Mf. Coscia et al., EFFECT OF ANESTHETIC VARIABLES ON DERMATOMAL SOMATOSENSORY-EVOKED POTENTIAL MONITORING IN ELECTIVE LUMBAR SPINAL SURGERY, Journal of spinal disorders, 8(6), 1995, pp. 451-456
We studied 108 adult cases of elective lumbar surgery using dermatomal
somatosensory-evoked potential (DSEP) monitoring to evaluate its usef
ulness due to concern over potential neurologic injury during pedicle
screw insertion. Both surgeons used all of the necessary precautions r
equired during surgery so that DSEP monitoring was not the ''primary,'
' but rather a backup system for operative security. Quality tracings
were obtained in 71% of cases; anesthetic difficulties being the major
cause of poor monitoring. There were no neurological complications re
lated to pedicle screw insertion. We found that DSEP monitoring was an
excellent method to verify intraoperative neurological status, but re
quired a high degree of cooperation between the anesthesiologists, mon
itoring technician, and surgeons, In today's cost-containment environm
ent, its usefulness is subjected to the expertise of the spine surgeon
and the hospital setting.