General perception of the usefulness and failings of spinal cord monitoring. The U.C.L. experience

Abstract

We have been monitoring somatosensory evoked potentials (SEP) for about five years in vascular and orthopaedic surgery. There is a general agreement among vascular surgeons that spinal cord monitoring in descending aorta surgery improves patient outcome, and this is largely confirmed in our statistics. The opinion of orthopaedists is more variable: some do not believe in monitoring, some consider it mandatory, some find it simply useful. Spinal cord monitoring is not a medico-legal obligation in Belgium and is not specifically covered by health insurance. Owing to its poor economic acceptability, the criteria of actual clinical yield of the technique should be studied. Two criteria will be considered: the pathophysiological adequacy of the technique and the initial agreement between the surgeon, the neurophysiologist, and the anaesthesiologist.