VALUE OF SOMATOSENSORY EVOKED POTENTIALS FOR SPINE PATHOLOGY STUDY
https://doi.org/10.14531/ss2005.3.101-110
Abstract
Objective. To analyze the efficacy of dynamic neurophysiologic monitoring for diagnosis and treatment of patients with spine diseases and injuries during decompression and decompression/stabilization surgery of the spine.
Materials and Methods. Somatosensory evoked potentials (SSEP) were recorded in 297 patients with the spine diseases and injuries. Besides, 118 patients underwent intraoperative monitoring of SSEP and neural evoked potentials. Patients with abdomen dysfunction were examined by cystometry, profilometry, and urofluometry.
Results. Neurophysiological examinations for spine injuries allow to verify the level of spinal cord conductor injury and to assess the degree of functional disorders in spinal cord structures. In degenerative spine the changes in SSEP parameters occur only in disturbed spinal arteriovenous and venous circulation accompanied by expressed motor and sensitive conduction disorders. The SSEP study is most informative when inflammatory process is localized in the cervical or thoracic spine. In different forms of dysraphic status (diastematomyelia, syringomyelia, Chiari malformation) the SSEP study can not be a determinative diagnosis method.
Conclusion. Considering the relative simplicity of SSEP study and its value for dynamic examination of spinal cord conductors, it can be recommended as an obligatory test to assess indications for spine surgery for vascular disorders associated with degenerative-dystrophic diseases of the spine.
About the Authors
Arkady Anatolyevich VishnevskyRussian Federation
Oksana Vasilyevna Posokhina
Russian Federation
Olesya Vladimirovna Ryzhova
Russian Federation
Sergey Alekseyevich Tikhodeev
Russian Federation
Vladimir Aleksandrovich Fadeev
Russian Federation
References
1. Вишневский А.А., Тиходеев С.А., Посохина О.В. Оценка диагностики соматосенсорных вызванных потенциалов при хирургическом и консервативном лечении у больных после травмы позвоночника и спинного мозга // Вопросы нейрохирургии. 1998. № 4. С. 30–35.
2. Вишневский А.А., Посохина О.В., Иванова Т.А. и др. Роль соматосенсорных вызванных потенциалов в оценке лечения больных с дегенеративно-дистрофическими заболеваниями пояснично-крестцового отдела // Вопросы нейрохирургии. 2000. № 3. С. 14–20.
3. Гнездицкий В.В. Вызванные потенциалы мозга в клинической практике. Таганрог, 1997.
4. Рыжова О.В. Тиходеев С.А., Вишневский А.А. Нейрофизиологический интраоперационный мониторинг в реконструктивно-восстановительных операциях на позвоночнике: проблемы и перспективы // Человек и здоровье: Тез. докл. VI конгресса. СПб., 2001. С. 168–169.
5. Рыжова О.Е., Тиходеев С.А., Вишневский А.А. и др. Оценка возможностей нейрофизиологического мониторинга в реконструктивно-восстановительных операциях на позвоночнике // Вопросы нейрохирургии. 2003. № 1. C. 27–32.
6. American Electroencephalographic Society: Guideline nine: Guidelines on Evoked Potentials // J. Clin. Neurophysiol. 1994. Vol. 11. P. 40–73.
7. Dawson E.G., Sherman J.E., Kanim L.E., et al. Spinal cord monitoring. Results of the Scoliosis Research Society and the European Spinal Deformity Society survey // Spine. 1991. Vol. 16. (8 Suppl.). P. S361–S364.
8. Kotani H., Senzoku F., Hattori S., et al. Evaluation of cervical cord function using spinal evoked potentials from surface electrode // Spine. 1992. Vol. 17. P. 339–344.
9. Owen J.H. Monitoring during surgery for spinal deformities // In: Bridwell K.H., DeWald R.L., eds. The Textbook of Spinal Surgery. Philadelphia, 1997. P. 39–60.
10. Owen J.H. The application of intraoperative monitoring during surgery for spinal deformity // Spine. 1999. Vol. 24. P. 2649–2662.
11. Nuwer M.R., Dawson E.G., Carlson L.G., et al. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multi-center survey // Electroencephalogr.Clin.Neurophysiol. 1995. Vol. 96. P. 6–11.
12. Komanetsky R.M., Padberg A.M., Lenke LG., et al. Neurogenic motor evoked potentials: a prospective comparison of stimulation methods in spinal deformity surgery // J. Spinal Disord. 1998. Vol. 11. P. 21–28.
Review
For citations:
Vishnevsky A.A., Posokhina O.V., Ryzhova O.V., Tikhodeev S.A., Fadeev V.A. VALUE OF SOMATOSENSORY EVOKED POTENTIALS FOR SPINE PATHOLOGY STUDY. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2005;(3):101-110. (In Russ.) https://doi.org/10.14531/ss2005.3.101-110