Evoked Spinal Cord Potentials

Abstract

PrefaceThe technique of using evoked spinal cord potentials (SCPs) has become an important clinical tool for monitoring spinal cord surgery and diagnosing spinal cord diseases. The technique is a result both of the technical development of recording evoked SCPs from the epidural space without perforation of the dura mater and of the development of medical electronics. Its use as a monitoring tool is based on continuous epidural analgesia with an epidural catheter. Since the first development of epidural recording of evoked SCPs in 1971, the technique has been applied in various institutes, particularly for monitoring during spine or spinal cord surgery and cardiovascular surgery, and recently for diagnosis of spinal cord diseases.Although the results of studies on monitoring during surgery have proved useful, more detailed neurophysiological mechanisms in the origin of each component of evoked SCPs remain to be explained in the area of diagnosis of spinal or central nervous system diseases. Further neurophysiological and neuropharmacological studies of the human spinal cord may contribute to the clinical application of recording evoked SCPs for diagnosis of spinal cord diseases.The aim of this book is to furnish a survey of the neurophysiological and neuropharmacological bases of evoked SCPs with reference to animal studies and the techniques of recording the potentials mainly from the spinal epidural space. The authors have been involved in the field from the beginning of the 1970s. Many illustrations are presented for better understanding the neurophysiological and neuropharmacological backgrounds of monitoring spinal cord functions. Case studies also are presented and discussed to provide more insight into the monitoring and diagnosis of spinal cord dysfunctions and spinal cord diseases. This book is thus appropriate even for students or those new to the fields of clinical neurophysiology, neurosurgery, neurology, orthopedics, and neuroanesthesia who are interested in monitoring spinal cord function during surgery or diagnosing spinal cord diseases. A diverse range of terminology has been used in the literature to date, sometimes leading to misinterpretation of each component in the field of evoked SCPs. To avoid such misinterpretation and to provide readers with an accurate understanding, terminology referring to basic animal studies is used, and lucid explanations are included in this volume.