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The technique of using evoked spinal cord potentials (SCPs) has become an important
clinical tool for monitoring spinal cord surgery and diagnosing spinal cord diseases.
The technique is a result both of the technical development of recording evoked
SCPs from the epidural space without perforation of the dura mater and of the development
of medical electronics. Its use as a monitoring tool is based on continuous
epidural analgesia with an epidural catheter. Since the first development of epidural
recording of evoked SCPs in 1971, the technique has been applied in various institutes,
particularly for monitoring during spine or spinal cord surgery and cardiovascular
surgery, and recently for diagnosis of spinal cord diseases.
Although the results of studies on monitoring during surgery have proved useful,
more detailed neurophysiological mechanisms in the origin of each component of
evoked SCPs remain to be explained in the area of diagnosis of spinal or central
nervous system diseases. Further neurophysiological and neuropharmacological
studies of the human spinal cord may contribute to the clinical application of recording
evoked SCPs for diagnosis of spinal cord diseases.
The aim of this book is to furnish a survey of the neurophysiological and neuropharmacological
bases of evoked SCPs with reference to animal studies and the
techniques of recording the potentials mainly from the spinal epidural space. The
authors have been involved in the field from the beginning of the 1970s. Many illustrations
are presented for better understanding the neurophysiological and neuropharmacological
backgrounds of monitoring spinal cord functions. Case studies
also are presented and discussed to provide more insight into the monitoring and
diagnosis of spinal cord dysfunctions and spinal cord diseases.
This book is thus appropriate even for students or those new to the fields of clinical
neurophysiology, neurosurgery, neurology, orthopedics, and neuroanesthesia who
are interested in monitoring spinal cord function during surgery or diagnosing spinal
cord diseases. A diverse range of terminology has been used in the literature to date,
sometimes leading to misinterpretation of each component in the field of evoked
SCPs. To avoid such misinterpretation and to provide readers with an accurate understanding,
terminology referring to basic animal studies is used, and lucid explanations
are included in this volume. |