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논문 기본 정보

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학술저널
저자정보
Kazuyoshi Kobayashi (Nagoya University Graduate School of Medicine) Kei Ando (Nagoya University Graduate School of Medicine) Hideki Yagi (Japanese Red Cross Nagoya Daiichi Hospital) Kenyu Ito (Nagoya University Graduate School of Medicine) Mikito Tsushima (Nagoya University Graduate School of Medicine) Masayoshi Morozumi (Nagoya University Graduate School of Medicine) Satoshi Tanaka (Nagoya University Graduate School of Medicine) Masaaki Machino (Nagoya University Graduate School of Medicine) Kyotaro Ota (Nagoya University Graduate School of Medicine) Yukihiro Matsuyama (Hamamatsu University) Naoki Ishiguro (Nagoya University) Shiro Imagama (Nagoya University Graduate School of Medicine)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.4
발행연도
2018.1
수록면
662 - 668 (7page)

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Study Design: Retrospective study. Purpose: To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative spinal cord monitoring with transcranial muscle action potentials (Tc-MsEP). Overview of Literature: Spinal surgery for spina bifida, spinal cord tumor, and spinal tethered cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. Methods: Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS monitoring using a needle electrode. Results: The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p <0.01). In patients with baseline waveform detection, the sensitivity and specificity for postoperative BBD were similar in the two groups. With needle electrodes, a cutoff amplitude of Tc-MsEP for the EAS at the end of surgery of 25% of the baseline amplitude had a sensitivity of 89% and specificity of 82% for the prediction of postoperative BBD aggravation. Conclusions: The significantly higher waveform derivation rate using needle electrodes suggests that these electrodes are effective for monitoring the EAS in spinal surgery in cases with preoperative BBD.

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참고문헌 (17)

참고문헌 신청
James HE / 1979 / Use of anal sphincter electromyography during operations on the conus medullaris and sacral nerve roots / Neurosurgery 4:521~523 Crossref Kobayashi K / 2017 / Prevention and prediction of postoperative bowel bladder disorder using an anal plug electrode with Tc-MsEP monitoring during spine surgery / Nagoya J Med Sci 79:459~466 google schola Floyd WF / 1953 / Electromyography of the sphincter ani externus in man / J Physiol 122:599~609 Crossref Haghighi SS / 2004 / Activation of the external anal and urethral sphincter muscles by repetitive transcranial cortical stimulation during spine surgery / J Clin Monit Comput 18:1~5 google schola Wiesner A / 2000 / EMG of the external anal sphincter: needle is superior to surface electrode / Dis Colon Rectum 43:116~118 Crossref

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