Spinal Cord Mapping with Somatosensory Evoked Potentials (SSEP) in Cervical and Thoracic Surgeries

Authors

  • Faisal R. Jahangiri Global Innervation LLC, Dallas, Texas, USA; Department of Neuroscience, School of Behavioral & Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA; Labouré College of Healthcare, Milton, Massachusetts, USA. https://orcid.org/0000-0002-1342-1977
  • Aisha Khan Global Innervation LLC, Dallas, Texas, USA; Arkansas College of Osteopathic Medicine, Fort Smith, Arkansas, USA.
  • Tal Allouche School of Behavioral & Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.
  • Hiral Gorasia , School of Behavioral & Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.
  • Yabsera Mesfin School of Behavioral & Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.
  • Nicholas Bathurst School of Behavioral & Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.

DOI:

https://doi.org/10.5281/zenodo.10207942

Keywords:

SSEP, MEP, EMG, mappin, cervical, thoracic, surgery, intramedullary tumor, phase reversal

Abstract

Intraoperative neurophysiological monitoring (IONM) is commonly used in surgeries to reduce post-operative deficits. IONM uses multiple modalities, including SSEP, TCeMEP, and EMG. In this chapter, we will discuss the use of SSEP in mapping the spinal cord for cervical and thoracic surgeries that involve intramedullary tumor resections.

We use SSEP phase reversals and collision studies to find the midline raphe to make a safe incision. We can either directly stimulate the spinal cord and record from the brain to tell the difference between the right and left dorsal columns, or we can stimulate the peripheral nerve (median or tibial), cause a collision with an epidural stimulator, and look for decreased amplitude of signal in the cortex.

Mounting evidence suggests that mapping the spinal cord using SSEP is a safe and effective method that can be used to determine the location of the midline raphe separating the sensory tracts for the midline myelotomy and epidural stimulator placement. SSEP monitoring is also an effective way to prevent postoperative deficits by constantly monitoring SSEP throughout the surgery.

In conclusion, we can say that cortical spinal mapping helps locate the midline raphe, which can help surgeons during surgical procedures to help keep the dorsal columns unharmed.

References

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Volume 1, Issue 1

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Published

2023-07-20

How to Cite

Jahangiri, F. R., Khan, A., Allouche, T., Gorasia, H., Mesfin, Y., & Bathurst, N. (2023). Spinal Cord Mapping with Somatosensory Evoked Potentials (SSEP) in Cervical and Thoracic Surgeries. J of Neurophysiological Monitoring, 1(1), 37–43. https://doi.org/10.5281/zenodo.10207942

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Vol. 1 No. 1 (2023): J of Neurophysiological Monitoring

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