Intraoperative spinal cord mapping during spinal cord tumor surgery

Abstract

The main treatment for most patients with intramedullary spinal cord tumors is surgical resection. Intraoperative neurophysiological monitoring can be applied in this case to reduce the risk for the occurrence of postoperative neurological complications. In addition to motor-evoked, somatosensory-evoked potentials and the bulbocavernosus reflex, which are applied in various spinal surgery types, 'spinal cord mapping (SCM)' can be used for intramedullary spinal cord tumor surgery. Two examples are the dorsal column mapping before myelotomy to determine the electrophysiological midline, to attempt minimizing the postoperative dorsal column damage, and motor tract mapping to reduce the risk of motor-pathway damage during tumor removal. Our review explores the research published overseas regarding these two mapping methods, including technical aspects and key points in the mapping application. Although SCM has not yet been established in Korea, its application is expected to increase soon.