The treatment of 10 patients with consciousness disorders due to brain injury using short⁃ term high cervical spinal cord stimulation
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R651.2

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    Abstract:

    Objective:To analyze the technical key points of short-term high cervical spinal cord electrical stimulation in the treatment of severe consciousness disorders in patients with brain injury and clinical diagnostic and therapeutic value of this procedure. Methods:A retrospective analysis was conducted on 10 cases of short -term high cervical spinal cord stimulation performed at the Department of Neurosurgery,the First Affiliated Hospital of Nanjing Medical University from June to September 2023. The technical key points of the surgical process were analyzed,and the clinical application value was evaluated through follow-up analysis. Results: Under general anesthesia,with the patient in the prone position,a percutaneous puncture of the thoracic 8 intervertebral space was performed to access the extradural space,and under X-ray fluoroscopy,the top of the spinal cord stimulation electrode was successfully placed at the level of C2. Stimulation therapy was conducted for 2-3 week,with stimulation parameters selected as follows:frequency 5/ 70 Hz,voltage 1-5V,small stimulation cycle:on for 15 min,off for 15 min,large stimulation cycle:on at 08:00 am,off at 20:00 pm. Follow-up was conducted at 4 weeks post-surgery,with 1 out of 8 patients in a vegetative state(VS)reaching a minimally conscious state (MCS)+,5 patients remaining MCS-,and 2 patients still in a VS status. Among the 2 patients who were MCS- preoperatively,1 patient recovered from a MCS,and 1 patient reached MCS+,with no surgery-related complications observed in either case. Conclusion:Short- term high cervical spinal cord stimulation is minimally invasive,safe and effective,with short-term therapeutic and diagnostic value. It has broad prospects for application in the diagnosis and treatment of consciousness disorders. Attention should be paid to the specific difficulties and technical aspects of electrode placement during the surgical procedure.

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王希,赵琳,张勇,毕立清,尤永平,季晶,颜伟.短程高颈段脊髓电刺激术治疗脑损伤意识障碍患者10例[J].南京医科大学学报(自然科学版英文版),2024,(2):242-246.

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  • Received:October 17,2023
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  • Online: February 05,2024
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