SPINAL-CORD AND NERVE ROOT MONITORING IN SPINE SURGERY AND RELATED PROCEDURES

Intensive research in the field of intraoperative neurophysiologic mon itoring has been performed directed at finding reliable stimulating an d recording techniques and adequate anesthetic regimes applicable to s pinal procedures. The aim is a comprehensive monitoring not only of af ferent and efferent spinal cord pathways but also of sensory and motor nerve roots and cauda equina fibers. Conventional somatosensory evoke d potentials (SEPs) are complemented by motor evoked potentials, derma tomal sensory evoked potentials, spinal cord evoked potentials, evoked electromyography, sensory and motor fiber mapping of the cauda equina , bulbocavernosus reflex testing, and neurogenic evoked potentials. Ap art from describing the essentials of these techniques and their indic ations and limitations, this article deals with the influence of anest hetic management on the production and interpretation of evoked potent ials.