Intraoperative Neurophysiological Monitoring during Surgical Correction of Scoliosis for Postoperative Recovery of the Patient’s Motor Function

Yu.S. Arestova, M. Sayfutdinov, D. Savin, M. Z. Nasyrov, T. V. Ryabykh, S. Ryabykh
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Abstract

The aim of the investigation was to study the effect of adverse intraoperative events on the subclinical decrease in the functional state of the sensorimotor system of patients with scoliosis and their early postoperative rehabilitation. Materials and Methods The results of the examination of 30 adolescents of 13–16 years old with scoliosis before and after surgical correction were compared. Intraoperative neurophysiological monitoring was used by the method of transcranial evoked motor potentials. The patients were divided into two groups depending on the presence or absence of neurophysiological signs of damage to nerve structures during the operation. Results The amplitude of the M-responses of the muscles of the lower limbs in the postoperative period remains at a level close to the initial one, with a noticeable decrease in the amplitude of voluntary electromyography, which is expressed unevenly and to a greater extent in patients with intraoperative signs of hazard for the motor pathways of the spinal cord. Conclusion Adverse intraoperative events cause significant changes in the state of the motor system of patients with scoliosis and reduce the effectiveness of rehabilitation treatment in the postoperative period.
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脊柱侧凸手术矫正术中神经生理监测对术后患者运动功能恢复的影响
本研究旨在探讨术中不良事件对脊柱侧凸患者感觉运动系统功能状态亚临床下降及术后早期康复的影响。材料与方法对30例13 ~ 16岁青少年脊柱侧凸矫治前后的检查结果进行比较。术中神经生理监测采用经颅运动诱发电位法。根据手术中有无神经结构损伤的神经生理体征将患者分为两组。结果术后期间下肢肌肉m -反应幅度保持在接近初始水平,随意肌电信号幅度明显下降,且在术中脊髓运动通路有危险体征的患者中表达不均匀,且程度更大。结论术中不良事件使脊柱侧凸患者运动系统状态发生明显改变,降低了术后康复治疗的效果。
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