Intraoperative monitoring of sensory-evoked potentials: efficacy of epidural recording

Purpose of the study To evaluate the usefulness of the epidural recording i n scoliosis surgery in children or young adults. Material and method We used somatosensory-evoked potentials in 60 children or young adults in surgical treatment of scoliosis. Somatosensory-evoked po tentials were elicited and recorded using a standard method recording of co rtical P40 and subcortical P27, simultaneously with the monitoring of spina l cord function using epidural electrode to record the ascending somatosens ory volley (by tibial nerve stimulation) at a high thoracic level. Results The use of subcortical and epidural recording sites for the somatos ensory-evoked potentials indicated that a reliable response could be obtain ed in 96 p. 100 of the patients. Cortical somatosensory-evoked demonstrated a 48 p. 100 false positive rate. Discussion Epidural recording in scoliosis surgery is safe and reliable. Co mbined subcortical and epidural recordings are especially useful in patient s with neuromuscular scoliosis or with cerebral palsy that may not have rel iable cortical potentials.