title: High-resolution direct microstimulation mapping of spinal cord motor pathways during resection of an intramedullary tumor.
abstract: Despite the use of advanced microsurgical techniques, resection of intramedullary tumors may result in significant postoperative deficits because of the vicinity or invasion of important functional tracts. Intraoperative monitoring of somatosensory evoked potentials and transcranial electrical motor evoked potentials has been used previously to limit such complications. Electromyography offers an opportunity for the surgeon to map the eloquent tissue associated with the tumor using intraoperative motor fiber stimulation. Similar to the use of cortical simulation in the resection of supratentorial gliomas, this technique can potentially advance the safety of intramedullary spinal cord tumor resection. The authors describe the use of intraoperative motor fiber tract stimulation to map the corticospinal tracts associated with an intramedullary tumor. This technique led to protection of these tracts during resection of the tumor.
authors.affiliation: Goodman Campbell Brain and Spine and Department of Neurological Surgery, Indiana University; and.
authors.forename: Ravi
authors.initials: R
authors.lastname: Gandhi
authors.forename: Corinne M
authors.initials: CM
authors.lastname: Curtis
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D004525:Efferent Pathways / Q000503:physiopathology / Q000601:surgery; D004558:Electric Stimulation / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011712:Pyramidal Tracts / Q000503:physiopathology*; D013116:Spinal Cord / Q000503:physiopathology*; D013120:Spinal Cord Neoplasms / Q000601:surgery*
keywords: EMG = electromyogram; MEP = motor evoked potential; SSEP = somatosensory evoked potential; TceMEP = transcranial MEP; brain mapping; electrical stimulation; microsurgical resection; oncology; spinal cord tumor