Abstract
A microcomputer-based automated spinal cord monitoring system was developed and 56 spinal operations have been carried out with it since 1986. The system comprises an electrodiagnostic system (Dantec 2000M), an FM tape recorder, a channel selector, an electrical relay, a Modem and a microcomputer which controls all of the elements. The program allowed for automated recording and analysis of evoked potentials during spinal surgery and alarm signals were generated according to the criteria of amplitude decrease and latency delay. It was demonstrated that automated spinal cord monitoring in the operating room was performed easily, reliably and safely allowing the surgeon to react quickly to possible compromise of the spinal cord. The design and usefulness of the system is described in this report.
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Ariyama H, Atsuta Y, Ando M, Goto E 1989 Sciatic nerve monitoring system during hip arthroplasty. Clinical Orthopaedic Surgery (in press).
Atsuta Y, Harada Y, Iwahara T, et al 1987 Relationship between locomotor function and spinal cord evoked potential during acute spinal cord compression. Journal of Electrodiagnosis of the Spinal Cord 10(1): 5–8.
Boston J R, Deneault L G 1984 Sensory evoked potentials: A system for clinical testing and patient monitoring. International Journal of Clinical Monitoring and Computing 1(1): 13–19.
Edwards B N, Tullos H S, Noble P C 1987 Contributory factors and etiology of sciatic nerve palsy in total hip arthroplasty. Clinical Orthopaedics and Related Research 218: 136–141.
Engler G L, Spielholz N I, Bernhard W N, et al 1978 Somatosensory evoked potentials during harrington instrumentation for scoliosis. The Journal of Bone and Joint Surgery 60-A(4): 528–532.
Friedman W A, Curran M T 1987 Somatosensory Evoked Potentials after Sequential Extremity Stimulation:A New Method for Improved Monitoring Accuracy. Neurosurgery 21(5): 755–758.
Gopalan R, Parker P A, Scott R N 1986 Microprocessor-based system for Monitoring spinal evoked potentials during surgery. IEEE Transactions Biomedical Engineering 33(10): 982–985.
Harada Y 1983 Study on experimental spinal cord injuries by distraction using spinal cord evoked potentials. Journal of the Japanese Orthopaedic Associatia 57: 685–701.
Imai M, Harada Y, Atsuta Y, et al 1986 Microcomputer-based system for automated measurements and analysis of spinal cord evoked potentials. Proceedings of 6th Joint Conference on Medical Informatics, pp 207–208.
Imai M, Harada Y, Atsuta Y, et al 1987 Automated spinal cord monitoring system using a micro-computer. Journal of Electrodiagnosis of the Spinal Cord 10(1): 75–78.
Iwahara T, Harada Y, Atsuta Y, et al 1987 Relation between spinal cord evoked potential and spinal cord blood flow under spinal cord distraction. Journal of Electrodiagnosis of the Spinal Cord 10(1): 83–86.
Johanson N A, Pellicci P M, Tsairis P, et al 1983 Nerve injury in total hip arthroplasty. Clinical Orthopaedics and Related Research 179: 214–222.
Jones S J, Edgar M A, Ransford A O, et al 1983 A system for the electrophysiological monitoring of the spinal cord during operations for scoliosis. Journal of Bone and Joint Surgery 65-b(2): 134–139.
Kaplan B J, et al 1986 Somatosensory evoked potential monitoring of spinal cord ischemia during aortic operations. Neurosurgery 19: 82–90.
Kurokawa T 1972 Spinal cord action potentials evoked by epidural stimulation of cord—A report of human and animal record. Japanese Journal of Electroencephalography, Electromyography and Clinical Neurophysiology 1: 64.
Lee K, Hirabayashi S, Hoshino Y, et al 1987 Spinal cord monitoring during operations on aortic aneurysm. Journal of Electrodiagnosis of the Spinal Cord 10(1): 95–98.
Micheli-Tzanakou J, Ingeholm J Jr, Haber L 1984 Collection and storage of data for evoked potential studies: A database. Computer Programs in Biomedicine 18: 51–60.
Nash C L, Lorig R A, Schatzinger L A, et al 1977 Spinal cord monitoring during operative treatment of the spine. Clinical Orthopaedics and Related Research 126: 100–105.
Ponte A 1973 Postoperative paraplegia due to hypercorrection of Scoliosis Research Society, Gothenburg, Sweden, 17–21 September.
Ryan T P, Britt R H 1983 Intraoperative Cortical and Spinal SEP Monitoring. Proceedings of the Annual Conference IEEE Engineering Medical Biological Society 5: 225–230.
Scoliosis Research Society 1987 Morbidity and Mortality Report.
Stone R G, Weeks L E, Hajdu M, et al 1985 Evaluation of sciatic nerve compromise during total hip arthroplasty. Clinical Orthopaedics and Related Research 201: 26–31.
Tamaki T, Yamashita T, Kobayashi H, et al 1972 Spinal cord monitoring. Japanese Journal of Electroencephalography, Electromyography and Clinical Neurophysiology 1: 196.
Tamaki T, Tsuji H, Inoue S 1981 The prevention of iatrogenic spinal cord injury utilizing the evoked spinal cord potential. International Orthopaedics (SICOT) 4: 313–317.
Weber E R, Daube J R, Coventry M B, et al 1976 Peripheral neuropathies associated with total hip arthroplasty. The Journal of Bone and Joint Surgery 58-A(1): 66–69.
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Imai, M., Harada, Y., Atsuta, Y. et al. Automated spinal cord monitoring for spinal surgery. Spinal Cord 27, 204–211 (1989). https://doi.org/10.1038/sc.1989.30
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DOI: https://doi.org/10.1038/sc.1989.30