[Veracity of cortical somatosensory evoked potential monitoring and influencing factors in operation for cervical spondylitic myelopathy].
OBJECTIVE
To investigate the veracity of cortical somatosensory evoked potential (CSEP) and the influencing factors of manipulation of CSEP monitoring during the operation for cervical spondylitic myelopathy (CSM).


METHODS
Sixty-eight CSM patients, 45 males and 23 females, aged 52.3, underwent CSEP monitoring at the ulnar, median, and posterior tibial nerves. The impact and level to CSEP of different period and manipulation during operation were recorded. The spinal cord function of post-operation were analyzed and evaluated.


RESULTS
The CSEP monitoring was successful in all cases. CSEP pre-warning appeared 44 times in 24 cases. Among them 31 times of common pre-warning of CSEP were recorded because of operative manipulations and all of the 31 times of common pre-warning recovered after careful manipulation. Dangerous pre-warning was recorded for 11 times, and then the operation had to be stopped to search for the causes and awaken test was needed in one case. When the agents causing dangerous pre-warning of CSEP were found and corrected, the CSEP was able to recover. Not a patient showed aggravation of nervous function damage and no false negative result was found.


CONCLUSIONS
CSEP can monitor the spinal cord function immediately and exactly. The main factors of operative manipulation causing pre-warning of CSEP include overextension and overflexion, overbrazing the space, operative manipulations for spinal cord thorough decompression, and overdeepening of graft.
Chen
Yu-guang
YG
Department of Orthopedics, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
Li
Fo-bao
FB
Peng
Xin-sheng
XS
Chen
Li-yan
LY
Wan
Yong
Y
Fu
Ming
M
Liao
Wei-ming
WM
D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement; D002574:Cervical Vertebrae; D017586:Diskectomy; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013117:Spinal Cord Compression / Q000503:physiopathology / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000503:physiopathology* / Q000601:surgery*