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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Combined motor and somatosensory evoked potentials for intraoperative monitoring: Intraoperative data in a series of 76 patients

Simultane Ableitung motorisch und somatosensibel evozierter Potentiale bei 76 Patienten zum intraoperativen Monitoring

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  • corresponding author Martin R. Weinzierl - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen, Aachen
  • P. Reinacher - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen, Aachen
  • J. M. Gilsbach - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen, Aachen
  • V. Rohde - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen, Aachen

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.02.03

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0157.shtml

Published: April 23, 2004

© 2004 Weinzierl et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

The primary objective of intraoperative neurophysiological monitoring during surgery is to avoid permanent neurological injury resulting from surgical manipulation. To achieve this objective, somatosensory (SEP) and motor evoked potentials (MEP) are used in neurosurgery as standard technique. This study was conducted to provide evidence for the accurate detection of the integrity of spinal cord pathways by combined SEP and MEP monitoring during surgery.

Methods

A retrospective analysis was performed on data from 76 patients with combined SEP and MEP monitoring during surgery. Repetitive transcranial electric or magnetic motor cortex stimulation were used to elicit MEP. Stimulation of tibial and median nerve was performed to record SEP.

Results

In most patients, no significant MEP and SEP changes were recorded. In three patients, SEP monitoring was unchanged during surgery, whereas MEP demonstrated significant changes. In case 1, MEP were abolished without intraoperative recovery. The patient experienced a transient motor deficit. In case 2, MEP amplitude decreased, but returned to baseline value during surgery. Postoperatively the patient neurological status was unchanged. In case 3, MEP amplitudes also declined requiring higher intensity stimuli. However, amplitudes did not regain baseline value. There was no change in postoperative clinical status.

Conclusions

Out data suggest that combined MEP and SEP monitoring is mandatory to detect impairment of the functional integrity of spinal cord pathways during surgery. On the other hand, intraoperative monitoring is still feasible, if one of both methods is not applicable.