Handbook of Spinal Cord Monitoring : Proceedings of the Fifth International Symposium on Spinal Cord Monitoring, London, UK, June 2–5, 1992

Surgery for the treatment of deformities such as scoliosis carries a small but significant risk of damage to the spinal cord through inadvertent compression or interference with the blood supply. Electrophysiological techniques, principally those for recording sensory and motor evoked potentials, offer a means of continuously assessing the conduction of nerve signals up and down the spinal cord and hence the possibility of detecting a defect at an early stage, when the cause may be reversible. This form of monitoring is now accepted practice in many countries. The main contributors to the __Handbook__ are surgeons, neurophysiologists and anaesthetists at the forefront of research. From the United States, where practice has been most widespread, come the results of the first large-scale, multi-centre survey into monitoring methods and their effectiveness. The research papers forming the remainder of the text provide an indication of the high level of current interest and the likely direction of future developments. Front Matter....Pages i-xvii Front Matter....Pages 1-1 Somatosensory evoked potentials and their use for spinal cord monitoring....Pages 3-20 Human spinal cord potentials recorded from the epidural space....Pages 21-36 Indications for the use of evoked potentials in spinal surgery — review of the Nottingham experience and current use....Pages 37-43 Anaesthetic requirements for spinal surgery and effective cord monitoring....Pages 44-58 Application of intraoperative spinal cord monitoring to neurosurgery....Pages 59-70 Lessons from spinal cord monitoring....Pages 71-77 A multicentre survey of spinal cord monitoring outcome....Pages 78-87 Round Table Debate on International Spinal Cord Monitoring Practice....Pages 88-88 Present status of spinal cord monitoring in Japan....Pages 89-91 Spinal cord monitoring in the UK....Pages 92-93 General perception of the usefulness and failings of spinal cord monitoring. The U.C.L. experience....Pages 94-96 Front Matter....Pages 97-97 Spinal cord evoked potentials in cervical and thoracic myelopathy....Pages 99-103 Spinal cord evoked potentials in spinal cord intermittent claudication....Pages 104-109 Somatosensory cerebral potentials evoked by paraspinal stimulation: an approach to spinal cord monitoring....Pages 110-116 The effect of changes in epidural temperature on spinal evoked potentials during scoliosis surgery....Pages 117-124 Threatened spinal cord damage due to Luque’s wires....Pages 125-129 Comparison of common peroneal and posterior tibial nerve stimulation for routine spinal cord monitoring during surgical correction of scoliosis....Pages 130-134 An explanation of the high ‘false-positive’ rate of lower-limb SEPs in descending aorta surgery....Pages 135-145 Decomposition of spinal cord evoked potentials into propagating and stationary components....Pages 146-152 An atlas of human spinal cord evoked potentials....Pages 153-157 Front Matter....Pages 97-97 A multichannel planar epidural electrode for spinal cord monitoring....Pages 158-160 Somatosensory evoked potentials (EPs) during anterior and posterior spinal surgery....Pages 161-166 Spinal cord monitoring with a new device for automated signal analysis....Pages 167-170 Evaluation of peroperative sensory evoked potentials recorded from nerve roots to the cervical epidural space during brachial plexus surgery....Pages 171-178 Automated spinal cord monitoring system with multimodal evoked potentials....Pages 179-183 Pain-related somatosensory evoked potentials following CO 2 laser stimulation in myelopathy....Pages 184-191 Level diagnosis of cervical myelopathy using somatosensory evoked potentials....Pages 192-196 Spinal cord monitoring during surgery for intramedullary spinal cord tumours....Pages 197-204 Graded risk levels of somatosensory evoked potentials during scoliosis surgery....Pages 205-209 Intraoperative spinal cord monitoring with spino-spinal evoked potentials....Pages 210-215 Monitoring cortical evoked potentials (EPs) in operations on the cervical spine....Pages 216-221 A computer simulation of conduction block — conduction block induced augmentation and killed-end potential....Pages 222-230 Quantifying the SSEP — the area under the curve....Pages 231-236 The effects of propofol and nitrous oxide on median nerve somatosensory evoked potentials during fentanyl anaesthesia....Pages 237-243 Front Matter....Pages 245-245 Effects of anaesthesia on the EEG — bispectral analysis correlates with movement....Pages 247-252 H-reflex spinal cord monitoring during vertebral column stabilization surgery....Pages 253-258 Central motor conduction time to upper versus lower extremities....Pages 259-265 Do neurogenic lesions of the spinal cord generate distinctive features of the epidurally recorded motor evoked potential?....Pages 266-271 Anaesthesia and the motor evoked potential....Pages 272-276 A method to assess the effect of neuromuscular blocking agents on the spinal motor evoked potential during spinal surgery....Pages 277-280 Front Matter....Pages 245-245 Defining reliable anaesthetic protocols for intraoperative monitoring of transcranial magnetic motor evoked potentials....Pages 281-285 Transcranial magnetic stimulation for spinal cord monitoring....Pages 286-293 Evaluation of motor pathways in patients with cervical myelopathy by magnetic stimulation: pre-, intra-, and postoperative study....Pages 294-300 An attempt at noninvasive mapping of the human motor cortex using transcranial magnetic stimulation....Pages 301-311 Separation of upper and lower extremity components of the corticospinal MEP (D-wave) recorded at the cervical level....Pages 312-320 Changes in the corticospinal MEP (D-wave) during microsurgical removal of intramedullary spinal cord tumours: experience in 16 cases....Pages 321-326 Ketamine anaesthesia allows recording of muscle responses to magnetic cortical stimulation: an electrophysiological study in man....Pages 327-333 Long-term and quantitative assessment of spinal cord motor function by motor evoked potentials....Pages 334-339 Correlation of clinical, radiological and electrophysiological (MEP) findings in cervical myelopathy....Pages 340-345 Recording of myogenic motor evoked potentials (mMEP) under general anaesthesia using a train of transcranial electric stimuli....Pages 346-352 Electromyography of paravertebral muscles for evaluation of spinal disorders....Pages 353-361 Differential effect of isoflurane on motor evoked potentials elicited by transcortical electric or magnetic stimulation....Pages 362-367 Temporal summation and motor evoked potential spinal cord monitoring in man....Pages 368-375 Near maximal transcranial magnetic motor evoked potentials during surgery....Pages 376-382 Rapid changes in killed-end corticospinal MEP in patients with acute spinal cord injury....Pages 383-390 Front Matter....Pages 391-391 Electrophysiological phenomena recorded from spinal cord slice preparation in the adult rat....Pages 393-397 Transcranial magnetic motor evoked potentials recorded from the spinal cord in cats: normal waves and spinal cord injuries....Pages 398-406 In vitro animal study of the spinal cord evoked potentials....Pages 407-411 Comparison of spinal evoked potentials by transcranial magnetic and electrical stimulation — a canine study....Pages 412-418 Comparison between descending segmental evoked spinal cord potentials and conductive evoked spinal cord potentials under acute spinal cord compression....Pages 419-425 Front Matter....Pages 391-391 Refractory period of motor evoked potentials and spinal cord evoked potentials in the cat....Pages 426-432 The effect of anaesthetic agents on descending spinal cord evoked potential and the compound muscle action potentials elicited by stimulation at the motor cortex and the spinal cord....Pages 433-437 Acute motor evoked potential changes following spinal cord ischaemia in the rat....Pages 438-443 Back Matter....Pages 445-450 Proceedings of the 5th International Symposium, London, June 2--5, 1992