Clinical application of evoked spinal cord potentials elicited by direct stimulation of the cord during temporary occlusion of the thoracic aorta

Paraplegia is a severe and disastrous complication of operations on the thoracic aorta. For preventing this complication, we employed evoked spinal cord potentials elicited by direct stimulation of the cord (ESPs-dsc) during operations on 89 patients with various aortic lesions. ''Delayed'' paraplegia occured in two patients with ''no change'' (n=59) and ''change with return'' (n=19) response (3%), ''immediate'' paralysis occured in three and ''delayed'' paraplegia occured in one of those with ''change with inconsistent return'' (n=6) response(67%), and all of those with ''change without return'' (n=5) response developed ''immediate'' paraplegia(100%). We conclude that ESPs-dsc is a good indicator of spinal cord ischemia and we can improve the outcome according to its changes.