髓内MRI信号异常的脊髓型颈椎病患者术中神经电生理的变化及其意义

doi:10.3969/j.issn.1671-7171.2022.03.03

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Abstract 【Objective】To investigate the changes of intraoperative neuroelectrophysiological monitoring (IONM) indexes, motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) in patients with cervical spondylotic myelopathy (CSM) with abnormal MRI signals, and to analyze the relationship between abnormal MRI signals and IONM changes.【Methods】The clinical and IONM data of 150 CSM patients with abnormal MRI signals from January 2019 to January 2021 were collected and divided into two groups according to their signal characteristics. Group A: T₂WIs high signal (120 cases); Group B: T₂WIs high signal and T₁WIs low signal (30 cases). The IONM data of important surgical nodes were recorded. 【Results】 Group A: 9 cases had IONM changes, 1 case had temporary nerve injury, and there was no new permanent nerve injury; Group B: 18 cases of IONM changes, 5 cases of temporary nerve injury and 2 cases of new permanent nerve injury. There was significant difference in IONM between the two groups (MEPs, 5/120 vs 12/30,P<0.05; SEPs, 4/120 vs 6/30,P<0.05). In addition, there was significant difference in IONM amplitude before and after decompression in the group B [MEPs,(134±30.2) μV vs (65±26.2) μV, P<0.05;SEPs, (2.4±0.9) μV vs (1.3±0.7) μV, P<0.05].【Conclusion】In CSM patients, high T₂WIs signal and low T₁WIs signal are more prone to IONM changes than high T₂WIs signal alone, resulting in nerve injury. In the process of CSM spinal cord decompression, we should pay attention to the changes of IONM, and take appropriate surgical intervention measures when necessary.

Key words： Spinal Cord Diseases/CO CERVICAL SPONDYLOSIS/SU Magnetic Resonance Imaging

Received: 16 February 2022

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R274

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	LIN Xiang-quan
	ZHENG Zhong
	LIN Qin
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Cite this article:

LIN Xiang-quan,ZHENG Zhong,LIN Qin, et al. Changes and Significance of Intraoperative Neurophysiology in Patients with Cervical Spondylotic Myelopathy with Abnormal Intramedullary MRI Signal[J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(3): 328-331.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2022.03.03 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2022/V39/I3/328

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