Abstract：
While open surgical repair remains the gold standard for thoracoabdominal aortic aneurysm (TAAA) treatment, there is still no consensus regarding perioperative neuromonitoring technique for prevention of spinal cord ischaemia.
In this systematic review, we aimed to explore the effects and practices of neuromonitoring during the open TAAA repair. A systematic literature search in PubMed, Embase via Ovid, Cochrane library and ClinicalTrialsGov until December 2022 was performed.
A total of 535 studies were identified from the literature search, of which 27 studies including a total of 3130 patients met the eligibility criteria. Most studies (21 out of 27, 78%) investigated the feasibility of motor-evoked potentials (MEP), while 15 analysed somatosensory-evoked potentials (SSEP) and 2 studies analysed near-infrared spectroscopy during open TAAA repair.
Current literature suggest that rates of postoperative spinal cord ischaemia can be kept at low levels after open TAAA repair with the adequate precautions and perioperative manoeuvres. Neuromonitoring with MEP provides the surgeon objective criteria to direct selective intercostal reconstruction or other protective anaesthetic and surgical manoeuvres. Simultaneous monitoring of MEP and SSEP is a reliable method that can rapidly detect important findings and direct adequate protective manoeuvres during open TAAA repair.
In this systematic review, we aimed to explore the effects and practices of neuromonitoring during the open TAAA repair. A systematic literature search in PubMed, Embase via Ovid, Cochrane library and ClinicalTrialsGov until December 2022 was performed.
A total of 535 studies were identified from the literature search, of which 27 studies including a total of 3130 patients met the eligibility criteria. Most studies (21 out of 27, 78%) investigated the feasibility of motor-evoked potentials (MEP), while 15 analysed somatosensory-evoked potentials (SSEP) and 2 studies analysed near-infrared spectroscopy during open TAAA repair.
Current literature suggest that rates of postoperative spinal cord ischaemia can be kept at low levels after open TAAA repair with the adequate precautions and perioperative manoeuvres. Neuromonitoring with MEP provides the surgeon objective criteria to direct selective intercostal reconstruction or other protective anaesthetic and surgical manoeuvres. Simultaneous monitoring of MEP and SSEP is a reliable method that can rapidly detect important findings and direct adequate protective manoeuvres during open TAAA repair.
摘要：
目的：虽然开放手术修复仍是胸腹主动脉瘤（TAAA）治疗的金标准，关于预防脊髓缺血(SCI)的围手术期神经监测技术仍未达成共识.
方法：在这篇系统综述中，我们旨在探讨开放式TAAA修复过程中神经监测的效果和实践。在PubMed中进行系统的文献检索，Embase通过Ovid,Cochrane图书馆和ClinicalTrialsGov进行到2022年12月。
结果：从文献检索中确定了总共535项研究，其中27项研究包括总共3130名患者符合资格标准.大多数研究（27个中的21个，78％）调查了运动诱发电位（MEP）的可行性，15项研究分析了开放TAAA修复过程中的体感诱发电位（SSEP），2项研究分析了近红外光谱（NIRS）。
结论：目前的文献表明，通过适当的预防措施和围手术期操作，开放TAAA修复术后SCI的发生率可以保持在较低水平。MEP的神经监测为外科医生提供了指导选择性肋间重建或其他保护性麻醉和外科手术的客观标准。同时监测MEP和SSEP是一种可靠的方法，可以在开放式TAAA修复期间快速检测重要发现并指导适当的保护性操作。
方法：在这篇系统综述中，我们旨在探讨开放式TAAA修复过程中神经监测的效果和实践。在PubMed中进行系统的文献检索，Embase通过Ovid,Cochrane图书馆和ClinicalTrialsGov进行到2022年12月。
结果：从文献检索中确定了总共535项研究，其中27项研究包括总共3130名患者符合资格标准.大多数研究（27个中的21个，78％）调查了运动诱发电位（MEP）的可行性，15项研究分析了开放TAAA修复过程中的体感诱发电位（SSEP），2项研究分析了近红外光谱（NIRS）。
结论：目前的文献表明，通过适当的预防措施和围手术期操作，开放TAAA修复术后SCI的发生率可以保持在较低水平。MEP的神经监测为外科医生提供了指导选择性肋间重建或其他保护性麻醉和外科手术的客观标准。同时监测MEP和SSEP是一种可靠的方法，可以在开放式TAAA修复期间快速检测重要发现并指导适当的保护性操作。
