Main description:

The spinal cord has a characteristic structure and functions that are distinct from those of the brain. Its functions are tremendously important since it modulates the peripheral sensory inputs to the dorsal horn, and it gives rise to the ascending pathways transmitting peripheral afferent inputs to the brain, and conveys the descending pathways from the brain both to the lower motor neurons, the final common pathway, and to dorsal horn sensory neurons. In spite of these vital functions, the spinal cord constitutes only a small percent age of the mass of the human central nervous system and is located far from the skin surface, which has obstructed the recording of its electrical activity. Recently, however, important advances have been made in several recording techniques, including epidural recording or averaging methods, allowing both sensory and motor evoked spinal cord potentials in man to be recorded. This volume is based on the papers presented at the Fourth International Symposium on Spinal Cord Monitoring and Electrodiagnosis. Each of these international symposia has brought together many of the specialists involved in this research, with an important increase in the number of participants since the first symposium was held in Toyko in 1981. At the past symposia several attempts were made to standardize data, techniques, and clinical applications and to integrate the new findings into patient care.

Contents:

I. Basic Considerations.- A. Animal Studies: 1. Neurophysiology of Spinal Cord.- The Spinothalamic Tract and Other Ascending Nociceptive Pathways of the Spinal Cord.- Motor and Sensory Tract Activation Following Epidural Electrical Stimulation.- Effects of Electric Current Application on the Evoked Spinal Cord Potentials in Dogs.- The Significance of Motor Evoked Spinal Cord Potentials Recorded from the Ventral Root in Cats.- Monitoring Motor Function of the Spinal Cord: The Descending Segmental Evoked Spinal Cord Potential.- Experimental Study of the Origin of Transcranially Evoked Descending Spinal Cord Potentials.- The Use of the Dog as a Model for Spinal Cord Monitoring Research.- 2. Neuropharmacology of Spinal Cord.- Neurotransmitter Receptors and Voltage-Operated Channels Expressed by Rat Spinal Cord mRNA in Xenopus Oocytes.- Prototypical Features of the Inhibitory Synapses in the Frog Spinal Cord as Revealed Pharmacologically.- Metabolic Depression of the Spinal Cord and Brain with Epidural Bupivacaine in Rats.- The Effects of Sevoflurane on Heterosegmental Slow Positive Cord Potentials in the Rat.- The Effects of Anesthetics on the Ventral Root Potential in Spinal Cats.- The Effects of Anesthetics on Spinal Cord Nociceptive Neural Activities.- Monitoring the Expression of the C-fos Proto-Oncogene to Study the Spinal Circuits that Contribute to Pain and its Control.- 3. Pathophysiology of Spinal Cord.- Electrophysiological Differentiation Between Muscle and Sensory Nerve Funiculi for Peripheral Nerve Repair.- Experimental Studies on the Spinal Cord Evoked Potentials in Cervical Spine Distraction Injuries.- Experimental Studies on the Spinal Cord Evoked Potentials in Compression Injury of the Cervical Spinal Cord.- Comparison Between Spinal Cord Evoked Potential and Cortical Evoked Potential by Experimental Dorsal Compression on the Thoracic Spinal Cord.- Spinal Cord Functions with Spinal Evoked Potentials and Spinal Blood Flow by Retracting the Spinal Cord.- New and Sensitive Methods for Detecting Acute Axonal Dysfunction After Experimental Spinal Cord and Root Compression Injury.- Physiological and Pharmacological Aspects of the Modulation of Nociceptive Transmission at the Dorsal Horn Level of the Spinal Cord.- B. Human Studies: 1. Electrical Stimulations.- Etomidate Augmentation of Scalp Recorded Somatosensory Waves: Time Course, Reproducibility, and Dose Effect.- Four Components and Their Origins of the Ascending Spinal Potential Evoked by Stimulation at the Conus Medullaris Level.- Somatotopical Evoked Responses from the Spinal Cord and Cerebral Cortex to Finger Stimulation.- Spinal Evoked Potentials After Stimulation of Ventral Roots: Do Ventral Root Afferents Exist in Man?.- Spinal Evoked Potentials and Spine-Scalp Propagation Velocities: Origins, Conduction Characteristics, and Clinical Observations.- Evoked Potential Patterns in Chronic Spinal Cord Lesions.- Observation of the Circulation of Cauda Equina in Spinal Canal Stenosis Following Electrical Stimulation of Peripheral Nerves.- Short Latency Somatosensory Evoked Potentials to Stimulation of Different Lower Extremity Nerves: Nature of Generator Sources as Inferred from Scalp Topography.- Reflexes Evoked in Various Human Muscles During Voluntary Activity.- 2. Magnetic Stimulations.- Peripheral Electrophysiological Correlates to Magnetic Transcranial Stimulation.- Motor Evoked Potentials Following Transcranial Magnetic Stimulation in Cervical Myelopathy.- Magnetic Transcutaneous Stimulation of the Motor Pathway in Spinal Cord Disorders.- Clinical Application of Motor Evoked Potentials in Disorders of the Spine.- Motor Evoked Potentials: Issues in Safety and Operative Monitoring.- II. Clinical Applications.- A. Monitoring.- Prognostication of Surgical Outcome in Cervical Spondylotic Myelopathy Using Evoked Spinal Cord Potentials.- Intraoperative Spinal Cord Monitoring Using Evoked Spinal Cord Potentials on Spinal Cord Tumors.- Clinical Correlations of Intraoperative Evoked Potential Monitoring in Spinal Cord Disorders.- Intraoperative Evoked Potential Monitoring: Fringe Benefits in the Operating Room.- Ketamine as a Major Component of an Anesthetic Plan for Spinal Cord Monitoring.- Sensory and Motor Thresholds to Electrical Stimulation of Ankles and Wrists During Spinal Cord Monitoring.- Somatosensory Evoked Potential Recordings for Decision Making on Instrumentation During Scoliosis Surgery.- Incidence of Spinal Cord Impairment Related to Extent of SEP Decline and Recovery, Aetiology and Instrumentation in Operations for Scoliosis.- Pre- and Intraoperative Electrodiagnosis of Compressive Lumbosacral Nerve Root Lesions.- Intraoperative Monitoring of Segmental Evoked Spinal Cord Potentials in Cervical Lesions.- Intraoperative Evoked Potential Monitoring in Patients with Poliomyelitis.- Motor Evoked Potentials Monitoring During Neurosurgical Operations on the Spinal Cord.- Analysis of Conductive Spinal Cord Function Using Spinal Cord Evoked Potentials During Surgery of Spinal Cord Tumors.- Anorectal Pressure Monitoring During Surgery for Reuntethering of the Spinal Cord in Cases of Lumbosacral Lipomyelomeningocele.- The Effect of Hypothermia on SEPs Recorded from the Posterior Pharynx and the Scalp During Cardiopulmonary Bypass in Man.- Spinal Cord Monitoring in Aortic Aneurysm Surgery.- B. Electrodiagnosis.- Somatosensory Evoked Potentials and Spinal Evoked Potentials in Patients with Cervical Myelopathy and Cerebrovascular Disease.- Spinal Evoked Potentials and Abnormal Sensory Modalities in Spinal Cord Injuries and Peripheral Neuropathies.- Dermatomal Somatosensory Evoked Potentials (DSSEPs) in Patients with Cervical Lesions and Brachial Plexus Injuries in Comparison with Somatosensory Evoked Potentials (SSEPs).- Level Diagnosis Using Spinal Cord Evoked Potentials in Cervical Myelopathy.- Experience of Diagnosis of Thoracic Myelopathy Using Spinal Cord Evoked Potentials.- Peripheral Versus Central Mechanisms for Integration.- Central Somatosensory Conduction Time.- Somatosensory Evoked Potentials After Posterior Tibial Nerve Stimulation in Children with Neurological Disorders.- Lumbosacral Evoked Potentials and Nerve Conduction Study to Posterior Tibial Nerve Stimulation in Patients with Long-Term Anticonvulsant Therapy.- Clinical Assessment of the Prognosis and Severity of Spinal Cord Injury Using Corticospinal Motor Evoked Potentials.- Killed-End Corticospinal Motor Evoked Potential (MEP) in Patients with Spinal Cord Injury.- Correlation of Somatosensory Evoked Potential Abnormalities with Brain and Cervical Cord Magnetic Resonance Imaging in Multiple Sclerosis.- Comparison Between Magnetic Resonance Imaging and Somatosensory Evoked Potentials in Chronic Spinal Cord Injury Patients.