诱发电位在不同磁共振信号脊髓型颈椎病术中的临床疗效预测价值  

Prediction value of clinical efficacy of somatosensory evoked potentials in the operation of cervical spondylotic myelopathy with different MRI signals

作　　者：丁小力[1] 叶鹏[1] 牛朋影[2] DING Xiaoli;YE Peng;NIU Pengying(Department of Orthopedics,General hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Imazging,Ningxia People′s Hospital,Yinchuan 750002,China)

机构地区：[1]宁夏医科大学总医院骨科,宁夏银川750004 [2]宁夏回族自治区人民医院影像中心,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第12期1056-1058,F0002,共4页Ningxia Medical Journal

基　　金：宁夏医科大学校级课题(XM2019044)。

摘　　要：目的探索不同磁共振信号脊髓型颈椎病患者术中体感诱发电位的变化对术后患者功能恢复及手术疗效的预测价值。方法选取手术治疗的脊髓型颈椎病患者65例,失访5例,根据MRI髓内有无信号改变分为病例组(30例)和对照组(30例)。通过一般观察指标、神经功能评定指标、影像学及诱发电位(SEP)观察指标进行对照研究,于术前、术中行体感诱发电位监测,依据日本骨科学会脊髓损害功能评分系统(JOA)对每例患者进行术前、术后1周、术后24周系统评分。结果术后1周JOA评分病例组为(13.23±1.10)分、对照组为(14.00±1.17)分和,术后24周JOA评分病例组为(11.17±1.58)分、对照组为(13.07±1.05)分,差异有统计学意义(P<0.05)。术后1周优良率病例组与对照组和术后24周优良率病例组与对照组对比,差异有统计学意义(P<0.05)。术中体感诱发电位病例组改善率和对照组改善率对比,差异无统计学意义(P>0.05)。结论脊髓内信号的改变联合体感诱发电位监测可以作为脊髓型颈椎病患者术后疗效的预测方法。Objective To explore the predictive value of somatosensory evoked potential changes in patients with cervical spondylotic myelopathy with different MRI signals for postoperative functional recovery and surgical efficacy.Methods 65 patients with cervical spondylotic myelopathy were selected,with 5 patients lost to following up.The patients were divided into case group(30 cases)and control group(30 cases)based on the presence or absence of signal changes in the spinal cord on MRI.The general indexes,neurological function indexes,imaging and SEP were measured,somatosensory evoked potential(SEP)was monitored before and during the operation.According to the Japanese orthopaedic association(JOA)spinal cord injury function scoring system,each patient was scored before surgery,1 week after surgery and 24 weeks after surgery.Results JOA score was(13.23±1.10)in the case group and(14.00±1.17)in the control group one week after surgery,and(11.17±1.58)in the case group and(13.07±1.05)in the control group 24 weeks after operation,and the difference was statistically significant(P<0.05).There was a statistically significant difference in the excellent rate between the case group and the control group at 1 week and 24 weeks after surgery(P<0.05).There was no statistically significant difference in the improvement rate of intraoperative somatosensory evoked potential between the case group and control group(P>0.05).Conclusion The changes of MRI signal in cervical spinal cord combined with somatosensory evoked potential monitoring can be used as a method to predict the postoperative efficacy in patients with cervical spondylotic myelopathy.

关 键 词：体感诱发电位 脊髓型颈椎病 不同核磁共振信号 

分 类 号：R681[医药卫生—骨科学]