Article

For intra-operative neurophysiological monitoring during spine and spinal cord
surgery, the challenge is to detect, in real-time, the occurrence of neurological
impairment at onset in order to remedy the problem as quickly as possible before
it becomes definitely acquired and irreversible. The past three decades were
marked by considerable technical progress. Feasibility and reliability have now
reached a very high level. A multimodal approach combining simultaneous
monitoring of somatosensory and motor pathways has enabled a considerable decline
in the rate of false negatives reported in the 80s when somatosensory evoked
potentials (SSEP) were monitored alone. Several methods of monitoring are
described in the literature. Combining transcranial electric stimulation of
muscle motor evoked potentials (mMEP) and cortical SSEP allows non-invasive and
selective monitoring of the posterior columns and pyramidal tract. One of the
most widely used techniques internationally backed by a broad consensus within
the International Society of Intra-operative Neurophysiology (ISIN), this
technique remains exceptional in French-speaking countries. We expose here the
methodological aspects for the readers of La Revue Neurologique.
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Langue : FRANCAIS