Direct spinal stimulation for intraoperative monitoring during scoliosis surgery.

Abstract:

:Intraoperative electrophysiological monitoring of the spinal cord has traditionally been done by recording somatosensory evoked potentials (SEP). There is a risk that SEPs can be unaltered when significant injury to the anterior spinal cord has occurred. The purpose of this report is to describe a simple technique for intraoperative spinal cord stimulation which monitors descending pathways in the anterior spinal cord. Stimulation occurs through needle electrodes inserted into spinous processes in the rostral surgical wound, and recordings are made from electrodes in the popliteal spaces. We report our experience in monitoring spinal instrumentation in 45 patients with idiopathic scoliosis and 20 with some form of neurological disease causing scoliosis. The neurogenic motor evoked potentials (NMEP) are stable and easily recorded from the popliteal spaces in the majority of patients. We describe the case of 1 patient with Friedreich's ataxia in whom no SEPs could be recorded, but NMEPs were used successfully for monitoring. We have fond that combining traditional SEP monitoring with NMEP recording provides a safe and effective method to monitor the spinal cord during surgical procedures where it is at risk.

journal_name

Muscle Nerve

journal_title

Muscle & nerve

authors

Phillips LH 2nd,Blanco JS,Sussman MD

doi

10.1002/mus.880180309

subject

Has Abstract

pub_date

1995-03-01 00:00:00

pages

319-25

issue

3

eissn

0148-639X

issn

1097-4598

journal_volume

18

pub_type

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