脊髄手術における術中神経生理学的モニタリングの有用性と限界

DOI Web Site 参考文献51件 オープンアクセス

書誌事項

タイトル別名
  • Utility and Limitations of Intraoperative Neurophysiological Monitoring during Surgery of the Spinal Cord
公開日
2016
DOI
  • 10.2531/spinalsurg.30.146
公開者
日本脊髄外科学会

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説明

<p>  Surgical treatment for spinal cord lesions carries a high risk of postoperative neurological deficits. Intraoperative neurophysiological monitoring has been developed to reduce such risks. Initially, somatosensory evoked potential (SEP) monitoring was successfully used in deformity correction surgery. Its major disadvantage was its inability to detect partial spinal cord damage affecting motor pathways. Motor evoked potential (MEP) monitoring was later developed to overcome this deficit of SEP monitoring. Both SEP and MEP monitoring were highly accurate in predicting postoperative neurological deficits in deformity correction surgery and were later introduced into surgery for intramedullary tumors (IMTs). These monitoring techniques provide accurate predictions in patients with intact neurologic function, but are prone to false positives when patients have compromised neurologic function. Some studies overemphasize the usefulness of intraoperative neurophysiological monitoring in surgical treatment for IMTs. We review the current understanding of neuroanatomy and physiology and the realistic utility and limitations of intraoperative neurophysiological monitoring during surgery for IMTs.</p>

収録刊行物

  • 脊髄外科

    脊髄外科 30 (2), 146-151, 2016

    日本脊髄外科学会

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