Jongsuk Choi, Alba Díaz-Baamonde, María de Los Ángeles Sánchez Roldán, Ana Mirallave Pescador, Jun-Soon Kim, Maria J Téllez, Kyung Seok Park, Vedran Deletis
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One of the critical benefits of reflex monitoring is that it can provide continuous feedback without disrupting the surgical process due to no movement being induced in the surgical field. These reflexes can be monitored in real time during surgical procedures to assess the integrity of the nervous system and detect potential neurological damage. It is particularly noteworthy that the reflexes provide motor and sensory information on the functional integrity of nerve fibers and nuclei. This article describes the current techniques used for monitoring various human reflexes and their clinical significance in surgery. We also address important methodological considerations and their impact on surgical safety and patient outcomes. 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引用次数: 0
摘要
人体反射是由各种感觉输入自动引起的简单运动反应。这些反射可为了解神经系统(尤其是脑干和脊髓)的功能提供宝贵的信息。涉及脑干的反射,如眨眼反射、喉内收反射、三叉舌下神经反射和颌间肌 H 反射,可提供有关颅神经功能和脑干整体状态的即时信息。同样,比目鱼肌 H 反射、后根肌反射和骶反射等脊髓反射也能提供有关脊髓和周围神经功能的重要信息。反射监测的关键优势之一是它可以提供连续的反馈信息,而不会因为手术区域没有任何运动而中断手术过程。在手术过程中可以实时监测这些反射,以评估神经系统的完整性并检测潜在的神经损伤。尤其值得注意的是,这些反射可提供有关神经纤维和神经核功能完整性的运动和感觉信息。本文介绍了目前用于监测各种人体反射的技术及其在外科手术中的临床意义。我们还讨论了重要的方法学注意事项及其对手术安全性和患者预后的影响。利用这些方法有可能推动甚至彻底改变术中连续监测领域,最终改善手术效果和加强患者护理。
Advancing Intraoperative Neurophysiological Monitoring With Human Reflexes.
Human reflexes are simple motor responses that are automatically elicited by various sensory inputs. These reflexes can provide valuable insights into the functioning of the nervous system, particularly the brainstem and spinal cord. Reflexes involving the brainstem, such as the blink reflex, laryngeal adductor reflex, trigeminal hypoglossal reflex, and masseter H reflex, offer immediate information about the cranial-nerve functionality and the overall state of the brainstem. Similarly, spinal reflexes such as the H reflex of the soleus muscle, posterior root muscle reflexes, and sacral reflexes provide crucial information about the functionality of the spinal cord and peripheral nerves. One of the critical benefits of reflex monitoring is that it can provide continuous feedback without disrupting the surgical process due to no movement being induced in the surgical field. These reflexes can be monitored in real time during surgical procedures to assess the integrity of the nervous system and detect potential neurological damage. It is particularly noteworthy that the reflexes provide motor and sensory information on the functional integrity of nerve fibers and nuclei. This article describes the current techniques used for monitoring various human reflexes and their clinical significance in surgery. We also address important methodological considerations and their impact on surgical safety and patient outcomes. Utilizing these methodologies has the potential to advance or even revolutionize the field of intraoperative continuous monitoring, ultimately leading to improved surgical outcomes and enhanced patient care.
期刊介绍:
The JCN aims to publish the cutting-edge research from around the world. The JCN covers clinical and translational research for physicians and researchers in the field of neurology. Encompassing the entire neurological diseases, our main focus is on the common disorders including stroke, epilepsy, Parkinson''s disease, dementia, multiple sclerosis, headache, and peripheral neuropathy. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, and letters to the editor. The JCN will allow clinical neurologists to enrich their knowledge of patient management, education, and clinical or experimental research, and hence their professionalism.