Intraoperative somatosensory evoked potential monitoring of the sciatic nerve: an animal model.
Sciatic, peroneal, and tibial nerves were isolated in 18 hind limbs in 10 adult mongrel cats. A pair of needle electrodes was used to stimulate both divisions of the sciatic nerve individually at the level of the popliteal fossa. The sciatic nerve was injured by complete or partial transection, crush, and controlled compression. Motor function was correlated with intraoperative cortical somatosensory evoked potential and spinal somatosensory evoked potential tracings. We observed that significant changes in the waveforms of cortical somatosensory evoked potential and spinal somatosensory evoked potential tracings immediately precede postoperative peripheral nerve deficits, and that loss of motor function may be avoided by immediate response to significant spinal somatosensory evoked potential and cortical somatosensory evoked potential waveform changes. A complete motor palsy can be created in one division of the sciatic nerve while normal tracings are being obtained in the other division of the nerve. Stimulating both divisions may result in a spinal somatosensory-evoked potential/cortical somatosensory evoked potential tracing that masks the deficit that is present in only one nerve division.
Moed
B R
BR
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan 48202.
Maxey
J W
JW
Minster
G J
GJ
D000818:Animals; D002415:Cats; D004195:Disease Models, Animal; D005069:Evaluation Studies as Topic; D005073:Evoked Potentials, Somatosensory; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards*; D009409:Nerve Crush / Q000295:instrumentation / Q000379:methods; D010543:Peroneal Nerve; D012584:Sciatic Nerve / Q000293:injuries*; D013979:Tibial Nerve