Neural Monitoring: The Prevention of Intraoperative Injury (Neurotrauma)

Acute spinal injury, although relatively uncommon, can result in serious loss of motor and sensory function, and is thus one of the most catastrophic medical conditions. In the work first reported here, it has been demonstrated that intraoperative neural monitoring by electrophysiological means should now be considered standard care for surgical procedures that carry risk of CNS injury. Neural Monitoring covers many new developments in the prevention and treatment of spinal cord injury, especially the use of somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs), in patient monitoring during many neurosurgical and orthopedic procedures. Although still largely considered experimental and not in routine use, intraoperative monitoring techniques using evoked-potential analyses are here shown to have a clear benefit in the prevention of injury to the patient. Experts in all aspects of neural monitoring have contributed chapters covering: neural substrates of normal somatosensory-evoked potentials • mechanisms of evoked potential responses to injury • clinical experience with somatosensory-evoked potentials • cerebrocortical and spinal motor monitors • future trends. Salzman's new book on Neural Monitoring is at the cutting edge of this exciting, high-powered new field and holds the promise of a bright future for new techniques to prevent CNS injury during surgery. It is an indispensable resource for all neurosurgeons, neurologists, orthopedic surgeons, and other specialists concerned with improving patients' chances for survival and drastic reduction of surgical risk.