关键词: 脊髓损伤后疼痛, 脊髓背根入髓区切开, 多模态, 神经电生理

Abstract: Objective To investigate the efficacy and safety of multimodal neuroelectrophysiological monitoring in the treatment of pain after spinal cord injury by incision of the dorsal root of the spinal cord into the medullary region.Methods Four patients with pain after spinal cord injury were treated with Dorsal Root Entry Zone (DREZ) incision under multimodal neuroelectrophysiological monitoring,including 2 cases of brachial plexus avulsion,1 case of thoracic spine injury,and 1 case of lumbar spine injury.All patients were monitored for lower limb movement and sensation through sensory evoked potentials (SEP) and motor evoked potentials (MEP).When the latency of SEP and MEP decreases by 10% on the healthy side or the amplitude decreases by 30% on the baseline,a warning is given to guide the incision angle and deep range of DREZ.All patients were analyzed for preoperative and postoperative pain visual analysis scale (VAS),muscle strength and deep sensory function of healthy limbs on the surgical side,and second bowel function.At the same time,the quality of life of patients before and after surgery was evaluated using the SF-36 quality of life scale.Results After a follow-up of 9 months to 3 years,the pain relief rate in 3 patients was 100%,and the pain relief rate in 1 patient was greater than 50%.None of the patients had muscle decline and deep sensory decline in the healthy limb on the surgical side,and there was no decline in the second bowel function in all patients.The total score of SF-36 increased from 80.6±10.2 before surgery to 108.9±12.4 (P<0.05).Conclusion Multimodal neuroelectrophysiological monitoring of spinal dorsal root incision can not only effectively alleviate pain,improve quality of life,but also effectively protect spinal cord function.

Key words: Pain after spinal cord injury, Incision of the spinal dorsal root into the medullary region, Multimodal, Neuroelectrophysiology