Main description:

Acute spinal injury, although relatively uncommon, can result in serious loss of motor and sensory function, and is thus one of the most catastrophic medical conditions. In the work first reported here, it has been demonstrated that intraoperative neural monitoring by electrophysiological means should now be considered standard care for surgical procedures that carry risk of CNS injury. Neural Monitoring covers many new developments in the prevention and treatment of spinal cord injury, especially the use of somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs), in patient monitoring during many neurosurgical and orthopedic procedures. Although still largely considered experimental and not in routine use, intraoperative monitoring techniques using evoked-potential analyses are here shown to have a clear benefit in the prevention of injury to the patient. Experts in all aspects of neural monitoring have contributed chapters covering: neural substrates of normal somatosensory-evoked potentials * mechanisms of evoked potential responses to injury * clinical experience with somatosensory-evoked potentials * cerebrocortical and spinal motor monitors * future trends.
Salzman's new book on Neural Monitoring is at the cutting edge of this exciting, high-powered new field and holds the promise of a bright future for new techniques to prevent CNS injury during surgery. It is an indispensable resource for all neurosurgeons, neurologists, orthopedic surgeons, and other specialists concerned with improving patients' chances for survival and drastic reduction of surgical risk.

Contents:

Basic Aspects of Evoked Neural Activity and Spinal Trauma Neural Substrates of Normal Somatosensory-Evoked Potentials. Field Theory as it Pertains to SEP Analysis.The Generators of the Human Spinal Somatosensory-Evoked Potentials. Pathophysiology and Pharmacology of Experimental Spinal Cord Injury. Neurochemical and Vascular Interactions in Experimental Spinal Cord Injury. Pharmacological Treatment of Acute, Experimental Spinal Cord Injury. Mechanisms of Evoked Potential Responses to Injury. Axonal Morphometric Correlates of Evoked Potentials in Experimental Spinal Cord Injury. Neurophysiological Mechanisms of Somatosensory-Evoked Potential Changes. Clinical Application of Electrophysiologic Methods for Intraoperative Neural Monitoring. Established Methods-Clinical Experience with Somatosensory-Evoked Potentials. Neural Monitoring During Orthopaedic Spine Surgery: Rationale and Case Studies. Reliability of Cortical Somatosensory-Evoked Potentials in Monitoring (Pediatric Orthopedic) Spinal Procedures. Invasive Somatosensory-Evoked Potential Monitoring. The Non-Pathological Variability of Somatosensory-Evoked Potentials. New Methods-Cerebrocortical and Spinal Motor Monitors. Quantified EEG Detects Ischemia: A Case Report. Motor Evoked Potentials. Anesthetic Considerations of Operative Safety. Evoked-Potential Analysis of the Protective Effect of Halothane in Experimental Spinal Cord Injury. Anesthetic Considerations in Spinal Surgery. The Present and Future of Neural Monitoring and Operative Safety. Clinical Review: Orthopedic Surgery. Preventing and Detecting Intraoperative Spinal Cord Injury. Conclusion. Index.