European Spine Journal

, Volume 6, Issue 5, pp 316–323

Intraoperative control by somatosensory evoked potentials in the treatment of cervical myeloradiculopathy. Results in 210 cases

  • C. Sebastián
  • J. P. Raya
  • M. Ortega
  • E. Olalla
  • V. Lemos
  • R. Romero
Original Article

DOI: 10.1007/BF01142677

Cite this article as:
Sebastián, C., Raya, J.P., Ortega, M. et al. Eur Spine J (1997) 6: 316. doi:10.1007/BF01142677

Abstract

Somatosensory evoked potentials (SEPs) were used for continuous monitoring of 210 patients during anterior surgery for cervical myeloradiculopathy, to test how effectively they help avoid irreversible neurological damage during surgery. The pathologies differed in severity and were treated by diskectomy or by extended corporectomy using the Senegas technique. Intraoperative SEP changes were recorded in 84 patients (40%); in 13 (6.2%) of these, changes in SEP amplitude and latency were caused by mechanical stress. SEPs revealed transient episodes of regional ischaemia or neurophysiological anomalies during anaesthesia (mainly hypotension) in 27 patients (12.8%). The traces detected incipient and potentially dangerous mechanical pressure on, or metabolic anomalies of, the spinal cord during manipulation and placement procedures of spinal fixation devices. They were particularly sensitive indicators of ischaemia; one of the most common causes of irreversible injury. The traces of 44 patients (21.0%) improved markedly during surgery. There were no false-negatives in this series and, thanks to the fact that SEPs gave immediate warnings of incipient ischaemia to the surgical team, we had no case of irreversible medullary or nerve-root deficit.

Key words

Cervical surgeryEvoked potentialsSomatosensory evoked potentialsSpinal cord monitoringSpondylotic myelopathy

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • C. Sebastián
    • 1
    • 4
  • J. P. Raya
    • 2
  • M. Ortega
    • 3
  • E. Olalla
    • 1
  • V. Lemos
    • 1
  • R. Romero
    • 1
  1. 1.Spinal Surgery UnitParque San Antonio ClinicMalagaSpain
  2. 2.Neurophysiology UnitParque San Antonio ClinicMalagaSpain
  3. 3.Department of AnaestheticsParque San Antonio ClinicMalagaSpain
  4. 4.MalagaSpain