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Spinal cord pathways mediating somatosensory evoked potentials

S K Powers, C A Bolger, M S Edwards

    Journal of Neurosurgery
    |October 1, 1982
    PubMed
    Summary
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    High-intensity nerve stimulation reveals spinal cord pathways contributing to somatosensory evoked potentials (SEP). This method may improve intraoperative spinal cord function assessment compared to current practices.

    Area of Science:

    • Neuroscience
    • Spinal Cord Physiology
    • Evoked Potentials

    Background:

    • Cortical somatosensory evoked potentials (SEP) are used to assess spinal cord function.
    • Current methods utilize low-intensity stimulation, potentially limiting accuracy.
    • Understanding specific neural pathways contributing to SEP is crucial for improving assessment techniques.

    Purpose of the Study:

    • To investigate the contribution of different spinal cord tracts to cortical SEP.
    • To evaluate the efficacy of high-intensity nerve stimulation for intraoperative spinal cord monitoring.

    Main Methods:

    • Discrete thoracic spinal cord lesions were created in cats using a CO2 laser under ketamine and xylazine anesthesia.
    • Cortical SEP were recorded following high-intensity (20x motor threshold) stimulation of the posterior tibial nerve.

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  • Nine combinations of unilateral spinal cord lesions were studied.

    • Main Results:

    • Nerve fibers in the ipsilateral dorsal column, ipsilateral dorsal spinocerebellar tract, and contralateral ventrolateral tracts contribute to cortical SEP.
    • Dorsal spinocerebellar tract lesions affected early SEP waves (ipsilateral stimulation).
    • Ventrolateral tract lesions primarily altered later SEP waves (contralateral stimulation).
    • Dorsal column lesions impacted both early and late SEP waves (ipsilateral stimulation).
    • Lesion effects were non-additive, indicating pathway interactions.

    Conclusions:

    • High-intensity peripheral nerve stimulation, activating C and A fibers, offers a more accurate method for intraoperative spinal cord function assessment.
    • Anesthetic agents that preserve cortical activity are important for accurate SEP interpretation.