Summary
In order to monitor descending pathways during neurosurgical operations on the spinal cord, motor evoked potentials (MEPs) were recorded from the thenar and anterior tibial muscles and from the epidural space along the spinal cord and the cauda equina in a total of 83 patients following transcranial electrical cortex stimulation. It was the aim of our study to find out whether MEP monitoring is a reliable and sensitive method for the detection of impending motor deficits. Interaoperative recordability of potentials was 79.7%. On the basis of acceptable changes in amplitudes of up to 50% at the end of surgery, 82.7% of the recordings correlated correctly with the postoperative motor status; there were false positive results in 17.3%. We did not observe false negative correlation. In conclusion, intraoperative MEP monitoring is a sensitive method for the detection of impending motor deficits. Major problems concern the influence of anesthesia, the definition of acceptable limits for changes in potentials, and the most suitable stimulation and recording techniques.
Keywords
- Motor Evoke Potential
- Anterior Tibial Muscle
- Neurosurgical Operation
- Acceptable Change
- Motor Evoke Potential Monitoring
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Dinner S, Lueders H, Lesser RP, Morris HH (1986) Invasive methods of somatosensory evoked potential monitoring. J Clin Neurophysiol 3: 113–130
Ducker TB, Saleman M, Lucas JT, Garrison WB, Perot PL (1978) Experimental spinal cord trauma. II: Blood flow, tissue oxygen, evoked potentials in both paretic and plegic monkeys. Surg Neurol 10: 66–72
Fehlings MG, Tator CH, Linden RD, Piper IR (1987) Motor evoked potentials recorded from normal and spinal cord-injured rats. Neurosurgery 20: 125–130
Konrad PE, Tacker WA, Levy WJ, Reedy DP, Cook JR, Geddes LA (1987) Motor evoked potentials in the dog: effects of global ischemia on the spinal cord and peripheral nerve signals. Neurosurgery 20: 117–124
Merton PA, Morton HB (1980) Stimulation of the cerebral cortex in the intact human subject. Nature 285: 227
Oro J, Levy WJ (1987) Motor evoked potential as a monitor of middle cerebral artery ischemia and stroke. Neurosurgery 20: 192–193
Patil AA, Nagaray MP, Mehta R (1985) Cortically evoked motor action potentials in spinal cord injury research. Neurosurgery 16: 473–476
Simpson RK, Baskin DS (1987) Corticomotor evoked potentials in acute and chronic blunt spinal cord injury in the rat: correlation with neurological outcome and histological damage. Neurosurgery 20: 131–137
Zentner J, Ebner A (1989) Nitrous oxide suppresses the electromyographic response evoked by electrical stimulation of the motor cortex. Neurosurgery 24: 60–62
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Zentner, J. (1991). Motor Evoked Potentials Monitoring During Neurosurgical Operations on the Spinal Cord. In: Shimoji, K., Kurokawa, T., Tamaki, T., Willis, W.D. (eds) Spinal Cord Monitoring and Electrodiagnosis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-75744-0_47
Download citation
DOI: https://doi.org/10.1007/978-3-642-75744-0_47
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-75746-4
Online ISBN: 978-3-642-75744-0
eBook Packages: Springer Book Archive