HU Jing,LI Hai-lin,WU Zhi-qiang,et al.Application of ultrasound-guided needling assisted the motor evoked potentials and electromyography monitoring in spinal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):960-963.
HU Jing,LI Hai-lin,WU Zhi-qiang,et al.Application of ultrasound-guided needling assisted the motor evoked potentials and electromyography monitoring in spinal surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(11):960-963. DOI: 10.11659/jjssx.02E025043.
Application of ultrasound-guided needling assisted the motor evoked potentials and electromyography monitoring in spinal surgery
To explore the effect and predictive value of ultrasound-guided needling assisted motor evoked potentials (MEP) and electromyography (EMG) monitoring on neurological recovery in spinal surgery.
Methods
2
A retrospective analysis was conducted on the clinical data of 80 patients who underwent spinal surgery at Jiangsu Province Hospital of Chinese Medicine from January 2020 to December 2024. A total of 41 patients in the observation group received ultrasound-guided needling assisted MEP and EMG monitoring, and 39 patients in the control group received conventional method for MEP and EMG monitoring. The operative time, intraoperative blood loss, and the proportions of intraoperative MEP and EMG warnings were compared between the two groups, and the sensitivity and specificity of intraoperative MEP monitoring were compared between the two groups. The
receiver operating characteristic
(
ROC
) curve was plotted, and the
area under the curve
(
AUC
) was calculated to analyze the efficiency of MEP warning in predicting the dysfunction of postoperative spinal cord.
Results
2
There were no significant differences in the operative time, intraoperative blood loss, or the proportions of intraoperative MEP and EMG warnings (
P
>
0.05). The sensitivity, specificity and
AUC
of intraoperative MEP monitoring in the obse
rvation group were significantly higher than those in the control group, with statistically significant differences(
P
<
0.05). The sensitivity, specificity, and
AUC
of postoperative MEP warning in predicting the dysfunction of spinal cord in the observation group were higher than those in the control group, with statistically significant differences(
P
<
0.05).
Conclusion
2
Ultrasound-guided needling assisted MEP and EMG monitoring can effectively enhance the intraoperative neural monitoring accuracy, and postoperative MEP warning demonstrates superior predictive value for postoperative neurological dysfunction.
关键词
Keywords
references
Romero-Muñoz LM , Segura-Fragoso A , Talavera-Díaz F , et al . Neurological injury as a complication of spinal surgery:incidence,risk factors, and prognosis [J]. Spinal Cord , 2020 , 58 ( 3 ): 318 - 323 . doi: 10.1038/s41393-019-0367-0 http://dx.doi.org/10.1038/s41393-019-0367-0 .
Sala F , Skrap B , Kothbauer KF , et al . Intraoperative neurophysiology in intramedullary spinal cord tumor surgery [J]. Handb Clin Neurol , 2022 , 186 : 229 - 244 . doi: 10.1016/B978-0-12-819826-1.00019-3 http://dx.doi.org/10.1016/B978-0-12-819826-1.00019-3 .
Buhl LK , Bastos AB , Pollard RJ , et al . Neurophysiologic intraoperative monitoring for spine surgery: a practical guide from past to present [J]. J Intensive Care Med , 2021 , 36 ( 11 ): 1237 - 1249 . doi: 10.1177/0885066620962453 http://dx.doi.org/10.1177/0885066620962453 .
Chen CH , Chen CM , Jaw FS , et al . Ultrasound guidance for full endoscopic spinal surgery: a technical note [J]. World Neurosurg , 2022 , 162 : 59 - 65 . doi: 10.1016/j.wneu.2022.03.066 http://dx.doi.org/10.1016/j.wneu.2022.03.066 .
Lai J , Wu Y , Xiang Y , et al . A novel transverse ultrasound-guided approach for puncturing the cervical dorsal root ganglion at the level of articular pillar for radiofrequency treatment [J]. J Pain Res , 2024 , 25 ( 17 ): 3473 - 3485 . doi: 10.2147/JPR.S479986 http://dx.doi.org/10.2147/JPR.S479986 .
Chalermkitpanit P , Pannangpetch P , Kositworakitkun Y , et al . Ultrasound-guided pulsed radiofrequency of cervical nerve root for cervical radicular pain: a prospective randomized controlled trial [J]. Spine J , 2023 , 23 ( 5 ): 651 - 655 . doi: 10.1016/j.spinee.2023.01.004 http://dx.doi.org/10.1016/j.spinee.2023.01.004 .
Olmsted ZT , Ryu B , Phayal G , et al . Direct wave intraoperative neuromonitoring for spinal tumor resection: a focused review [J]. World Neurosurg X , 2022 , 15 ( 17 ): 100139 . doi: 10.1016/j.wnsx.2022.100139 http://dx.doi.org/10.1016/j.wnsx.2022.100139 .
Antkowiak L , Putz M , Sordyl R , et al . Relevance of intraoperative motor evoked potentials and D-wave monitoring for the resection of intramedullary spinal cord tumors in children [J]. Neurosurgeon Rev , 2022 , 45 ( 4 ): 2723 - 2731 . doi: 10.1007/s10143-022-01788-2 http://dx.doi.org/10.1007/s10143-022-01788-2 .