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Neural Monitoring

The Prevention of Intraoperative Injury

  • Steven K. Salzman

Part of the Neurotrauma book series (NT)

Table of contents

  1. Front Matter
    Pages i-xiv
  2. Basic Aspects of Evoked Neural Activity and Spinal Trauma

    1. Front Matter
      Pages 1-1
    2. Neural Substances of Normal Somatosensory-Evoked Potentials

    3. Pathophysiology and Pharmacology of Experimental Spinal Cord Injury

    4. Mechanism of Evoked Potential Responces to Injury

  3. Clinical Application of Electrophysiologic Methods for Intraoperative Neural Monitoring

    1. Front Matter
      Pages 149-149
    2. Established Methods-clinical Experience with Somatosensory-Evoked Potentials

      1. Henry L. Bennett, Pasquale X. Montesano, Daniel R. Benson
        Pages 153-163
      2. Dudley S. Dinner, M. D. Hans Luders, Ronald P. Lesser, Harold H. Morris III, Gene Barnett, George Klem
        Pages 179-196
      3. Neil I. Spielholz, Gordon L. Engler
        Pages 197-204
    3. New Methods-Cerebrocortical and Spinal Motor Monitors

      1. Henry L. Bennett, Amira M. Safwat, Leland H. Hanowell
        Pages 207-217
      2. Jeffrey H. Owen
        Pages 219-241
      3. Betty L. Grundy
        Pages 253-270
  4. The Present and Future of Neural Monitoring and Operative Safety

    1. Front Matter
      Pages 271-271
    2. Clyde L. Nash Jr.
      Pages 273-279
    3. Steven K. Salzman
      Pages 315-318
  5. Back Matter
    Pages 319-322

About this book

Introduction

The symposium from which this book originates represents a sig­ nificant watershed in the field of intraoperative neural monitoring, since the participants concluded that electrophysiologic monitoring techniques should be considered a "standard of care" for surgical pro­ cedures that place the central nervous system (CNS) at risk for injury. Specifically, it was agreed that the somatosensory-evoked potential (SEP) is a remarkably reliable and sensitive indicator of several aspects of CNS function, and should be routinely employed as an intraopera­ tive monitor during many neurosurgical and orthopedic procedures. The significance of this conclusion cannot be overstated, for at the time of this writing, intraoperative monitoring methods based on evoked-potential analyses are still considered experimental and are not in routine use. The reasons for this are not clear, given the accu­ mulation of literature and expertise on this subject over the past five years. Granted, the cost of electrophysiological monitoring equip­ ment is high, but only initially. The benefits of injury prevention far outweigh these costs, from both medical and economic viewpoints. It is our sincere hope and goal that the medical community be made aware of the value of intraoperative neural monitoring.

Keywords

Nervous System Surgery clinical application electroencephalography (EEG) spinal cord trauma

Editors and affiliations

  • Steven K. Salzman
    • 1
  1. 1.Spinal Trauma Research ProgramAlfred I. duPont Institute of the Nemours FoundationWilmingtonUSA

Bibliographic information