title: Somatosensory- and motor-evoked potential monitoring during spine and spinal cord surgery.
abstract: METHODS
  Prospective, observational study.
  
  
  METHODS
  Regional Trauma Center, Torino, Italy.
  
  
  OBJECTIVE
  Complex spinal surgery carries a significant risk of neurological damage. The aim of this study is to determine the reliability and applicability of multimodality motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SEPs) monitoring during spine and spinal cord surgery in our institute.
  
  
  METHODS
  Recordings of MEPs to multipulse transcranial electrical stimulation (TES) and cortical SEPs were made on 52 patients during spine and spinal cord surgery under propofol/fentanyl anaesthesia, without neuromuscular blockade.
  
  
  RESULTS
  Combined MEPs and SEPs monitoring was successful in 38/52 patients (73.1%), whereas only MEPs from at least one of the target muscles were obtained in 12 patients (23.1%); both MEPs and SEPs were absent in two (3.8%). Significant intraoperative-evoked potential changes occurred in one or both modalities in five (10%) patients. Transitory changes were noted in two patients, whereas three had persistent changes, associated with new deficits or a worsening of the pre-existing neurological disabilities. When no postoperative changes in MEP or MEP/SEP modalities occurred, it was predictive of the absence of new motor deficits in all cases.
  
  
  CONCLUSIONS
  Intraoperative combined SEP and MEP monitoring is a safe, reliable and sensitive method to detect and reduce intraoperative injury to the spinal cord. Therefore, the authors suggest that a combination of SEP/MEP techniques could be used routinely during complex spine and/or spinal cord surgery.
authors: Section of Clinical Neurophysiology, CTO Hospital, Via Zuretti 29, Torino 10126, Italy.
authors: P
authors: P
authors: Costa
authors: A
authors: A
authors: Bruno
authors: M
authors: M
authors: Bonzanino
authors: F
authors: F
authors: Massaro
authors: L
authors: L
authors: Caruso
authors: I
authors: I
authors: Vincenzo
authors: P
authors: P
authors: Ciaramitaro
authors: E
authors: E
authors: Montalenti