TY - JOUR
T1 - Intraoperative spinal somatosensory evoked potential monitoring
AU - Dinner, D. S.
AU - Luders, H.
AU - Lesser, R. P.
AU - Morris, H. H.
AU - Barnett, G.
AU - Klem, G.
PY - 1986
Y1 - 1986
N2 - The relationship of intraoperative monitoring of spinal cord somatosensory evoked potentials and postoperative deficit in 220 cases (121 with scoliosis, 41 with neoplasms, and 58 others) is reported. Bilateral posterior tibial nerve stimulation was used in 181 cases and unilateral median nerve stimulation in 39. Spinal cord (interspinous ligament needles), subcortical (neck surface), and cortical (scalp surface) SEP's were monitored. Seven patients had a worsening of neurological function after surgery, 3 of whom demonstrated significant changes in SEP's monitored. In an additional 4 cases, there was more than a 50% decrease in amplitude of subcortical/cortical SEP's during monitoring, but no change in neurological status postoperatively. Combined monitoring of spinal cord, subcortical, and cortical SEP's enhanced the certainty of detecting spinal cord dysfunction even though there was a significant number of false-negative and false-positive results. A marked change in the SEP's indicated a high chance of developing a neurological deficit (3 or 43% of 7 cases), and if there was no change the chance of any neurological postoperative deficits was extremely low (4 or 1.87% of 213 cases). These data justify the use of intraoperative SEP monitoring.
AB - The relationship of intraoperative monitoring of spinal cord somatosensory evoked potentials and postoperative deficit in 220 cases (121 with scoliosis, 41 with neoplasms, and 58 others) is reported. Bilateral posterior tibial nerve stimulation was used in 181 cases and unilateral median nerve stimulation in 39. Spinal cord (interspinous ligament needles), subcortical (neck surface), and cortical (scalp surface) SEP's were monitored. Seven patients had a worsening of neurological function after surgery, 3 of whom demonstrated significant changes in SEP's monitored. In an additional 4 cases, there was more than a 50% decrease in amplitude of subcortical/cortical SEP's during monitoring, but no change in neurological status postoperatively. Combined monitoring of spinal cord, subcortical, and cortical SEP's enhanced the certainty of detecting spinal cord dysfunction even though there was a significant number of false-negative and false-positive results. A marked change in the SEP's indicated a high chance of developing a neurological deficit (3 or 43% of 7 cases), and if there was no change the chance of any neurological postoperative deficits was extremely low (4 or 1.87% of 213 cases). These data justify the use of intraoperative SEP monitoring.
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U2 - 10.3171/jns.1986.65.6.0807
DO - 10.3171/jns.1986.65.6.0807
M3 - Article
C2 - 3772479
AN - SCOPUS:0022975930
SN - 0022-3085
VL - 65
SP - 807
EP - 814
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 6
ER -