Spinal Cord Monitoring. Electrophysiological Measures of Sensory and Motor Function During Spinal Surgery

History of the development of intraoperative spinal cord monitoring

“…Another group of orthopaedic surgeons used stimulation of the spinal cord to evoke peripheral muscle contraction [36]. Similar to the muscle evoked potential after brain stimulation, this potential was much more difficult to record under general anaesthesia.…”

Thoracolumbar spinal deformity: Part II. Developments from 1990 to today

“…The monitoring of MEPs provides feedback from descending motor pathways via the use of magnetic scalp coils. Machida and colleagues 68 subsequently introduced spinal MEP monitoring of peripheral nerve responses, which was later popularized by Owen et al 85 in the early 1990s. The monitoring of MEPs was initially used to minimize the discrepancy that can occur when crossing of ascending and descending track signals.…”

Direct Spinal Cord Electrical Stimulations during Surgery of Intramedullary Tumoral and Vascular Lesions

“…Some authors have suggested the use of motor evoked potentials, based on the principle of transcranial electrical [26] or magnetic [38] stimulation of the motor cortex, with recording from the spinal epidural (or subdural) space, or from peripheral nerves, or from muscles [7,12,29,40]. However, this method is difficult to perform in the operative room, and is not precise, because of the inability to stimulate the upper and lower, or left and right extremities separately [12].…”

“…These findings are explained by the fact that this method is unable to assess the functional integrity of either the anterior spinal cord or the motor pathways. Motor evoked potentials were also tried during spinal surgery [29,39,40], but not widely used because of their imprecision and the many technical difficulties of the procedure.…”