■意识障碍(DoC)代表了一系列神经系统疾病,这些疾病带来了重大的治疗挑战。经皮短期脊髓刺激(SCS)已成为评估和潜在改善意识水平的有前途的实验性诊断治疗方法。然而,这种干预的有效性经常受到电极移位的影响,特别是在宫颈区域,这可能会对治疗结果产生负面影响。
■这项回顾性研究旨在研究DoC患者经皮短期SCS的电极移位是否会影响结果。我们分析了电极移位长度与患者预后之间的关系,以及与各种解剖参数的相关性,包括颈椎的实际长度,线性长度,椎管横径,椎管直径,和C2锥体高度,在接受手术的患者队列中。
■我们的研究结果表明,在预后较好的患者中,电极移位的患者明显减少(p=0.019)。Further,发现电极移位长度与患者预后之间存在线性相关(Rho=0.583,p=0.002),较长的轮班长度与较差的结果相关。与我们的期望相反,测得的解剖参数与电极移位程度之间没有显著关联.然而,在颈椎的实际长度和电极的移位之间发现了趋势(p=0.098)。值得注意的是,在接受经皮短期SCS的DoC患者中,较短的椎管横径与较好的预后显著相关(p=0.033).
■这些结果突出了在对DoC患者进行SCS治疗期间宫颈区域电极稳定性的临床重要性。确保电极的安全放置可能在提高患者预后和减少术后并发症方面发挥关键作用。鉴于与预期的解剖参数缺乏关联,未来的研究应该调查可能影响电极稳定性的其他因素,以优化这种治疗干预.
UNASSIGNED: Disorders of consciousness (DoC) represent a spectrum of neurological conditions that pose significant treatment challenges. Percutaneous short-term spinal cord stimulation (SCS) has emerged as a promising experimental diagnostic treatment to assess and potentially improve consciousness levels. However, the effectiveness of this intervention is frequently compromised by the shift of electrodes, particularly in the cervical region, which can negatively affect therapeutic outcomes.
UNASSIGNED: This retrospective study aimed to study if electrodes shift in percutaneous short-term SCS in patients with DoC would affect the outcome. We analyzed the relationship between electrode shift length and patient outcome, as well as the correlation with various anatomical parameters, including the actual length of the cervical spine, linear length, spinal canal transverse diameter, spinal canal diameter, and C2 cone height, in a cohort of patients undergoing the procedure.
UNASSIGNED: Our findings revealed that in patients with better outcome, there are significant less patient with electrode shift (p = 0.019). Further, a linear correlation was found between the length of electrode shift and patients\' outcome (Rho = 0.583, p = 0.002), with longer shift lengths associated with poorer outcomes. Contrary to our expectations, there was no significant association between the measured anatomical parameters and the extent of electrode shift. However, a trend was found between the actual length of the cervical spine and the shift of the electrode (p = 0.098). Notably, the shorter spinal canal transverse diameter was found to be significantly associated with better outcome in patients with DoC receiving percutaneous short-term SCS (p = 0.033).
UNASSIGNED: These results highlight the clinical importance of electrode stability in the cervical region during SCS treatment for patients with DoC. Ensuring secure placement of electrodes may play a crucial role in enhancing patients\' outcome and minimize postoperative complications. Given the lack of association with expected anatomical parameters, future research should investigate other factors that could impact electrode stability to optimize this therapeutic intervention.