Monitoring of motor action potentials after stimulation of the spinal cord.

Spinal Cord Monitoring in Patients With Spinal Deformity and Neural Axis Abnormalities

“…1,2 Multimodal intraoperative SCM is now routinely used in an effort to alert the surgeon to a potential spinal cord injury. 2,4,6,7,10,[17][18][19][20][21][22][23][24]38 In the current study, we used a multimodal approach with the application of both somatosensory-evoked potential and neurogenic mixed evoked potential monitoring. Responses from somatosensory-evoked potentials are transmitted along the sensory pathways of the dorsal column, while responses from neurogenic mixed evoked potentials are composed of both orthodromic motor as well as antidromic sensory components.…”

“…6 Given the limitations of the wake-up test, intraoperative spinal cord monitoring (SCM) was developed in the late 1970s and is now commonly used 3,4,6 -9 to provide accurate continuous information regarding spinal cord function. 4,6,10 Initially, somatosensory-evoked potential (SSEP) monitoring was used and had been found to produce reliable data in most patients. 3,11 Reliability of the SSEPs was influenced by multiple factors, including anesthetic agents, hypotension, and hypothermia, 3,12 which all contribute to the relatively high false-positive rate of this technique.…”

Discrepancy between decreases in the amplitude of compound muscle action potential and loss of motor function caused by ischemic and compressive insults to the spinal cord

“…19 However, it is difficult to use CMAP in the clinical situation because the recording of CMAP is affected by anesthesia. Recently, with improvements in stimulating methods, it has become to possible to record CMAP stably.…”

Peripheral Nerve Monitoring During Surgery for Upper Extremity Lengthening

“…4). The strategy of immediate response to evoked potential abnormalities has been reported to reduce substantially the rate of postoperative neurologic complications (3,9,20,23,41). To proceed effectively with the case, the surgeon must be alerted as quickly as possible of any change in the evoked potential that could initiate nerve damage.…”

“…Many different applications of intraoperative monitoring and electrical measures of neural function have been proposed, and most have been found useful for protecting neural structures at risk from surgical manipulations. Somatosensory evoked potentials (SSEP) were first employed to monitor the integrity of spinal cord function during spinal surgeries ( 1,8,9,19,20,25,26). Spine surgery remains the most common application for this technique.…”