢体感诱发电位（SEP）的潜伏期及波幅、经颅电刺激运动诱发电位（MEP）的潜伏期及最大波幅，计算各指标侧间差值及不对称SEP发生率。结果显示，畸形类型以脊柱后凸最常见（14例，63.7%），顶椎多位于胸腰椎（15例，68.2%）；术前最大侧凸Cobb角为71.9°±26.3°，最大后凸Cobb角为84.3°±27.0°。基线获取率SEP为81.8%（18/22），MEP为72.7%（16/22）；术中SEP报警4例，MEP报警2例，术后新发神经损害2例。SEP敏感度100.0%、特异度87.5%，MEP敏感度100.0%、特异度92.8%。双侧SEP-P37潜伏期差为（1.7±1.6）ms，SEP-N45潜伏期差为（2.5±2.3）ms，SEP波幅差为（0.7±0.7）μV，MEP潜伏期差为（2.2±2.4）ms，MEP波幅差为（174.7±150.3）μV，异常SEP发生率55.5%（10/18）。研究发现，IONM在ACH伴脊柱侧后凸畸形矫形术中具有可靠的监测价值，但该类患者普遍存在IONM参数侧间不对称，术中阳性事件风险较高，与其椎管狭窄、长期脊髓压迫及术前脊髓形态异常密切相关。.
Entry Date(s):	Date Created: 20260923 Date Completed: 20260923 Latest Revision: 20260923
Update Code:	20260924
DOI:	10.3760/cma.j.cn112137-20251223-03393
PMID:	42778321
Βάση Δεδομένων:	MEDLINE

Full Text Finder

Περιγραφή
ISSN:	0376-2491
DOI:	10.3760/cma.j.cn112137-20251223-03393