脊椎・脊髄手術におけるモニタリング

Monitoring for Spine and Spinal Cord Surgery

Point

・脊椎・脊髄手術では病変の局在によって行うモニタリングや記録電極が異なり，症例ごとに適切なモニタリングの選択が重要である．

・モニタリングの意義を十分に理解し，適切に併用し補完し合うmultimodal monitoringを心がける．

・アラームポイントの設定やアラート時の対応は，医師や臨床検査技師などの多職種チームで議論し共有しておく．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2026年6月まで）。

　Injuries of the spine and nerve root may occur during spine or spinal cord surgery, which can induce serious neurological deficits. Intraoperative monitoring plays important roles in monitoring the nerve function in various surgical manipulations, such as surgical positioning, mechanical compression, and tumor removal. This monitoring issues a warning to neuronal injuries at an early stage, and surgeons are able to prevent postoperative complications. The appropriate monitoring systems should be chosen with compatibility to the disease, surgical procedure, and lesion localization. The team should share the significance of monitoring and understand the timing of stimulation to perform a safe surgery. In this paper, we overview various intraoperative monitoring techniques and pitfalls in spine and spinal cord surgeries based on cases from our hospital.