诱发肌电图对椎弓根螺钉植入的术中监测  

The application of evoked EMG monitoring during pedicle screws implant

作　　者：山卫东[1] 龚耀成[1] 梁裕[1] 汪柳锵[1] 张云海[1] 吴文坚[1] 

机构地区：[1]上海第二医科大学附属瑞金医院骨科,200025

出　　处：《中国脊柱脊髓杂志》2001年第2期85-88,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的 :探讨通过术中诱发肌电图监测来减少椎弓根螺钉植入并发症发生的可行性。方法 :11只新西兰兔 48个椎弓根钉术中监测 ,验证该技术的可靠性。临床 12例患者 6 2个椎弓根螺钉术中监测。术后CT扫描观察螺钉位置。结果 :动物实验发现钢针完全在椎弓根内时的刺激阈值明显高于椎弓根破裂时。临床监测螺钉位置正常 5 8个 ,异常 4个 ;位置正常的螺钉阈值均明显高于基准阈值 ,异常者与基准阈值无差异。结论 :电诱发肌电图监测能及时发现螺钉位置异常 。Objective:To reduce complications during pedicle screws placement intraoperative monitoring with evoked EMG technic.Method:11 rabbits were monitored during transepedicular instrumentation to validate the reliability of the technic.Then 62 pedicle screws in 12 patients were monitored intraoperatively.CT scans were taken after surgery to document the position of pedicle screws.Result:In animal models,needles complete in pediclarcus thresholds were higher than those pedicles were broken.In patients group,58 screws were found normal and 4 screws abnormal.Evoked thresholds of normal positioned screws were higher than base line thresholds.No difference was found between thresholds of abnormal screws and base line thresholds.Conclution:Evoked EMG monitoring can instantly find improperly placed screws.Self compared continuously monitoring is suggested.

关 键 词：电诱发电肌图 椎弓根螺钉 术中监测 

分 类 号：R687.32[医药卫生—骨科学]