Intraoperative monitoring for surgery of the spinal cord and cauda equina

Abstract

The spinal cord is the conduit by which sensory input and motor output influence human behavior. Although the function of the spinal cord mostly involves moving information to and from the brain, there are several important functions that are regulated at the level of the cord and even more functions that local spinal cord circuits influence or modulate. Surgery of the spinal cord or cauda equina carries with it the risk of serious complications, including paralysis and other morbidities that have the potential to negatively impact the quality of life of a patient forever [1, 2]. Nevertheless, there are certain pathologies that have no other treatment option than surgical intervention [3-5]. Intraoperative monitoring and mapping of the spinal cord and cauda equina are helpful for protecting spinal cord function during surgery as well as providing the surgeon with real-time functional information that may allow more aggressive and complete treatment of the pathology [6-8]. This chapter will discuss spinal cord monitoring for surgery to remove intramedullary spinal cord tumors and for spinal cord untethering.