Experimental Study On Monitoring Cervical Spinal Cord Injury By Transcranial Electrical Stimulation Motor Evoked Potential

ObjectiveThrough the establishment of an animal model of acute cervical spinal cord injury,to explore the protective effect of intracranial transcranial electrical stimulation motor evoked potential(TceMEP)on acute cervical spinal cord compression injury,as well as the relationship with the function of lower limbs and cervical spinal cord damage pathology.MethodTake 40 healthy New Zealand white rabbits weighing between 4.0 and 6.0 kg,no male or female,and randomly divide white rabbits into control group(n=10)and 3 experimental groups,ie mild group(n=10).,moderate group(n=10),severe group(n=10).The control group was used to rule out the effects of anesthesia and surgery on TceMEP,and only surgical treatment.The experimental group was divided into mild compression group(1 mm),moderate compression group(1.5 mm),and severe compression group(2 mm)according to different thickness of the hose.After the New Zealand white rabbits in the experimental group were anesthetized,the high cervical spinal cord was implanted into the silica gel column,and TceMEP was continuously observed for 2 h.The effects of the anesthetics on the electrophysiological indexes were excluded,and the changes of the cervical spinal cord waveform in the acute phase were observed.The waveform was compared to the baseline and distributed over 1 d,and the TceMEP waveform was detected after 2 d.The control group(n=10)was surgically treated after anesthesia,and then TceMEP was recorded as described above.Before the operation,the Tarlov motor function score was performed 1 h after anesthesia and 1 d and 2 d after the anesthesia.After 2 days,the cervical spinal cord HE staining was performed.ResultBefore and after anesthesia in the control group,the TceMEP latency was analyzed by variance,and the difference was not statistically significant(F=0.002,P>0.05).There was no significant difference in TceMEP amplitude before and after anesthesia in the control group(F=0.003,p>0.05).There was no significant difference in the TceMEP latency between the control group and the control group before and after surgery(F=0.25,p>0.05).There was no significant difference in the TceMEP amplitude before and after surgery in the control group(F=0.004,p>0.05)..After the cervical spinal cord compression in the experimental group,the incubation period was immediately prolonged,the amplitude immediately decreased,and it was stable within 5 min.The postoperative incubation period,amplitude ratio,lower limb motor function score and preoperative t-test were statistically significant(p<0.05).The amplitude ratio of TceMEP after compression to pre-compression and the lower limb movement after 2 days in the experimental group).The functional score was correlated by spearman correlation analysis.The r value was 0.991,and the difference was statistically significant.The amplitude of the TceMEP after compression and the pre-compression amplitude of the experimental group were positively correlated with the pathological slice score after 2 days,r=0.981,the difference was statistically significant.ConclusionTceMEP is associated with lower limb function and cervical spinal cord pathological damage.Intraoperative TceMEP can sensitively reflect the cervical spinal cord compression spinal cord injury,and can detect ischemic injury during the reversible period of cervical spinal cord compression ischemia,which helps to timely apply methods to avoid irreversible spinal cord injury.