Application of Triggered EMG in the Intraoperative Neurophysiological Monitoring of Posterior Percutaneous Endoscopic Cervical Discectomy
| Autor: | Yaobin Wang, Chen Cao, Xiao-Yun Sheng, Shulian Chen, Kai Zhang, Xiao-Bing Zhao, Bin Geng, Yayi Xia |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous Nerve root Intraoperative Neurophysiological Monitoring Visual analogue scale Triggered EMG medicine Paralysis Cervical endoscopy Humans Orthopedics and Sports Medicine Diskectomy Percutaneous Radiculopathy Intraoperative monitoring Pain Measurement Retrospective Studies Orthopedic surgery Cervical discectomy Clinical Article business.industry Electromyography Retrospective cohort study Endoscopy Middle Aged Surgery Percutaneous endoscopic cervical discectomy Clinical Articles Cervical spondylotic radiculopathy Female Spondylosis medicine.symptom Complication business RD701-811 Intraoperative neurophysiological monitoring |
| Zdroj: | Orthopaedic Surgery Orthopaedic Surgery, Vol 13, Iss 8, Pp 2236-2245 (2021) |
| ISSN: | 1757-7861 1757-7853 |
| Popis: | Objective To describe the rationale and application of triggered EMG (T‐EMG) in intraoperative neurophysiological monitoring, and to explore the efficacy and safety of posterior percutaneous endoscopic cervical discectomy (PPECD) in the treatment of cervical spondylotic radiculopathy (CSR) under multimodal intraoperative neurophysiological monitoring (IOM). Methods This study was a retrospective cohort control study. The clinical data of 74 patients with single‐segment CSR from June 2015 to August 2018 were analyzed retrospectively, of whom 35 underwent IOM‐assisted PPECD with triggered EMG (T‐EMG group), while 39 were subjected to IOM‐assisted PPECD alone (IOM group). Operation time, hospital stay, and complications were recorded for both groups. The curative effect was evaluated according to the Visual Analog Scale (VAS) of neck and arm pain, Japanese Orthopaedic Association (JOA) score, and modified MacNab scale. Results Operations were successful and all patients were followed up for at least 24 (average 31.77 ± 9.51) months with no patient lost to follow‐up. No significant difference was found in preoperative baseline data between the T‐EMG and the IOM group (P > 0.05). Also, no significant difference was found in the operation time between the T‐EMG (108.29 ± 11.44 min) and the IOM (110.13 ± 12.70 min) (P > 0.05) group, but the difference in hospital stay (T‐EMG: 5.66 ± 0.99 days; IOM: 7.10 ± 1.43 days) was statistically significant (P 0.05). The 1‐month postoperative JOA scores for the two groups (12.69 ± 0.76; 12.59 ± 0.82) and those at the last follow‐up (14.60 ± 0.77; 14.36 ± 0.78) were significantly different from the preoperative scores (11.09 ± 0.98; 11.05 ± 0.89) (P 0.05). One patient in the T‐EMG group developed a transient aggravation of symptoms on the first day after surgery. In the IOM group, three patients had intraoperative cerebrospinal fluid leakage, and symptoms of C5 nerve root paralysis were presented in four patients following surgery. Compared with the IOM group, the T‐EMG group had fewer complications (1/35; 7/39, P |
| Databáze: | OpenAIRE |
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