Evoked potentials in experimental myelopathy.

Evoked potentials recorded from the cerebral cortex and spinal cord secondary to peripheral stimulation are reversibly reduced in amplitude by both pathologic distraction and pathologic flexion of the vertebral column. While the cerebral responses are lost within two minutes after complete occlusion of the ascending aorta, the responses recorded from the spinal cord persist without change for approximately ten minutes and then gradually disappear. During the first few minutes after aortic occlusion, changes produced by spinal distraction and spinal flexion are indistinguishable from those produced when the same maneuvers are made with the aorta patent. The responses mediated by dorsal columns and corticospinal tracts are affected in the same way by flexion and distraction, suggesting that somatosensory evoked potential recordings should be a reliable means of detecting spinal cord dysfunction during surgical procedures affecting the spinal cord. It may also be possible to differentiate a mechanical from a vascular insult by the time required for the evoked potential to become abnormal following a particular surgical maneuver.