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2017•Zhonghua shiyan waike zazhiRequires access

Effect of intraoperative electromyogram stimulation on surgical effectiveness of cubital tunnel syndrome

Xu Zhu

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Abstract

Objective To observe the effect of intraoperative electromyogram (EMG) stimulation on surgical effectiveness of cubital tunnel syndrome. Methods A total of 288 patients with cubital tunnel syndrome and confirmed as invalid conservative treatment cases were divided into intraoperative EMG stimulation treatment group (experimental group) and control group, 144 cases in each. All cases were monitored by intraoperative electrophysiological examination 1 time before operation, and by recording the latency and amplitude of compound muscle action potential (CMAP) in the abductor muscle of the little finger. After release again the same intraoperative electrophysiological monitoring was done. In the experimental group after the release of nerve compression at the most serious site, electrical stimulation was done, and the stimulation parameters were as follows: 100 mA, 2 Hz, 10 min. The latency and amplitude of CMAP before and after the intraoperative release were compared. The patients were followed up every 2 months, and all cases were followed up for at least 8 months. The number of cases with different evaluation criteria was evaluated at each follow-up visit. The chi square test was used for the comparative analysis. Results The amplitude difference was (3.4±0.4) mV, and the latency difference was (10.1±0.2) ms in the control group, and those were (2.5±0.4) mV and (14.4±0.6) ms in the experimental group, with the difference being statistically significant (P=0.007 and P=0.001). At 2nd month after operation, the number of cases obtaining recovery and improvement in the experimental group was significantly greater than in the control group (P=0.000), more significant at 4th month after operation. At 6th month after operation, the recovery rate and improvement in experimental group and control group showed no significant difference (P=0.054). At 8th month after operation, the number of ineffective cases in experimental group was significantly less than in the control group (P=0.000). Conclusion Intraoperative EMG stimulation after surgical release of cubital tunnel syndrome can quickly improve the CMAP amplitude and latency of abductor muscle of the little finger. Key words: Intraoperative electromyogram stimulation; Cubital tunnel syndrome

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What this paper is about

Objective To observe the effect of intraoperative electromyogram (EMG) stimulation on surgical effectiveness of cubital tunnel syndrome. Methods A total of 288 patients with cubital tunnel syndrome and confirmed as invalid conservative treatment cases were divided into intraoperative EMG stimulation treatment group (experimental group) and control group, 144 cases in each. All cases were monitored by intraoperative electrophysiological examination 1 time before operation, and by recording the latency and amplitude of compound muscle action potential (CMAP) in the abductor muscle of the little finger. After release again the same intraoperative electrophysiological monitoring was done. In the experimental group after the release of nerve compression at the most serious site, electrical stimulation was done, and the stimulation parameters were as follows: 100 mA, 2 Hz, 10 min. The latency and amplitude of CMAP before and after the intraoperative release were compared. The patients were followed up every 2 months, and all cases were followed up for at least 8 months. The number of cases with different evaluation criteria was evaluated at each follow-up visit. The chi square test was used for the comparative analysis. Results The amplitude difference was (3.4±0.4) mV, and the latency difference was (10.1±0.2) ms in the control group, and those were (2.5±0.4) mV and (14.4±0.6) ms in the experimental group, with the difference being statistically significant (P=0.007 and P=0.001). At 2nd month after operation, the number of cases obtaining recovery and improvement in the experimental group was significantly greater than in the control group (P=0.000), more significant at 4th month after operation. At 6th month after operation, the recovery rate and improvement in experimental group and control group showed no significant difference (P=0.054). At 8th month after operation, the number of ineffective cases in experimental group was significantly less than in the control group (P=0.000). Conclusion Intraoperative EMG stimulation after surgical release of cubital tunnel syndrome can quickly improve the CMAP amplitude and latency of abductor muscle of the little finger. Key words: Intraoperative electromyogram stimulation; Cubital tunnel syndrome

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Available abstract

Objective To observe the effect of intraoperative electromyogram (EMG) stimulation on surgical effectiveness of cubital tunnel syndrome. Methods A total of 288 patients with cubital tunnel syndrome and confirmed as invalid conservative treatment cases were divided into intraoperative EMG stimulation treatment group (experimental group) and control group, 144 cases in each. All cases were monitored by intraoperative electrophysiological examination 1 time before operation, and by recording the latency and amplitude of compound muscle action potential (CMAP) in the abductor muscle of the little finger. After release again the same intraoperative electrophysiological monitoring was done. In the experimental group after the release of nerve compression at the most serious site, electrical stimulation was done, and the stimulation parameters were as follows: 100 mA, 2 Hz, 10 min. The latency and amplitude of CMAP before and after the intraoperative release were compared. The patients were followed up every 2 months, and all cases were followed up for at least 8 months. The number of cases with different evaluation criteria was evaluated at each follow-up visit. The chi square test was used for the comparative analysis. Results The amplitude difference was (3.4±0.4) mV, and the latency difference was (10.1±0.2) ms in the control group, and those were (2.5±0.4) mV and (14.4±0.6) ms in the experimental group, with the difference being statistically significant (P=0.007 and P=0.001). At 2nd month after operation, the number of cases obtaining recovery and improvement in the experimental group was significantly greater than in the control group (P=0.000), more significant at 4th month after operation. At 6th month after operation, the recovery rate and improvement in experimental group and control group showed no significant difference (P=0.054). At 8th month after operation, the number of ineffective cases in experimental group was significantly less than in the control group (P=0.000). Conclusion Intraoperative EMG stimulation after surgical release of cubital tunnel syndrome can quickly improve the CMAP amplitude and latency of abductor muscle of the little finger. Key words: Intraoperative electromyogram stimulation; Cubital tunnel syndrome

Key concepts: Medicine, Compound muscle action potential, Stimulation, Anesthesia, Electrophysiology, Significant difference, Surgery, Electromyography

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