Development of intraoperative measuring device for spinal cord potentials and prevetion of paraplegia during thoraoabdominal aortic surgery

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The purpose of this study is to develop the device and procedure for trans-intercostal nerve evoked spinal cord potentials. We devised special electrodes to stimulate intercostals nerve and record spinal cord potebtials through intercostals nerve stimulation. We performed animal experiments of this electrode for trans-intercostal nerve evoked potentials using mongrel dogs and evaluated efficacy of this electrode to detect spinal cord potentials instead of motor evoked spinal cord potnetials. The results of this experiment are as follows1) In animal experiments using mongrel dogs, trans-intercostal nerve evoked spinal cord potentials showed accurate spinal cord electrogram, which was the same elecrogram as motor evoked spinal cord potentials. In addition, electrogram of trans-intercostal nerve evoked spinal cord potential was not effected by operative procedure and anesthesia.2) After animal experiments recording trans-intercostal nerve evoked spinal and potential, autopsy was performed The same region, in which trans-intercostal nerve evoked spinal cord potentials changed during aortic cross damping, involved critical interostals artery which supply spinal cord. We used red regin stain method to identify the critical Ma/pastels artery3) In clinical experiences, trans-intercostal nerve evoked spinal cord potentials could be detected in the intercostal nerves from Th7 to Th12. Trans-intercostal nerve evoked spinal cord potentials were taken very clearly and not influenced by anesthetic agents, including asipiratory and venous anesthetic agents. Trans-intercostal nerve evoked spinal cord potential could be used intraoperative monitoring of spinal cord ischemia instead of monitoring by motor and sensory evoked spinal cord potentials.