[Possibilities and limits of intraoperative functional assessment of the spinal cord]

Based on a series of 95 neurosurgical spinal cord monitoring cases with space-occupying lesions, most of which were monitored using both spinal and cortical recordings, the use and the limits of intraoperative monitoring of sensory pathway function of the spinal cord is described. Intraoperative spinal cord monitoring performed by recording of somatosensory evoked potentials following peripheral nerve or intrathecal stimulation is shown to be a useful adjunct in cases of difficult spinal cord surgery. In our own material using both spinal and cortical recordings there have been no false-negative monitoring cases so far. In the discussion the limitations and pitfalls of this technique are reviewed.