UtilityofMotorEvokedPotentialsforIntraoperativeNerveRootMonitoring
运动诱发电位在术中神经根监测中的应用
作者:MacdonaldDB,StigsbyB,AlHomoudI,AbalkhailT,MokeemA.
来源:JClinNeurophysiol.;29(2):-25
译者:Eason校对:Yuan
METHODOLOGY
研究方法
MuscleMEPmethodologiesaredetailedelsewhere(CalancieandMolano,;Deletis,;Langelooetal.,;Qui?ones–Hinojosaetal.,;MacDonald,;MacDonaldetal.,).Basically,oneappliestranscranialelectricstimulation(TES)throughscalpelectrodesoverlyingmotorcortextoevokemuscleresponses.Pulsetrainstimuliareneededtogenerateenoughcorticospinaltractactionpotentialvolleystomakesomelowermotorneuronsfirethroughtemporalsummationofexcitatorypostsynapticpotentials.Increasingintensityrecruitsadditionallowermotorneurons,butmaximumTESintensity,stillactivatesonlyasubpopulationofmotorunits.Incontrast,singlepulsesreadilygeneratemuscleresponseswhenapplieddirectlytoanerveorrootcontainingmotoraxonsbecauseneuromusculartransmissionneedsnotemporalsummation.Inthiscase,supramaximalintensityrecruitsallthenerve’smotoraxons,andtheresulting