Monitoring the spinal cord during corrective spinal surgery : a clinical study of TES-MEP

Abstract

This thesis reports from clinical studies of TES-MEP neuromonitoring used in the Sint Maartenskliniek for corrective spinal surgery since 1997. It has been shown that TES-MEP can be used in surgical procedures at all spinal levels and in different patients groups, even in patient groups for which neuromonitoring was thought to be impossible, such as patients with neuromuscular deficits. Good criteria to interpret TES-MEP monitoring results have been determined and no false negatives occurred, which was a great concern when using somatosensory evoked potentials (SSEP) in the past. Based on published results in this thesis, I conclude that TES-MEP monitoring should be applied in all high-risk spinal procedures. It has been shown to be an effective, practical and reliable technique to monitor the motor tract that allows the surgical team to prevent permanent post-operative neurological deficits.