Neuromonitoring for Spinal Cord Stimulation Lead Placement Under General Anesthesia.
10.3988/jcn.2018.14.4.444
- Author:
Jay L SHILS
1
;
Jeffrey E ARLE
Author Information
1. Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA. Jay_l_shils@rush.edu
- Publication Type:Review
- Keywords:
Spinal cord stimulation;
EMG;
Standard somatosensory evoked potential;
Collision;
Neurophysiology
- MeSH:
Action Potentials;
Anesthesia, General*;
Evoked Potentials, Somatosensory;
Extremities;
Humans;
Neurophysiology;
Spinal Cord Stimulation*;
Spinal Cord*
- From:Journal of Clinical Neurology
2018;14(4):444-453
- CountryRepublic of Korea
- Language:English
-
Abstract:
Spinal cord stimulation (SCS) is a common therapeutic technique for treating medically refractory neuropathic back and other limb pain syndromes. SCS has historically been performed using a sedative anesthetic technique where the patient is awakened at various times during a surgical procedure to evaluate the location of the stimulator lead. This technique has potential complications, and thus other methods that allow the use of a general anesthetic have been developed. There are two primary methods for placing leads under general anesthesia, based on 1) compound muscle action potentials and 2) collisions between somatosensory evoked potentials. Both techniques are discussed, and the literature on SCS lead placement under general anesthesia using intraoperative neurophysiological mapping is comprehensively reviewed.
