多模式术中神经电生理监测在经腰大肌入路极外侧腰椎椎间融合术治疗退行性脊柱侧凸中的应用

胡玮, 张清顺, 王簕, 刘松, 梁达轩, 吴增晖

doi:10.13418/j.issn.1001-165x.2026.4.18

中国临床解剖学杂志 >

2026 , Vol. 44 >Issue 4: 486 - 490

DOI: https://doi.org/10.13418/j.issn.1001-165x.2026.4.18

临床研究

多模式术中神经电生理监测在经腰大肌入路极外侧腰椎椎间融合术治疗退行性脊柱侧凸中的应用

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广东省产科重大疾病重点实验室暨广东省妇产疾病临床医学研究中心暨广州医科大学附属第三医院脊柱外科，广东广州 510150

胡玮（1992-），女，硕士研究生，从事脊柱外科术中神经电生理监测方面的研究工作，E-mail: weihu_dr@163.com

收稿日期: 2025-09-24

网络出版日期: 2026-07-27

基金资助

广州市脊柱疾病防治重点实验室（202102010008）

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Application of multimodal intraoperative neurophysiological monitoring in extreme lateral interbody fusion via the psoas muscle approach for degenerative scoliosis

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Department of Spine Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou 510150, Guangdong Province, China

Received date: 2025-09-24

Online published: 2026-07-27

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摘要

目的探究多模式神经监测在极外侧腰椎椎间融合术治疗退行性脊柱侧凸中的应用情况。方法回顾性分析2021年1月至2023年12月广州医科大学附属第三医院脊柱外科收治的19例采用多模式神经监测的行XLIF手术治疗退行性脊柱侧凸患者的临床资料。结果所有患者均顺利完成矫形手术，手术时间（262±94）min，术后冠状面主弯Cobb角（8±6）°，矫正率为（73±13）%。多模式联合预警3例，其中2例术后出现肌力下降，经对症治疗术后3个月肌力恢复至4级以上，1例术后无神经功能损伤表现，灵敏度100%，特异度94.1%。结论多模式神经监测的应用弥补了单一模式的片面和不足，提升了神经监测的准确性，降低了XLIF手术神经损伤的发生风险，有助于XLIF的技术推广和应用拓展。

关键词： 多模式神经电生理监测; ; ; 经腰大肌入路; ; ; 腰椎椎间融合术; ; ; 退行性脊柱侧凸

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胡玮, 张清顺, 王簕, 刘松, 梁达轩, 吴增晖 . 多模式术中神经电生理监测在经腰大肌入路极外侧腰椎椎间融合术治疗退行性脊柱侧凸中的应用[J]. 中国临床解剖学杂志, 2026 , 44(4) : 486 -490 . DOI: 10.13418/j.issn.1001-165x.2026.4.18

Abstract

Objective To investigate the application of multimodal intraoperative neuromonitoring (IONM) in transpsoas extreme lateral interbody fusion (XLIF) for degenerative scoliosis. Methods A retrospective analysis was conducted on clinical data from 19 patients with degenerative scoliosis who underwent XLIF surgery with multimodal IONM at the Third Affiliated Hospital of Guangzhou Medical University, between January 2021 and December 2023. Results All patients were successfully completed the surgery, with an average operative time of (262 ± 94) min. Postoperative coronal Cobb angle of the major curve was (8 ± 6) °, achieving a correction rate of (73 ± 13) %. Multimodal monitoring triggered alerts in 3 cases: Postoperative muscle weakness happened in 2 patients, who gradually resolved after treatment, while 1 patient showed no neurological deficits. The sensitivity of multimodal IONM was 100%, and specificity was 94.1%. Conclusions Multimodal IONM compensates for the limitations of single-mode monitoring, improves diagnostic accuracy, reduces the risk of neurological injury in XLIF procedures, and facilitates the technical promotion and expanded application of XLIF.

Key words： Multimodal intraoperative neurophysiological monitoring; ; ; Lateral lumbar interbody fusion; Degenerative scoliosis

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