Application of intraoperative neurophysiological monitoring in spinal cord surgery

To study application of intraoperative neurophysiological monitoring(IONM) in spinal cord surgery.In the study, 24 patients with spinal cord tumors were divided into 4 groups according to the method of monitoring. Group A (ventral tumors) underwent somatosensory evoked potential (SEP) + motor evoked potential (MEP) + electromyography (EMG) monitoring, group B (intramedullary tumors) underwent SEP + MEP monitoring, group C (subdural extramedullary tumors) underwent SEP + EMG monitoring, group D (conus medullary and cauda equina lesions) underwent EMG monitoring. The relationship between changes of IONM and postoperative neurological function was analyzed.All of the 3 patients in group A had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group B had IONM alteration, of whom 5 recovered before the end of surgery, and 1 did not recover and neurological function deteriorated in this case. Seven of the nine patients in group C had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case. All of the 6 patients in group D had IONM alteration which recovered before the end of surgery, but neurological function deteriorated in 1 case.IONM is useful to reduce postoperative neurological deterioration. However, IONM neurophysiological monitoring needs further improvement.PubMed05776-94