Neurophysiological monitoring during spinal endovascular procedures

Abstract

Publisher Summary This chapter explores that all vascular lesions involving the spine, the spinal cord, and the surrounding tissues are potential candidates for endovascular embolization. The indications include preoperative treatment to decrease vascularity and therefore, intraoperative blood loss, palliation for incurable diseases, and curative therapy by embolization alone. The chapter reviews that all spinal endovascular procedures are performed under general anesthesia and neurophysiological monitoring. The role of neurophysiological monitoring varies depending on the nature of the disease and the procedures performed. Motor evoked potentials (MEPs) and somatosensory evoked potentials (SEPs) retain their own specificity to assess the functional integrity of motor and sensory pathways. The chapter concludes that neurophysiological monitoring and pharmacological provocative testing during endovascular procedures also offer a unique opportunity to investigate the spinal cord hemodynamics, and to integrate functional and vascular anatomy.