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

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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
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  Label: Title
  Group: Ti
  Data: [The application value of neuroelectrophysiological monitoring in posterior spinal corrective surgery for patients with osteochondrodysplasia complicated by kyphoscoliosis].
– Name: Author
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  Data: <searchLink fieldCode="AU" term="%22Liu+WY%22">Liu WY</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Qiu+JY%22">Qiu JY</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Liu+S%22">Liu S</searchLink>; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China.<br /><searchLink fieldCode="AU" term="%22Cai+ZP%22">Cai ZP</searchLink>; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China.<br /><searchLink fieldCode="AU" term="%22Wang+P%22">Wang P</searchLink>; Department of Spine Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen 518033, China.<br /><searchLink fieldCode="AU" term="%22Shi+BL%22">Shi BL</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Mao+SH%22">Mao SH</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Liu+Z%22">Liu Z</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Sun+X%22">Sun X</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Zhu+ZZ%22">Zhu ZZ</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.<br /><searchLink fieldCode="AU" term="%22Qiu+Y%22">Qiu Y</searchLink>; Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
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  Data: <searchLink fieldCode="JN" term="%227511141%22">Zhonghua yi xue za zhi</searchLink> [Zhonghua Yi Xue Za Zhi] 2026 Sep 29; Vol. 106 (36), pp. 3906-3909.
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  Data: English Abstract; Journal Article
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  Data: Chinese
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  Label: Journal Info
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Zhonghua+yi+xue+hui%22">Zhonghua yi xue hui </searchLink><i>Country of Publication: </i>China <i>NLM ID: </i>7511141 <i>Publication Model: </i>Print <i>Cited Medium: </i>Print <i>ISSN: </i>0376-2491 (Print) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2203762491%22">03762491 </searchLink><i>NLM ISO Abbreviation: </i>Zhonghua Yi Xue Za Zhi <i>Subsets: </i>MEDLINE
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  Label: Imprint Name(s)
  Group: PubInfo
  Data: <i>Publication</i>: Beijing : Zhonghua yi xue hui<br /><i>Original Publication</i>: Beijing : Zhonghua yi xue hui.
– Name: SubjectMESH
  Label: MeSH Terms
  Group: Su
  Data: <searchLink fieldCode="MM" term="%22Kyphosis%22">Kyphosis*</searchLink>/<searchLink fieldCode="MM" term="%22Kyphosis+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Kyphosis%22">Kyphosis*</searchLink>/<searchLink fieldCode="MM" term="%22Kyphosis+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Scoliosis%22">Scoliosis*</searchLink>/<searchLink fieldCode="MM" term="%22Scoliosis+surgery%22">surgery</searchLink> <br /><searchLink fieldCode="MM" term="%22Scoliosis%22">Scoliosis*</searchLink>/<searchLink fieldCode="MM" term="%22Scoliosis+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Osteochondrodysplasias%22">Osteochondrodysplasias*</searchLink>/<searchLink fieldCode="MM" term="%22Osteochondrodysplasias+complications%22">complications</searchLink> <br /><searchLink fieldCode="MM" term="%22Intraoperative+Neurophysiological+Monitoring%22">Intraoperative Neurophysiological Monitoring*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Child%22">Child</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Evoked+Potentials%2C+Somatosensory%22">Evoked Potentials, Somatosensory</searchLink> ; <searchLink fieldCode="MH" term="%22Adolescent%22">Adolescent</searchLink> ; <searchLink fieldCode="MH" term="%22Spinal+Fusion%22">Spinal Fusion</searchLink> ; <searchLink fieldCode="MH" term="%22Achondroplasia%22">Achondroplasia</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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.
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: 所有作者声明不存在利益冲突
– Name: GrantInfo
  Label: Grant Information
  Group: Grant
  Data: 82302685 National Natural Science Foundation of China
– Name: SubjectMinor
  Label: Contributed Indexing
  Group:
  Data: <i>Local Abstract: </i>[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。.
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        Value: 10.3760/cma.j.cn112137-20251223-03393
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        Text: Chinese
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        StartPage: 3906
    Subjects:
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Female
        Type: general
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      – SubjectFull: Spinal Fusion
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      – SubjectFull: Achondroplasia
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      – SubjectFull: Kyphosis surgery
        Type: general
      – SubjectFull: Kyphosis complications
        Type: general
      – SubjectFull: Scoliosis surgery
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      – SubjectFull: Scoliosis complications
        Type: general
      – SubjectFull: Osteochondrodysplasias complications
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      – SubjectFull: Intraoperative Neurophysiological Monitoring
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      – TitleFull: [The application value of neuroelectrophysiological monitoring in posterior spinal corrective surgery for patients with osteochondrodysplasia complicated by kyphoscoliosis].
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