脊髄誘発電位測定（片側脊髄刺激法）による脊髄腫瘍の術中モニタリング

Intraoperative Monitoring for Spinal Cord Tumor by Spinal Cord Evoked Potential Following Unilateral Spinal Cord Stimulation

I．はじめに

　近年，顕微鏡手術の普及により，脊髄腫瘍の摘出は安全に行われるようになってきた．しかしながら，腫瘍摘出をより安全に行うためには，術中，脊髄機能をモニタリングすることは重要と考えられる^{1,2,4-7,10,13,14）}．

　今回，われわれは，脊髄刺激法による脊髄誘発電位モニタリング下に腫瘍摘出を行った脊髄腫瘍を経験したので報告する．本報告では，われわれが施行している片側脊髄刺激による脊髄誘発電位測定法の利点並びに問題点について言及する．

We described our experiences with intraoperative spinal cord monitoring in 6 cases of spinal cord tumor. During the operation, spinal cord evoked potential fol-lowing unilateral spinal cord stimulation was recorded from subdural monitoring electrodes. This series in-cluded two cases of intradural extramedullary tumor(one case each of neurinoma and of meningioma) and four cases of intramedullary tumor (2 cases of cavernous angioma, one case each of ependymoma, and of glioblas-toma multiforme). Before the removal of the tumor, the spinal cord evoked potential showed lower amplitude or no response on the more affected side in all 6 cases. Dur-ing the operation, the different intraoperative changes were shown on each sidle. The authors think that the de-tection of unilateral damage to the spinal cord is possible in spinal cord evoked potential using unilateral spinal cord stimulation.