Journal Basic Info

  • Impact Factor: 1.989**
  • H-Index: 6
  • ISSN: 2637-4625
  • DOI: 10.25107/2637-4625
**Impact Factor calculated based on Google Scholar Citations. Please contact us for any more details.

Major Scope

  •  Vascular Surgery
  •  Anesthesiology
  •  Colorectal Surgery
  •  Orthopaedic Surgery
  •  Obstetrics & Gynecology
  •  Urological Surgery
  •  Surgical Procedures
  •  Cardiac Surgery

Abstract

Citation: World J Surg Surg Res. 2020;3(1):1197.DOI: 10.25107/2637-4625.1197

The Application of Neuroelectrophysiological Monitoring in Posterior Percutaneous Endoscopic Cervical Discectomy

Hao Zhang1#*, Xinle Luo1#, Yawei Hu1, Jiancheng Yang1,2, Shaochu Chen1, Jianhua Zhou1, Wang Zhang1, Zengfeng Guo1 and Ming Gong1

1Department of Spine Surgery, Affiliated Hospital of Southern Medical University, China
2School of Life Sciences, Northwestern Polytechnical University, China
#These authors contributed equally to this work

*Correspondance to: Hao Zhang 

 PDF  Full Text Research Article | Open Access

Abstract:

Study design: Retrospective case analysis.
Purpose: To investigate the application of neuroelectrophysiological monitoring in Posterior
Percutaneous Endoscopic Cervical Discectomy (P-PECD).
Overview of literature: There is an injury risk of nerve root and spinal cord during P-PECD.
Intraoperative neuroelectrophysiological monitoring can dynamically monitor the function of the
nerve roots and spinal cord, providing real-time data for the surgeon to avoid the risks during
P-PECD.
Methods: A retrospective review was performed on 25 patients in an average of 45.9 years +/- 10.9
years old with single segment of cervical disc herniation between May 2018 and June 2019. All the
patients underwent a P-PECD and Free-run Electromyography (f-EMG), Motor Evoked Potential
(MEP), and Somatosensory Evoked Potential (SEP) were used to monitor the function of nerve
roots and spinal cords in the operation. The monitoring results were recorded and analyzed.
Results: When placing operation channels and grinding vertebral plates, f-EMG displayed no
obvious reactions, MEP could be induced on both sides, and bilateral SEP waveforms were stable,
showing the function of nerve roots and spinal cords was normal. f-EMG detected a series of changes
in the motion unit waveform on the patient's diseased side when the removal of the ligamentum
flavum and the inner layer of the vertebral plate. The waveforms of f-EMG returned to normal
following the surgical tools were removed from the nerve root and dural sac. The double-sided
waveforms can be induced in MEP, and were stable in SEP. The true positive rate was 96% and the
false negative rate was 4% during the operation. No nerve damages were found in all patients.
Conclusion: Combined applications of free-EMG, MEP and SEP can provide objective functional
indicators of the nerve root and spinal cord for surgery, thereby improving the efficiency and safety
of the operation.

Keywords:

Percutaneous endoscopic cervical discectomy; Neuroelectrophysiological monitoring; Free-run electromyography; Motor evoked potential; Somatosensory evoked potential

Cite the Article:

Zhang H, Luo X, Hu Y, Yang J, Chen S, Zhou J, et al. The Application of Neuroelectrophysiological Monitoring in Posterior Percutaneous Endoscopic Cervical Discectomy. World J Surg Surgical Res. 2020; 3: 1197..

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