Skip to main content
Log in

Direct spinal versus peripheral nerve stimulation as monitoring techniques in epidurally recorded spinal cord potentials

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

We recorded spinal cord evoked potentials (SCEPs) and spinal somatosensory evoked potentials (spinal SEPs) in 30 operations following stimulation of the epidural spinal cord and the peripheral nerve, respectively, to compare their feasibility as an intraoperative technique for spinal cord monitoring. SCEPs produced quicker responses and had larger amplitudes with simpler waveforms. SCEPs could reflect residual function of the pathological spinal cord and predict the postoperative clinical outcome, findings which are not observed with spinal SEPs. Moreover, SCEPs had a much higher sensitivity to spinal cord insult. Therefore, we conclude that the SCEPs were more appropriate indicator than the spinal SEPs as an intra-operative monitoring method for spinal cord function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Berić A, Dimitrijević MR, Sharkey PC, Sherwood AM (1986) Electroenceph Clin Neurophysiol 65: 102–111

    PubMed  Google Scholar 

  2. Bradshaw K, Webb JK, Fraser AM (1984) Clinical evaluation of spinal cord monitoring in scoliosis surgery. Spine 9: 636–643

    PubMed  Google Scholar 

  3. Dinner DS, Lüders H, Lesser RP, Morris HH (1986) Invasive methods of somatosensory evoked potential monitoring. J Clin Neurophysiol 3: 113–130

    PubMed  Google Scholar 

  4. Epstein F, Wishoff J (1987) Intra-axial tumors of the cervicomedullary junction. J Neurosurg 67: 483–487

    PubMed  Google Scholar 

  5. Ertekin C, Sarica Y, Üşkardesler L (1984) Somatosensory cervical potentials evoked by stimulation of the lumbo-sacral spinal cord in normal subjects and in patients with conus medullaris and cauda equina lesions. Electroenceph Clin Neurophysiol 59: 57–66

    PubMed  Google Scholar 

  6. Friedman WA, Richards R (1988) Somatosensory evoked potential monitoring accurately predicts hemi-spinal cord damage: a case report. Neurosurgery 22: 140–142

    PubMed  Google Scholar 

  7. Halonen JP, Jones SJ, Edgar MA, Ransford AO (1989) Conduction properties of epidurally recorded spinal cord potentials following lower limb stimulation in man. Electroenceph Clin Neurophysiol 74: 161–174

    PubMed  Google Scholar 

  8. Jones SJ, Edgar MA, Ransford AO (1982) Sensory nerve conduction in the human spinal cord: epidural recordings made during scoliosis surgery. J Neurol Neurosurg Psychiatry 45: 446–451

    Google Scholar 

  9. Jones SJ, Edgar MA, Ransford AO, Thomas NP (1983) A system for the electrophysiological monitoring of the spinal cord during operations for scoliosis. J Bone Joint Surg (Br) 65B: 134–139

    Google Scholar 

  10. Lueders H, Gurd A, Hahn J, Andrish J, Weiker G, Klem G (1982) A new technique for intraoperative monitoring of spinal cord function. Spine 7: 110–115

    PubMed  Google Scholar 

  11. Machida M, Weinstein SL, Yamada T, Kimura J (1985) Spinal cord monitoring. Electrophysiological measures of sensory and motor function during spinal surgery. Spine 10: 407–413

    PubMed  Google Scholar 

  12. Macon JB, Poletti CE (1982) Conducted somatosensory evoked potentials during spinal surgery. Part 1: Control conduction velocity measurements. J Neurosurg 57: 349–353

    PubMed  Google Scholar 

  13. Macon JB, Poletti CE, Sweet WH, Ojemann RG, Zervas NT (1982) Conducted somatosensory evoked potentials during spinal surgery. Pars 2: Clinical applications. J Neurosurg 57: 354–359

    PubMed  Google Scholar 

  14. Morioka T, Fujii K, Tobimatsu S, Fukui M, Sakaguchi Y (1991) Usefulness of epidurally evoked cortical potential monitoring during cervicomedullary glioma surgery. J Clin Monit (in press)

  15. Mortimer JT, Shealy CN, Wheeler C (1970) Experimental non-destructive electrical stimulation of the brain and spinal cord. J Neurosurg 32: 553–559

    PubMed  Google Scholar 

  16. Pudenz RH, Bullara LA, Jaques S, Hambrecht FT (1975) Electrical stimulation of brain III: The neural damage model. Surg Neurol 4: 389–400

    PubMed  Google Scholar 

  17. Schramm J, Romstöck J, Watanabe F (1987) Cortical versus spinal recordings in intraoperative monitoring of space-occupying spinal lesions. In: Barber C, Blum T (eds) Evoked potentials III. The third international evoked potentials symposium, Butterworths, Boston, pp 328–334

    Google Scholar 

  18. Shimoji K, Higashi H, Kano T (1971) Epidural recording of spinal electrogram in man. Electroceph Clin Neurophysiol 30: 236–238

    Google Scholar 

  19. Takano H, Tamaki T, Noguchi T, Takakuwa K (1985) Comparison of spinal cord evoked potentials elicited by spinal cord and peripheral nerve stimulation. In: Schramm J, Jones SJ (eds) Spinal cord monitoring. Springer, Berlin Heidelberg New York Tokyo, pp 29–34

    Google Scholar 

  20. Tamaki T, Tsuji H, Inoue S, Kobayashi H (1981) The prevention of iatrogenic spinal cord injury utilizing the evoked spinal cord potential. Int Orthop (SICOT) 4: 313–317

    Google Scholar 

  21. Tamaki T, Noguchi T, Takano H, Tsuji H, Nakagawa T, Imai K, Inoue S (1984) Spinal cord monitoring as a clinical utilization of the spinal evoked potential. Clin Orthop 184: 58–64

    PubMed  Google Scholar 

  22. Tsuyama N, Tsuzaki N, Kurokawa T, Imai T (1978) Clinical application of spinal cord action potential measurement. Int Orthop (SICOT) 2: 39–46

    Google Scholar 

  23. Whittle IR, Johnston IH, Besser M (1984) Spinal cord monitoring during surgery by direct recording of somatosensory evoked potentials. Technical note. J Neurosurg 60: 440–443

    PubMed  Google Scholar 

  24. Whittle IR, Johnston IH, Besser M (1986) Recording of spinal somatosensory evoked potentials for intraoperative spinal cord monitoring. J Neurosurg 64: 601–612

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morioka, T., Tobimatsu, S., Fujii, K. et al. Direct spinal versus peripheral nerve stimulation as monitoring techniques in epidurally recorded spinal cord potentials. Acta neurochir 108, 122–127 (1991). https://doi.org/10.1007/BF01418519

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01418519

Keywords

Navigation