SOMATOSENSORY EVOKED POTENTIALS (SEP) IN CERVICAL SPINAL CORD COMPRESSION

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The present investigation uses Somatosensory Evoked Potentials (SEPs) to assess spinal cord function in 50 patients undergoing cervical decompression. The primary objective of this study is to determine the relationship between preoperative, intraoperative and postoperative SEPs, and the neurological outcome of patients following cervical spinal cord decompression. An additional focus is on the effect of bolus and continuous infusion of muscle relaxants (vercuronium bromide) on the SEPs. Preoperatively, the patients will undergo a standardized neurological examination, as well as an evoked potentials recording. The median nerve at the wrist will be stimulated and clavicular (Erb's), cervical (C2 and C7), and cortical (contralateral cortex) evoked potentials will be obtained. The recordings will be taken at the Erb's and contralateral cortex. After baseline recording is obtained, one group (N=25) will receive an intravenous bolus of vercuronium (0. 1mg/kg), and the other group (N=25) will receive continuous infusion (0.9-1 .7ug/kg/min) of vercuronium during their operative procedures. Ten minutes after administration of vercuronium, SEPs will be recorded in each group. SEPs will be monitored and evaluated during essential stages, as well as at the end of the operative procedures. Three months postoperatively another set of SEPs will be performed. The protocol will be identical with the preoperative one. The patients also will undergo a follow up neurological examination.