PDF(Pubmed)
Abstract：
Intraoperative neurophysiological monitoring (IONM) involves monitoring the functional integrity of critical brain regions and pathways as well as identifying and preserving functionally viable neural tissues (mapping) during surgery using electrophysiological techniques. Multimodality combines various neurophysiological techniques to optimise diagnostic effectiveness and to improve the outcomes of the surgeries. The present study is a case series with comprehensive and illustrative descriptions of the neurophysiological changes in five neuromonitored cases of cranial and spinal cord tumour surgeries conducted with a multimodal approach. The cases were monitored with somatosensory evoked potentials (SSEP), transcranial motor evoked potentials (TcMEP), and both free run and triggered electromyography (fEMG and tEMG). No false negative outcomes were identified in the cases studied as there was an association of absence of change in SSEP and TcMEP both, with no neurological deficit postoperatively. Two cases were identified as having true positive neuromonitoring alerts. No false positive alerts were found in any case. Multimodal monitoring using SSEP, TcMEP, and EMG (fEMG and tEMG) in cranial and spinal tumour surgeries can improve performance with fewer false-negative and false-positive results. Neuromonitoring approaches used in combination can provide reliable information regarding postoperative neurological outcomes.
摘要：
术中神经生理监测(IONM)涉及使用电生理技术在手术期间监测关键脑区域和通路的功能完整性以及识别和保留功能上可行的神经组织(映射)。多模态结合了各种神经生理学技术，以优化诊断效果并改善手术结果。本研究是一个案例系列，对使用多模式方法进行的五例神经监测的颅骨和脊髓肿瘤手术的神经生理学变化进行了全面和说明性的描述。对病例进行体感诱发电位(SSEP)监测,经颅运动诱发电位（TcMEP），以及自由运行和触发肌电图（fEMG和tEMG）。在研究的病例中没有发现假阴性结果，因为SSEP和TcMEP均无变化。术后无神经功能缺损.两例被确定为具有真阳性神经监测警报。在任何情况下都没有发现假阳性警报。使用SSEP的多模态监测，TcMEP,和EMG（fEMG和tEMG）在颅骨和脊柱肿瘤手术中可以提高性能，减少假阴性和假阳性结果。联合使用的神经监测方法可以提供有关术后神经系统结果的可靠信息。
