[Intraoperative monitoring of spinal cord function in spinal and spinal cord surgery]

It has become essential to monitor spinal cord function during operations which may involve the risk of stretching, compressing, or injuring the spinal cord, or compromise its blood supply. The recordings of sensory and motor functions include the spinal cord-evoked potential (SCEP), motor-evoked potential (MEP), and somatosensory-evoked potential (SEP). Each of these recordings is not sufficient as a single modality to evaluate the integrity of spinal cord function, so they are used in combination. In particular, to prevent and detect early motor disturbance, the MEP is widely used, which has the advantages of the lowest invasiveness and greatest case of setting. Although spinal cord monitoring is conducted by surgeons, anesthetists, and medical technologists, it should preferably be performed by those routinely engaged in neurophysiological examinations including intraoperative monitoring. Its success depends largely on good coordination and mutual trust between surgeons, anesthesiologists, operative nurses, and clinical engineers, as well as the development of individual expertise.