王洪伟;李长青;周跃;

• 1:第三军医大学新桥医院骨科

摘要(Abstract)：

<正>近年来,随着术中影像导航技术的提高,椎弓根螺钉固定技术在脊柱后路内固定准确性、安全性上得到了显著的提高。然而,术中的影像导航技术难以做到病变及其周围的功能性定位,术中进行椎弓根螺钉置入时仍然存在损伤神经的医源性损伤的危险,而且术中影像导航还可造成较大的射线

关键词(KeyWords)： 术中监测;神经电生理;脊柱;椎弓根螺钉;进展

Abstract:

Keywords:

基金项目(Foundation): 军队临床高新技术重大项目(编号:2010gxjs072)

作者(Author): 王洪伟;李长青;周跃;

Email:

DOI:

参考文献(References)：

• [1]王振宇.术中神经电生理监测在微创神经外科的应用[J].中国微创外科杂志,2010,1:13-15.
• [2]Castellon AT,Meves R,Avanzi O.Intraoperative neurophysiologic spi-nal cord monitoring in thoracolumbar burst fractures[J].Spine,2009,24:2662-2668.
• [3]Thuet ED,Winscher JC,Padberg AM,et al.Validity and reliability ofintraoperative monitoring in pediatric spinal deformity surgery[J].Spine,2010,20:1880-1886.
• [4]Fehlings MG,Brodke DS,Norvell DC,et al.The evidence for intraoper-ative neurophysiological monitoring in spine surgery:does it make adifference[J].Spine,2010,9:37-46.
• [5]Drake J,Zeller R,Kulkarni AV,et al.Intraoperative neurophysiologicalmonitoring during complex spinal deformity cases in pediatric patients:methodology,utility,prognostication,and outcome[J].Childs NervSyst,2010,4:523-544.
• [6]Collado-Corona MA,de Leo-Yargas R,Sandoval-Sanchez V,etal.Neurophysiological monitoring in spinal cord surgery[J].Cir Cir,2009,5:361-366.
• [7]Kamerlink JR,Errico T,Xavier S,et al.Major intraoperative neurologicmonitoring deficits in consecutive pediatric and adult spinal deformitypatients at one institution[J].Spine,2010,2:240-245.
• [8]Yamazaki T,Matsudaira K.Diathermy testing:a novel method with e-lectric knife stimulation to avoid nerve injuries during lumbar pediclescrewplacement-technical note[J].J Neurosurg Spine,2007,5:479-484.
• [9]Bolger C,Kelleher MO,McEvoy L,et al.Electrical conductivity meas-urement:a newtechnique to detect iatrogenic initial pedicle perforation[J].Eur Spine J,2007,11:1919-1924.
• [10]Zeller R,Canavese F,Kulkarni AV,et al.Technique for drilling instru-ment monitoring electrical conductivity in pediatric cervical spine screwinsertion:a preliminary report[J].J Pediatr Orthop,2009,7:760-764.
• [11]Koller H,Hitzl W,Acosta F,et al.In vitro study of accuracy of cervicalpedicle screw insertion using an electronic conductivity device(ATPSpartⅢ)[J].Eur Spine J,2009,9:1300-1313.
• [12]de Blas G,Burgos J,Regidor I,et al.Recording diffusion responsesfrom contralateral intercostal muscles after stimulus-triggered electro-myography refining a tool for the assessment of thoracic pedicle screwplacement in an experimental porcine model[J].Spine,2009,11:391-396.
• [13]Norton JA,Hedden DM.Monitoring placement of high thoracic pediclescrews by triggered electromyography of the intercostal muscles[J].Can J Surg,2009,3:47-48.
• [14]Rodriguez-Olaverri JO,Zimick NC,Merola A,et al.Using triggeredelectromyographic threshold in the intercostal muscles to evaluate theaccuracy of upper thoracic pedicle screw placement(T3~6)[J].Spine,2008,7:194-197.
• [15]Donohue ML,Murtagh-Schaffer C,Basta J,et al.Pulse-train stimu-lation for detecting medial malpositioning of thoracic pedicle screws[J].Spine,2008,12:378-385.
• [16]Raynor BL,Lenke LG,Bridwell KH,et al.Correlation between lowtriggered electromyographic thresholds and lumbar pedicle screw mal-position[J].Spine,2007,24:2673-2678.
• [17]Wood MJ,Mannion RJ.Improving accuracy and reducing radiation ex-posure in minimally invasive lumbar interbody fusion:clinical article[J].J Neurosurg Spine,2010,5:533-539.
• [18]刘峰,张佐伦,崔新刚,等.皮层体感诱发电位对脊髓型颈椎病中脊髓功能的评价[J].中国矫形外科杂志,2005,18:1408-1409.
• [19]何杰民,唐勇,刘尚礼,等.127例脊柱侧凸术中皮层体感诱发电位特点的分析[J].中国矫形外科杂志,2005,1:72-73.
• [20]Accadbled F,Henry P,de Gauzy JS.Spinal cord monitoring in scoliosissurgery using an epidural electrode.Results of a prospective,consecu-tive series of 191 cases[J].Spine,2006,22:2614-2623.
• [21]Tsirikos AI,Aderinto J,Tucker SK,et al.Spinal cord monitoring usingintraoperative somatosensory evoked potentials for spinal trauma[J].JSpinal Disord,2004,5:385-394.
• [22]谢红雯,沙成,袁庆国,等.经颅磁刺激运动诱发电位在脊柱脊髓术中监测的应用研究[J].中华外科杂志,2010,14:1092-1096.
• [23]Nemec M,Bednarik J,Krbec M,et al.Intraoperative monitoring of som-atosensory and motor evoked potentials in scoliosis surgery[J].Ceska a Slovenska Neurologie a Neurochirurgie,2006,1:45-51.
• [24]Costa P,Bruno A,Bonzanino M,et al.Somatosensory-and motor-e-voked potential monitoring during spine and spinal cord surgery[J].Spinal Cord,2007,1:86-91.
• [25]Taunt CJ,Sidhu KS,AndrewSA.Somatosensory evoked potential moni-toring during anterior cervical discectomy and fusion[J].Spine,2005,17:1970-1972.
• [26]Kelleher MO,Tan G,Sarjeant R,et al.Predictive value of intraopera-tive neurophysiological monitoring during cervical spine surgery:a pro-spective analysis of1 055 consecutive patients[J].J Neurosurg Spine,2008,3:215-221.
• [27]Lee JY,Hilibrand AS,Lim MR,et al.Characterization of neurophysio-logic alerts during anterior cervical spine surgery[J].Spine,2006,17:1916-1922.
• [28]Quraishi NA,Lawis SJ,Kelleher MO,et al.Intraoperative multimodalitymonitoring in adult spinal deformity:analysis of prospective series ofone hundred two cases with independent evaluation[J].Spine,2009,14:1504-1512.
• [29]Sutter MA,Eggspuehler A,Grob D,et al.Multimodal intraoperativemonitoring(MIOM)during 409 lumbosacral surgical procedures in409 patients[J].Eur Spine J,2007,2:221-228.