Abstract
Spinal cord evoked potentials (SCEPs) were recorded epidurally in 95 surgical cases of cervical and/or thoracic compressive myelopathy. Abnormal SCEPs occurred in 91% of the patients with cervical myelopathy and in all with thoracic involvement at the levels suspected to be responsible for neurological damage. Abnormal SCEPs correlated significantly with the severity of spinal cord compromise and symptoms, such as myelopathy. It was not possible to predict postoperative neurological improvement on the basis of the preoperative SCEP findings alone, but better neurological improvement after surgery was closely associated with early recovery of intra- and postoperative SCEPs. Epidural SCEPs are therefore useful in making a level-specific diagnosis, especially in the patient with multilevel vertebral involvement, and in assessing the severity of neurological compromise and surgical outcome to some extent.
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Brown R H, Nash C L Jr . Intra-operative spinal cord monitoring. Chapter 27. In: Frymoyer JW (ed). The Adult Spine: Principles and Practice. Raven Press: New York 1991, pp 557–558.
Dawson E G, Sherman J E, Kanim L E A, Nuwer M R . Spinal cord monitoring: results of the Scoliosis Research Society and European Spinal Deformity Society survey. Spine 1991; 16: S361–S365.
Kalkman C J, Drummond J C . Intraoperative evaluation using somatosensory and motor evoked potentials. In: Garfin SR, Northrup BE (eds). Surgery for Spinal Cord Injuries. Raven Press: New York 1993, pp 33–44.
Nash C L Jr, Brown R H . Current concepts review: spinal cord monitoring. J Bone Joint Surg Am 1989; 71: 627–630.
Zentner J, Rieder G . Diagnostic significance of motor evoked potentials in space-occupying lesions of the brainstem and spinal cord. Eur Arch Psychiatr Neurol Sci. 1990; 239: 285–289.
Baba H, Shima I, Tomita K, Umeda S, Sawada Y . Somatosensory evoked potentials in cervical myelopathy. In: Schramm J, Jones SJ (eds). Spinal Cord Monitoring. Springer-Verlag: Berlin Heidelberg 1985, pp 284–289.
Baba H, Tomita K, Umeda S . Clinical study of spinal cord evoked potentials. In: Ducker TB, Brown RH (eds). Neurophysiology and Standards of Spinal Cord Monitoring. Springer-Verlag: New York 1988, pp 216–221.
Baba H, Tomita K, Maezawa Y, Imura S . Intermittent claudication of the spinal cord due to ossification of the ligamentum flavum. Int Orthop 1993; 17: 169–172.
Satomi K, Okuma T, Kenmotsu K, Nakamura Y, Hirabayashi K . Level diagnosis of cervical myelopathy using evoked spinal potentials. Spine 1986; 13: 1217–1224.
Kotani H, Senzoku F, Hattori S, Moritake A, Hara T, Omote K . Evaluation of cervical cord function using spinal evoked potentials from surface electrode. Spine 1992; 17: 339–344.
Kikuchi Y, Baba H, Kawahara N, Nagata S, Tomita K, Nomura S, Yugami H . Experience of diagnosis of thoracic myelopathy using spinal cord evoked potentials. In: Shimoji K, Kurokawa T, Tamaki T, Willis WD Jr (eds). Spinal Cord Monitoring and Electrodiagnosis. Springer-Verlag: Berlin Heidelberg 1991, pp 461–471.
Japanese Orthop Assn. Criteria on evaluation of the treatment of cervical myelopathy. J Jpn Orthop Assn (Tokyo) 1976; 49: addendum No. 12.
Baba H, Tomita K, Kawahara N, Kikuchi Y, Imura S . Spinal cord evoked potentials in thoracic myelopathy with multi-segmental vertebral involvement. Spine 1992; 17: 1291–1295.
Baba H, Kawahara N, Tomita K, Imura S . Spinal cord evoked potentials in cervical and thoracic myelopathy. Int Orthop 1993; 17: 82–86.
Baba H, Kawahara N . Spinal cord evoked potential monitoring in orthopaedic spinal surgery. In: Dimitrijevic MR, Halter JA (eds). Atlas of Human Spinal Cord Evoked Potentials. Butter-worth Heinemann: Boston 1995, pp 123–131.
Schramm J, Krause R, Shigeno T, Brock M . Experimental investigation on the spinal cord evoked injury potential. J Neurosurg 1983; 59: 485–492.
Halter J A, Haftek I, Sarzynska M, Dimitrijevic M R . Spinal cord evoked injury potentials in patients with acute spinal cord injury. J Neurotrauma 1989; 6: 231–245.
Prestor B, Zgur T, Dolenc V V . Incomplete spinal cord evoked injury potential in man. Spine 1993; 18: 252–256.
Tomita K, Nomura S, Umeda S, Baba H . Cervical laminoplasty to enlarge the spinal canal in multilevel ossification of the posterior longitudinal ligament with myelopathy. Arch Orthop Trauma Surg 1988; 107: 148–153.
Baba H, Furusawa N, Imura S, Kawahara N, Tsuchiya H, Tomita K . Late radiographic findings after cervical fusion for spondylotic myeloradiculopathy. Spine 1993; 18: 2167–2173.
Baba H, Furusawa N, Imura S, Kawahara N, Tomita K . Laminoplasty following anterior cervical fusion for spondylotic myelopathy. Int Orthop 1994; 18: 1–5.
Baba H, Furusawa N, Chen Q, Imura S, Tomita K . Anterior decompressive surgery for cervical ossified posterior longitudinal ligament causing myeloradiculopathy. Paraplegia 1995; 33: 18–24.
Baba H, Furusawa N, Chen Q, Imura S . Cervical laminoplasty for ossified posterior longitudinal ligament. Paraplegia 1995; 33: 25–29.
Nagata S, Baba H, Kawahara N, Kikuchi Y, Tomita K, Nomura S, Yugami H . Experimental studies on the spinal cord evoked potentials in compression injury of the cervical spinal cord. In: Shimoji K, Kurokawa T, Tamaki T, Willis WD Jr (eds). Spinal Cord Monitoring and Electrodiagnosis. Springer-Verlag: Berlin Heidelberg 1991, pp 116–121.
Baba H, Kawahara N, Nagata S, Tomita K, Imura S . Spinal somatosensory evoked potentials in compressive and distraction injury. Paper presented at the 59th Annual Meeting of the American Academy of Orthopaedic Surgeons, February 20-25, 1992, Washington, D.C., USA.
Kawahara N, Baba H, Nagata S, Kikuchi Y, Tomita K, Yugami H . Level diagnosis of cervical myelopathy using somatosensory evoked potentials. In: Jones SJ, Boyd S, Hetreed M, Smith NJ (eds). Handbook of Spinal Cord Monitoring. Kluwer Academic: Dordrecht 1994, pp 192–196.
Tomita K, Kawahara N, Baba H, Kikuchi Y, Nishimura H . Circumspinal decompression for thoracic myelopathy due to ossification of the posterior ligament and ligamentum flavum. Spine 1990; 15: 1114–1120.
Shinomiya K, Okamoto A, Komori H, Matsuoka T, Yoshida H, Muto N, Furuya K . Prognosticating study for cervical myelopathy using evoked spinal cord potentials. Spine 1990; 15: 1053–1057.
Baba H, Tomita K, Umeda S, Kawahara N, Nagata S, Nomura S, Yugami H . Experimental ascending evoked potentials in spinal cord injury. In: Ducker TB, Brown RH (eds). Neurophysiology and Standards of Spinal Cord Monitoring. Springer-Verlag: New York 1988, pp 46–51.
Takano H, Kitagawa H, Yamamoto N, Takakuwa K, Tsuji H . Origins and conducting tracts of evoked spinal cord potentials in cats. J Spinal Disord 1991; 4: 455–461.
Barker A T, Freeston I L, Jalinous R, Jarratt J A . Noninvasive stimulation of motor pathways within the brain using time-varying magnetic field. Electroencephalogr Clin Neurophysiol 1985; 61: 245–246.
Dimitrijevic M R, Eaton W J, Sherwood A M, Van der Linden C . Assessment of corticospinal tract integrity in human chronic spinal cord injury. In: Rossini PM, Marsden CD (eds). Neurology and Neurobiology, Volume 41, Non-invasive Stimulation of Brain and Spinal Cord. Fundamentals and Clinical Applications. Alan R. Liss: New York 1988, pp 243–253.
Dvorák J, Herdmann J, Janssen B, Theiler R, Grob D . Motor-evoked potentials in patients with cervical spine disorders. Spine 1990; 15: 1013–1016.
Katz R T, Vandenburg C, Weinberge D, Cadwell J . Magneto-electric stimulation of human motor cortex: normal values and potential safety issues in spinal cord injury. Arch Phys Med Rehabil 1990; 71: 597–600.
Baba H, Tomita K, Umeda S, Kawahara N, Nagata S, Kikuchi Y . Somatosensory cortical evoked potentials in cervical OPLL myelopathy. Clin Orthop Surg (Tokyo) 1988; 23: 1409–1416.
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Baba, H., Maezawa, Y., Imura, S. et al. Spinal cord evoked potential monitoring for cervical and thoracic compressive myelopathy. Spinal Cord 34, 100–106 (1996). https://doi.org/10.1038/sc.1996.18
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DOI: https://doi.org/10.1038/sc.1996.18
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