中文摘要：

背景：有文献报道,采用脊髓内移术修复伴有脊髓神经受压的脊柱侧后凸畸形,术后大部分患者的神经功能可以达到不同程度的恢复,但该方案改善术后神经功能的有效性机制仍不明确。目的：观察脊髓内移后路矫形内固定修复伴神经损害的脊柱侧后凸畸形后神经功能的改善情况。方法：选择脊柱侧后凸畸形同时伴神经损害患者18例,经检查确诊后,行脊髓内移后路矫形内固定治疗。所有患者均在术前和术后1周行体感诱发电位检测,术中监测其运动诱发电位和体感诱发电位。在MRI上测定椎管内缘至顶椎区凸侧脊髓外缘之间的距离,并计算脊髓内移的距离。结果与结论：（1）术前胫后神经体感诱发电位检测到P40的波幅（1.66±0.29）μV、峰潜伏期为（39.25±3.02）ms;术中胫后神经体感诱发电位检测到P40的波幅和峰潜伏期的值分别（1.68±0.28）μV、和（38.68±2.67）ms,术中与术前的波幅与峰潜伏期比较差异无显著性意义（P〉0.05）;（2）术后冠状面主弯Cobb角矫正率以及后凸Cobb角矫正率分别为（51.1±21.2）%以及（38.9±18.1）%;顶椎区脊髓位置在术后平均内移距离为（2.4±1.7）mm;（3）胫后神经体感诱发电位检测到P40的波幅与潜伏期在术后1周时分别为（2.21±0.40）μV和（34.98±2.83）ms,较术前有显著改善,差异有显著性意义（P〈0.05）;（4）结果提示,脊髓内移后路矫形内固定可明显改善伴神经损害脊柱侧后凸畸形患者的神经电生理指标及神经功能。

英文摘要：

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 still 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, all 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 （38.9：1：18.1 ）%. 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 fixati