title: [Selective and non-invasive monitoring of the posterior columns and pyramidal tract during surgery of the spine and spinal cord].
abstract: For intra-operative neurophysiological monitoring during spine and spinal cord surgery, the challenge is to detect, in real-time, the occurrence of neurological impairment at onset in order to remedy the problem as quickly as possible before it becomes definitely acquired and irreversible. The past three decades were marked by considerable technical progress. Feasibility and reliability have now reached a very high level. A multimodal approach combining simultaneous monitoring of somatosensory and motor pathways has enabled a considerable decline in the rate of false negatives reported in the 80s when somatosensory evoked potentials (SSEP) were monitored alone. Several methods of monitoring are described in the literature. Combining transcranial electric stimulation of muscle motor evoked potentials (mMEP) and cortical SSEP allows non-invasive and selective monitoring of the posterior columns and pyramidal tract. One of the most widely used techniques internationally backed by a broad consensus within the International Society of Intra-operative Neurophysiology (ISIN), this technique remains exceptional in French-speaking countries. We expose here the methodological aspects for the readers of La Revue Neurologique.
authors: Service de physiologie explorations fonctionnelles, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France. Electronic address: eric.azabou@rpc.ap-hop-paris.fr.
authors: E
authors: E
authors: Azabou
authors: Service de physiologie explorations fonctionnelles, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors: J-M
authors: JM
authors: Delage
authors: Service de physiologie explorations fonctionnelles, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors: M
authors: M
authors: Hennig
authors: Service de physiologie explorations fonctionnelles, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors: G
authors: G
authors: Macadoux
authors: Service de physiologie explorations fonctionnelles, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors: F
authors: F
authors: Lofaso
authors: Service de chirurgie orthopédique et traumatologique, hôpital Raymond-Poincaré, AP-HP, UVSQ, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
authors: C
authors: C
authors: Garreau de Loubresse
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D001863:Bone Screws / Q000009:adverse effects; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000379:methods*; D009460:Neurologic Examination; D019635:Neurosurgical Procedures; D011300:Preoperative Care; D011712:Pyramidal Tracts / Q000502:physiology*; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D013116:Spinal Cord / Q000502:physiology / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013131:Spine / Q000601:surgery*
keywords: Intra-operative monitoring; La colonne vertébrale; La moelle épinière; Monitorage peropératoire; Motor evoked potentials; Potentiels évoqués moteurs; Potentiels évoqués somesthésiques; Somatosensory evoked potentials; Spinal cord; Spine