Evaluation of motor- and sensory-evoked potentials for spinal cord monitoring during thoracoabdominal aortic aneurysm surgery.
OBJECTIVE
To assess the utility of spinal cord monitorings for prediction of spinal cord ischemia, we investigated the role of both motor evoked potentials and sensory evoked potentials during thoracoabdominal aortic aneurysm surgeries.


METHODS
We monitored two kinds of sensory evoked potentials; descending evoked spinal cord potentials from the lumbar enlargement after cervical spinal cord stimulation and segmental evoked spinal cord potentials at the lumbar enlargement elicited by peroneal nerve stimulation, and motor evoked potentials from the lumbar enlargement elicited by direct subcranial stimulation in 9 thoracoabdomonal aortic aneurysm surgeries.


RESULTS
Postoperative paraplegia occurred in one case in which the patients died during the perioperative period. One case showed transient paraparesis, but recovered following rehabilitatation. These cases showed a decrease in the amplitude of descending evoked spinal cord potentials and motor evoked potentials.


CONCLUSIONS
The recovery of the amplitude of the motor evoked potentials and the descending evoked spinal cord potentials after declamping correlated with the neurologic outcome.
Sueda
T
T
First Department of Surgery, Hiroshima University School of Medicine, Japan.
Okada
K
K
Watari
M
M
Orihashi
K
K
Shikata
H
H
Matsuura
Y
Y
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000175:diagnosis; D011237:Predictive Value of Tests; D013116:Spinal Cord / Q000098:blood supply / Q000502:physiology*