Clinical Review: Orthopedic Surgery

  • Clyde L. NashJr.
Part of the Neurotrauma book series (NT)


Monitoring of spinal cord function during corrective spinal surgery is a concept that has been actively considered for over twenty years. The introduction of the Wake Up test and the publication of early reports of the use of somatosensory-evoked potentials (SEPs) for assessment of intraoperative spinal cord monitoring arrived independently in the early 1970’s. Since then there has been a growing interest and activity in this work with numerous international symposia, many articles and not a small amount of debate. The interest in this subject is worldwide and the ramifications of it’s development are profound.


Spinal Instrumentation Scoliosis Research Society Potential Monitoring Spinal Cord Function Sublaminar Wiring 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Ben-David, B.: Spinal cord monitoring. Orthop. Clin. North Am., 2:427–448, 1988.Google Scholar
  2. 2.
    Ben-David, B., Taylor, P.D., Haller, G.S.: Posterior spinal fusion complicated by posterior column injury: A case report of a false-negative wake-up test. Spine 12:540–543, 1987.PubMedCrossRefGoogle Scholar
  3. 3.
    Ben-David, B., Haller, G., Taylor, P.: Anterior spinal fusion complicated by paraplegia: A case report of a false-negative somatosensory-evoked potential. Spine 12:536–539, 1987.PubMedCrossRefGoogle Scholar
  4. 4.
    Bieber, E., Tolo, V. and Uematsu, S.: Spinal cord monitoring during posterior spinal instrumentation and fusion. Clin. Orthop. Rel. Res., 229:121–124, 1988.Google Scholar
  5. 5.
    Bradford, D., Hensinger, R.: The Pediatric Spine. Thieme Inc., New York, Chapter 31, 1985.Google Scholar
  6. 6.
    Britt, R.H. and Ryan, T.P.: Use of a flexible epidural stimulating electrode for intraoperative monitoring of somatosensory-evoked potentials. Spine 11:348–351, 1986.PubMedCrossRefGoogle Scholar
  7. 7.
    Brown, R.H.: Personal communication.Google Scholar
  8. 8.
    Campbell’s Operative Orthopaedics: C.V. Mosby Company, Chapter 71, 1987.Google Scholar
  9. 9.
    Chapman, M.W.: Operative Orthopaedics. J. B. Lippincott Company, Chapters 157, 158, 159, 160, 1988.Google Scholar
  10. 10.
    Epps, C. H.: Complications in Orthopaedic Surgery. J. B. Lippincott Company, Chapter 40, 1986.Google Scholar
  11. 11.
    Ginsburg, H.H., Shetter, A.G. and Raudzens, P.: Postoperative paraplegia with preserved intraoperative somatosensory-evoked potentials. A case report. J. Neurosurg. 63:296–300, 1985.PubMedCrossRefGoogle Scholar
  12. 12.
    Herron, L.D., Trippi, A.C., Gonyeau, M.: Intraoperative use of dermatomal somatosensory-evoked potentials in lumbar stenosis surgery. Spine 12:379–383, 1987.PubMedCrossRefGoogle Scholar
  13. 13.
    Johnson, C.E., Happel, L.T., Norrie, R., Burke, S.W., King, A.G. and Roberts, J.M.: Delayed paraplegia complicating sublaminar segmental spinal instrumentation. J. Bone Joint Surg. (Am), 68:556–563, 1986.Google Scholar
  14. 14.
    Kiem, H.G., Hajdu, M., Gonzalez, E.G., Brand, L. and Balasubramanian, E.: Somatosensory-evoked potentials as an aid in the diagnosis and intraoperative management of spinal stenosis. Spine 10:338–344, 1985.CrossRefGoogle Scholar
  15. 15.
    Lesser, R.P., Raudzens, P., Luders, H., Nuwer, M.R., Goldie, W.D., Morris, H.H., Dinner, D.S., Klem, G., Hahn, J.F., Shetter, A.G., Ginsburg, H.H. and Gurd, A.R.: Postoperative neurological deficits may occur despite unchanged intraoperative somatosensory-evoked potentials. Ann. Neurol. 19:22–25, 1986.PubMedCrossRefGoogle Scholar
  16. 16.
    MacEwen, G.D., Bunnell, W.P. and Sriram, K.: Acute neurological complications in the treatment of scoliosis: a report of the Scoliosis Research Society. J. Bone Joint Surg. (Am), 47:404–408, 1975.Google Scholar
  17. 17.
    Machida, M., Weinstein, S.L., Yamada, T. and Kiumura, J.: Spinal cord monitoring: electrophysiological measures of sensory and motor function during spinal surgery. Spine 10:407–413, 1985.PubMedCrossRefGoogle Scholar
  18. 18.
    Moe’s Textbook of Scoliosis: W.B. Sauders, Chap. 22, 1987.Google Scholar
  19. 19.
    More, R.C., Nuwer, M.R and Dawson, E.G.: Cortical evoked potential monitoring during spinal surgery: sensitivity, specificity, reliability and criteria for alarm. J. Spine Disorders 1:75–80.Google Scholar
  20. 20.
    Nuwer, M.R.: Evoked Potential Monitoring in the Operating Room. New York, Raven Press, 246pp, 1986.Google Scholar
  21. 21.
    Roy, E.P., Gutmann, L., Riggs, J.E., Jones, E.T., Byrd, J.A. and Ringel, R.A.: Intraopertive somatosensory-evoked potential monitoring in scoliosis. Clin. Orthop. Rel. Res., 229:94–98.Google Scholar
  22. 22.
    Ryan, T.P. and Britt, R.H.: Spinal and cortical somatosensory-evoked potential monitoring during corrective spinal surgery with 108 patients. Spine 10:352–361, 1986.CrossRefGoogle Scholar
  23. 23.
    Schrader, S.C., Sloan, T.B. and Toleikis, J.R.: Detection of sacral sparing in acute spinal cord injury. Spine 12:533–535, 1987.PubMedCrossRefGoogle Scholar
  24. 24.
    Schubert, A., Drummond, J.C. and Garfin, S.R.: The influence of stimulus presentation rate on the cortical amplitude and latency of intraoperative somatosensory-evoked potential recordings in patients with varying degrees of spinal cord injury. Spine 12:969–973, 1987.PubMedCrossRefGoogle Scholar
  25. 25.
    Scoliosis Research Society Morbidity and Mortality Report. 1982, Schmitt, E.W., Jr. Scoliosis Research Society Morbidity and Mortality Report, 1987, Lowe, T.G.Google Scholar
  26. 26.
    Szalay, E.A., Carollo, J.J. and Roach, J.W.: Sensitivity of spinal cord monitoring to intraoperative events. J. Pediatr. Orthop. 6:437–441, 1986.PubMedCrossRefGoogle Scholar
  27. 27.
    York, D.H., Chabot, R.J. and Gaines, R.W.: Response variability of somatosensory-evoked potentials during scoliosis surgery. Spine 12:864–876, 1987.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1990

Authors and Affiliations

  • Clyde L. NashJr.
    • 1
  1. 1.Spine CenterSt. Luke’s HospitalClevelandUSA

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