Use of sensory-evoked potentials recorded from the human occiput for intraoperative physiologic monitoring of the spinal cord

R. John Hurlbert, Michael G. Fehlings, Maria S. Moncada

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Study Design This is a report of a prospective case series. ObjectiveThe purpose of this study was to determine whether evoked potential activity recorded from occipital scalp electrodes in humans is similar to that recorded in animals, and to evaluate the independence of this activity from the classical somatosensory-evoked potential. Summary of Background DataIntraoperative somatosensory-evoked potentials can be of limited usefulness in predicting spinal cord injury because they are transmitted primarlly through the dorsal columns, and therefore do not reflect integrity of important ventral pathways. It recently has been shown in animal studies that a sensory-evoked potential recorded from the cerebellum is mediated via ventral tracts and is useful as an adjunct to the somatosensory-evoked potential in spinal cord monitoring. MethodsTwenty-five patients undergoing spinal or posterior fossa surgery were consecutively entered into the study. Evoked responses were recorded transcranially from over the cerebellar hemispheres and from the vertex. Recordings were made directly from the surface of the cerebellar hemispheres in seven of these patients. ResultsWaveforms could be recorded and reproduced in all but one of the patients. The overall appearance of the occipital recordings was similar to the appearance of responses obtained in animals. The mean latency of the first negative peak recorded from the ipsilateral occiput was 33.0 msec (standard deviation, 3.7 msec) compared with 52.4 msec (standard deviation, 6.1 msec) for the somatosensory-evoked potential. In addition, the amplitude of this response (0.35 V; standard deviation, 0.20 V) was independent of the amplitude of the somatosensory-evoked potential (0.76 V; standard deviation, 0.69 V). In five cases, one evoked potential could be recorded in the absence of the other. Recordings from the surface of the cerebellum were of the same morphology, but of greater amplitude than the transcranial recordings.

Original languageEnglish (US)
Pages (from-to)2318-2327
Number of pages10
JournalSpine
Volume20
Issue number21
StatePublished - Nov 1995
Externally publishedYes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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