脊髄脊椎手術と術中モニタリング—開頭術との違いは？

Intraoperative Neurophysiological Monitoring in Spinal Surgery:Differences Coumpared to Brain Surgery

Point

・神経障害を防ぐという術中モニタリングの目的はどの手術においても変わらないが，画一的な手法を当てはめるべきではない．

・本邦で最も頻用される運動誘発電位（MEP）においては，刺激・記録電極，刺激条件，アラームポイントなど，脊髄脊椎手術と開頭術の違いを理解する必要がある．

・脊髄脊椎手術では各種モダリティの特性を理解し，場合によっては併用することが重要である．

　The purpose of intraoperative monitoring in any surgery is to detect deterioration of neurological function and prevent serious disorder. However, it is impossible to apply a uniform method of monitoring. MEP is the most common modality, and is necessary to understand the differences between spinal and brain surgeries, such as stimulation/recording electrodes, configuration conditions, and alarm criteria. There are various modalities in spinal surgery, each with its own problems. The characteristics of various modalities should be known, and multimodal monitoring should be considered in some cases.