Интраоперационный нейрофизиологический мониторниг при удалении интрамедуллярных опухолей (литературный обзор)

Abstract

Progress in the field of neurosurgery and the possibility of total removal of the majority of intramedullary tumors leads to the question about maximum security functions of the spinal cord. The invention and implementation of intra-operative neuro-physiological monitoring (IOM) provides real-time to assess the impact of surgical procedures on the pathways of the spinal cord. Effective and informed monitoring includes an assessment of motor and sensitive ways to complete information about the functions of the spinal cord. Identifying predictors of favorable functional outcome and algorithm development monitoring allows the authors to modify neurosurgical tactics and improve the patient´s quality of life after surgery. This article describes all the methods IOM and physiological factors affecting the monitoring of responses. The authors review data on the effects of different anesthetics on the ability of neurons to conduct impulses and the most favorable combinations of drugs. It is proved that the IOM is effective as predictors of high risk of postoperative complications (4 studies class I and 7 studies of class II). It is important to consider the factors such as experience neurophysiologist and his ability to interpret data, as well as experience of the surgeon in using these data, the actions of the anesthesiologist - the whole process of interaction affects the final outcome of the operation.