Transvertebral transposition of the spinal cord and posterior correction in patients suffering from neurologic deficit secondary to angular kyphoscoliosis:improvement of electrophysiology and function

Li Ping; Sun Jian-min; Wang Tong

doi:10.3969/j.issn.2095-4344.2016.31.007

Abstract：BACKGROUND:Previous studies have shown that nerve function may achieve different degrees of recovery in most patients after transvertebral transposition of the spinal cord for repair of spinal cord nerve compression and kyphoscoliosis. However, the effective mechanism of the proposed method to improve postoperative nerve function is stil not clear. OBJECTIVE:To investigate the improvement in neurological outcomes after transvertebral transposition of the spinal cord and posterior correction in patients suffering from neurologic deficit secondary to angular kyphoscoliosis. METHODS:Eighteen patients suffering from neurologic deficit secondary to angular kyphoscoliosis underwent transvertebral transposition of the spinal cord and posterior correction. Preoperatively and 1 week postoperatively, al patients were subjected to somatosensory evoked potential detection. During operation, motor evoked potentials and somatosensory evoked potentials were monitored. Using MRI, the distance from the inner edge of the spinal canal to the outer edge of the convex side of the spinal cord at apical region was measured, and the distance of spinal cord transposition was calculated. RESULTS AND CONCLUSION:(1) There were no significant differences in terms of the latency and amplitude of posterior tibial nerve P40 (preoperatively versus intraoperatively:amplitude:(1.66±0.29)μV vs. (1.68±0.28)μV, P>0.05;latency:(39.25±3.02) ms vs. (38.68±2.67) ms, P>0.05). (2) After surgery, the major curve was improved with (51.1±21.2)%correction rate, and the mean kyphosis was improved with (38.9±18.1)%. The distance between spinal cord and canal on the convex side at the apex was decreased by (2.4±1.7) mm on average. (3) The amplitude and latency of posterior tibial nerve P40 at 1 week postoperatively were (2.21±0.40)μV and (34.98±2.83) ms, respectively (P<0.05). (4) These results suggest that posterior correction and internal fixation can remarkably improve neurophysiological index and nerve function in patients with neurologic deficit secondary to angular kyphoscoliosis.