The Safety And Efficacy Of Spinal Cord Combine With Nerve Electrophysiology Shift For The Treatment Of Spinal Kyphoscoliosis

ObjectiveTo explore the safety and effectiveness of transvertebral transposition of the spinal cord and posterior correction combined electrophysiological monitoring in patients suffering from neurologic deficit secondary to angular kyphoscoliosis.MethodsRetrospective analysis of case data of patient with kyphoscoliosis with nerve injury who were treated in the department of spinal surgery of affiliated Provincial Hospital Affiliated of Shandong University between May 2004 and December 2014. 18 cases of patients were treated with transvertebral transposition of the spinal cord and posterior correction under nerve electrophysiological examination.18 cases of patients were treated with standing all spine MRI, CT examination and X-ray examination of the right side of the spine in Preoperative and postoperative. Accorded to the results of MRI, CT and X-ray examination, the distance of the spinal cord, the Cobb angle of the coronal plane and the Cobb angle of the coronal plane were calculated. Accorded to the results of MRI examination, the distance between the horizontal line and the horizontal line at the outer edge of the outer edge of the convex side of the top cone were measured. Accorded to the results of X-ray examination, the Cobb angle and Cobb angle were measured in preoperative and postoperative. SEP examination were performed on the patients in preoperative, intraoperative and postoperative. MEP detection was performed on the patients during the operation. The quality of life were assessed with SRS-22 scale at follow-up visits of preoperative and postoperative.Results1.The distance between the horizontal line and the horizontal line at the outer edge of theouter edge of the convex side of the cone area of preoperative was significantly shorter than one of postoperative.2. The Coronal Cobb angle and Back convex Cobb angle were significantly smaller than one of postoperative.3. The height of the patients increased by an average of 6.1± 1.2cm, the height increase rate was 3.6±1.4%, There was no significant difference between the preoperative and postoperative.6 of the 7 patients, which were C grade, improve to D grade.3 months after surgery those was improved to grade E.1 cases were considered although C, but 9 months after the surgery improved to grade D.11 cases of preoperative D in 10 of the patients discharged from hospital when improved to grade E,1 cases were considered although D, but 6 months after the surgery improved to grade E,18 patients at the last follow-up were improved for E.4. The amplitude and latency of SEP after postoperative 7 days were significantly lower than preoperative and intraoperative.5. Pain, psychological status, self image and functional status of the four aspects of score and total score in postoperative were significantly higher preoperative.6. No complications such as paralysis, death, broken nail breaking, loosening of internal fixation, and the formation of false join in intraoperative and postoperative.7. The positive predictive value, negative predictive value, specificity and sensitivity of SEP were 100%,94.4%,100%,50%, respectively. The positive predictive value, negative predictive value, specificity and sensitivity of MEP were 88.9%,100%, 94.4%,100%, respectively. The positive predictive value, negative predictive value, specificity and sensitivity of SEP combined with MEP were 100%,100%,100%, 100%.ConclusionsTransvertebral transposition of the spinal cord and posterior correction combined electrophysiological monitoring in patients suffering from neurologic deficit secondary to angular kyphoscoliosis can be effective in orthopedic spinal deformity, and can significantly improve the neurological functions. However, due to the lack of this study, the follow-up period is not long enough, can be widely used in clinical practice to be further studied.