Human motor evoked potential responses following spinal cord transection: an in vivo study

Abstract

<jats:p>Motor evoked potential (MEP) monitoring has been used increasingly in conjunction with somatosensory evoked potential monitoring to monitor neurological changes during complex spinal operations. No published report has demonstrated the effects of segmental spinal cord transection on MEP monitoring.</jats:p> <jats:p>The authors describe the case of an 11-year-old girl with lumbar myelomeningocele and worsening thoracolumbar scoliosis who underwent a T11–L5 fusion and spinal transection to prevent tethering. Intraoperative MEP and somatosensory evoked potential monitoring were performed, and the spinal cord was transected in 4 quadrants. The MEPs were lost unilaterally as each anterior quadrant was sectioned.</jats:p> <jats:p>This is the first reported case that demonstrates the link between spinal cord transection and MEP signaling characteristics. Furthermore, it demonstrates the relatively minor input of the ipsilateral ventral corticospinal tract in MEP physiology at the thoracolumbar junction. Finally, this study further supports the use of MEPs as a specific intraoperative neuromonitoring tool.</jats:p>

Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences

“…In our study, we registered incidents in 7.8% of the patients, but only 3.1% required an intraoperative action. In line with the results from our study, there is scientific evidence to suggest that the use of intraoperative neurophysiological monitoring is essential to prevent lasting neurological damage as a result of spinal correction [11,24,25]. Therefore, it is still of great clinical value to continue with neurophysiological intraoperative monitoring to avoid neurological damage during scoliosis surgery.…”