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A Comparison of Dermatomal and Major Nerve Evoked Responses with Clinical Diagnosis in Acute Spinal Injury

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Neurophysiology and Standards of Spinal Cord Monitoring

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Abstract

The present status of evoked potential technology has made it relatively commonplace to monitor activity along the sensory neural pathways in human peripheral nerves, spinal cord and the brain. It has been widely applied for monitoring of these pathways during surgical procedures where undesired trauma may occur. Similarly, it can be utilized to evaluate the functional integrity of an already traumatized spinal cord and the process of recovery from that injury. Several such studies using somatosensory evoked potentials (SEPs) have been published regarding the evaluation of patients who have sustained spinal cord injuries (1–6). The patients in these studies were generally evaluated with lower extremity (e.g., posterior tibial or peroneal nerve) SEPs because the signals obtained from such stimulation in normal individuals are relatively large in amplitude and have characteristic morphologies. It has been accepted that the presence of a SEP resulting from stimulation of a nerve originating below the level of injury in the period of 24 hours to one week post injury is a favorable prognostic sign. This is thought to indicate an incomplete lesion where return of some degree of neural function is possible. On the other hand, the consistent absence of such a signal is an unfavorable prognostic indicator and generally correlates with a complete lesion.

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Authors and Affiliations

  1. Department of Anesthesia, Northwestern University Medical School, 303 East Superior Street, Passavant Pavillion — Room 360, 60611, Chicago, IL, USA

    J. R. Toleikis

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  1. J. R. Toleikis
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  2. T. B. Sloan
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Editor information

Editors and Affiliations

  1. University of Maryland, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  2. Johns Hopkins University, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  3. Division of Surgical Research, St. Luke’s Spine Center, Cleveland, OH, USA

    Richard H. Brown Ph.D (Director, Research Director) (Director, Research Director)

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© 1988 Springer-Verlag New York Inc.

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Toleikis, J.R., Sloan, T.B. (1988). A Comparison of Dermatomal and Major Nerve Evoked Responses with Clinical Diagnosis in Acute Spinal Injury. In: Ducker, T.B., Brown, R.H. (eds) Neurophysiology and Standards of Spinal Cord Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3804-1_36

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  • DOI: https://doi.org/10.1007/978-1-4612-3804-1_36

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8359-1

  • Online ISBN: 978-1-4612-3804-1

  • eBook Packages: Springer Book Archive

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