Spinal cord monitoring.
Over the past two decades, intraoperative spinal cord monitoring has matured into a widely used clinical tool. It is used when the spinal cord is at risk for damage during a surgical procedure. This includes orthopedic, neurosurgical, and certain cardiothoracic procedures. Both somatosensory evoked potential (SEP) and direct motor pathway stimulation techniques are available. The SEP techniques are used most widely, are generally accepted, and have been shown to reduce surgical morbidity. A large multicenter study has shown that SEP monitoring reduces postoperative paraplegia by more than 50-60%. Techniques and literature on clinical applications are reviewed in this report.
Nuwer
M R
MR
Department of Clinical Neurophysiology, UCLA Medical Center, Reed Neurological Research Center, 710 Westwood Plaza, Room 1-194, Los Angeles, California 90024-6987, USA. mrn@ucla.edu
D004558:Electric Stimulation; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology; D006801:Humans; D016343:Monitoring, Intraoperative; D013116:Spinal Cord / Q000187:drug effects / Q000502:physiology; D013119:Spinal Cord Injuries / Q000209:etiology / Q000503:physiopathology; D013514:Surgical Procedures, Operative / Q000009:adverse effects*