Somatosensory Evoked Potential Monitoring of Spinal Cord Ischemia during Aortic Operations

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Abstract
Somatosensory evoked potentials were monitored in 22 consecutive patients undergoing surgical correction of an aortic coarctation. Induction of spinal cord ischemia by cross clamping of the aorta elicited a change in the evoked potential in 9 patients (41%). These alterations occurred within 5 minutes of aortic clamping in 3 cases and after 18 to 21 minutes in the remaining 6 cases. Loss of the somatosensory evoked potential for more than 14 minutes was associated with postoperative neurological deficit. Alteration of the evoked potential within 5 minutes of aortic cross clamping was significantly related to poor collateral circulation shown on the preoperative aortogram. The pathophysiology of evoked potential changes in spinal ischemia is discussed in detail.

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