The Application Of MIOM In Anterior Cervical Surgery

Purpose:In recent years, as China’s rapid development of spine surgery,especially the popularity of spinal fixation technology and all kinds of advanced surgical instruments,spine surgery can be extensive in all types of hospitals.But with the coming.the increase in the number of patients with spinal cord injury and nerve damage in spinal surgery.The application of intraoperative neurophysiological monitoring is an important technical means to prevent iatrogenic spinal cord and nerve damage.what should be attracted the attention of the spine surgery community.Intraoperative neurophysiological monitoring can dynamically response the function of the nervous system, found the spinal cord injury in a timely manner, corrective partially reversible spinal cord injury, and reduce surgical risk.It can let the surgeon get feedback informations,improve operational efficiency.giving patients the most complete treatment.It can help spine surgery standardization, and provide medical records to identify surgical complications.Currently, the awareness of domestic intraoperative electrophysiological monitoring needs to be universal and publicity,monitoring equipment and technology need to further promote,and the high-quality care professionals need to be cultured.Through research, objective evaluating the role of neurophysiological monitoring in spine surgery to provide a basis for deeper study and summarize the clinical experience for the promotion of the monitoring methods.Method:Collected from January2011to January2013,22cases of patients with cervical who have been treated as cervical corpectomy or anterior cervical discectomy and arthrodesis in Wuxi City Chinese Medicine Hospital.Monitoring patients during surgery somatosensory evoked potential (SEP) and motor evoked potential (MEP), the EMG diagram (EMG).With the analysis technique MIOM abnormal electrophysiological activity changes, understanding the surgical procedure with or without injury to the spinal cord and nerve roots, and postoperative neurological function.A prospective study of the correlation of the monitoring results of intraoperative and postoperative neurologic symptoms, and to analyze the clinical value of MIOM in anterior cervical surgery.Using SPSS17.0for statistical analysis, data using t test.Comparing the latency and amplitude of SEP/MEP preoperative and postoperative, p<0.05considered statistically significant. Result:22patients have joint monitoring of the application of SEP, MEP and EMG During surgery.10cases of apparent anomalies in the intraoperative electrophysiological signals change.Within1-30minutes after taking corresponding measures physiological signal gradually restore the normal level to the preoperative and there is no postoperative neurological dysfunction.Compared with the preoperative reference potential, surgery SEP and MEP amplitude have increased (p<0.05), but the incubation period did not significantly change;JOA score significantly improved (p<0.05) than the preoperative.Improved Volatility and improved JO A score are both associated.Conclusion:In the surgery of the anterior cervical nerve electrophysiological monitoring can effectively reduce the neurological deficit and the risk of surgery. Postoperative surgical treatment and recovery of neurological function can be as objective basis.