Whittle I R, Johnston I H, Besser M
J Neurosurg. 1986 Apr;64(4):601-12. doi: 10.3171/jns.1986.64.4.0601.
The authors' experience with intradural and epidural recording of spinal somatosensory evoked potentials (SSEP's) during 26 cases of spinal surgery is described. The techniques of monitoring spinal cord function provided good quality SSEP waveforms in patients both with and without neurological deficits. The SSEP configuration and peak latencies remained stable for up to 5 hours during anesthesia with nitrous oxide, halothane, and fentanyl. Patterns of baseline SSEP's were characteristic of different spinal segments. Distortion and asymmetry of these baseline patterns were seen in several patients with spinal neoplasms. Loss of waveform components during surgery occurred with profound hypotension, overdistraction of the vertebral axis, dorsal midline myelotomy, and removal of intramedullary tumors. Persistent loss of waveform components was associated with an acquired neurological deficit. Fluctuations in the amplitude of the SSEP's were common but were not associated with postoperative neurological deficits. Spinal cord monitoring by means of SSEP recording would appear to be useful during extradural spinal surgery, but there are limitations associated with this technique during some types of intradural surgery.
本文描述了作者在26例脊柱手术中进行硬脊膜内和硬脊膜外脊髓体感诱发电位（SSEP）记录的经验。监测脊髓功能的技术在有或没有神经功能缺损的患者中均能提供高质量的SSEP波形。在使用氧化亚氮、氟烷和芬太尼麻醉期间，SSEP波形和峰潜伏期长达5小时保持稳定。基线SSEP的模式是不同脊髓节段的特征。在一些患有脊柱肿瘤的患者中可见这些基线模式的畸变和不对称。手术期间波形成分的丢失发生在严重低血压、脊柱过度牵张、背侧中线脊髓切开术以及髓内肿瘤切除时。波形成分的持续丢失与获得性神经功能缺损相关。SSEP振幅的波动很常见，但与术后神经功能缺损无关。通过SSEP记录进行脊髓监测在硬脊膜外脊柱手术中似乎是有用的，但在某些类型的硬脊膜内手术中该技术存在局限性。
