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SPINAL CORD MONITORING OF PATIENTS WITH NEUROLOGICAL DEFICITS

  • ZİLELİ M.
  • MİRZAİ H.
  • TUNÇBAY E.

J Turk Spinal Surg 1991;2(2):66-70

Intraoperative monitoring of spinal cord function is a useful tool to decrease the poterıtial risk of neural damage particularly in intradural and intramendullay surgery. However, most of the experience on spinal cord monitoring in the literatüre is a collection of the cases vvithout neurological deficits and with reiative low risk of morbidity. İt seems very difgicult to make a reliable monitoring of the cases with neurological deficits and preoperative evoked potential abnormalities.

This is a report of our first experience with spinal cord monitoring on 9 patients (2 intradural tumors, 1 intrame-dullary tumor, 1 clivus tumor, 3 tethered cord syndrome, 1 cervical spondylotic myelopathy), Cortical and intradural spinal somatosensory evoked potentials after stimulation of tibial and median nerves were monitored in ali cases.

7 cases showed good correlation with evoked potential changes. There were 1 false-positivity and 1 falsenega-tivity. İn one case with lipomeningocel, stimulation of the spinal cord gave useful information in identifying function-al tissue from nonfunctional part.

We experienced some pitfalls, which should be adressed to offer reliable information to the surgeon. An app-ropriate selection and combination of evoked potentials is an important factor to carry out effective spinal cord monitoring especially the cases with neurological deficits.