{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:17:21Z","timestamp":1769044641558,"version":"3.49.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:p>The authors report herein a case of anterior cervical discectomy and fusion (ACDF) surgery in which findings on somatosensory evoked potential (SSEP) monitoring led to the correction of carotid artery compression in a patient with a vascularly isolated hemisphere (no significant collateral blood vessels to the carotid artery territory). The amplitude of the cortical SSEP component to left ulnar nerve stimulation progressively decreased in multiple runs, but there were no changes in the cervicomedullary SSEP component to the same stimulus. When the lateral (right-sided) retractor was removed, the cortical SSEP component returned to baseline. The retraction was then intermittently relaxed during the rest of the operation, and the patient suffered no neurological morbidity. Magnetic resonance angiography demonstrated a vascularly isolated right hemisphere.<\/jats:p>\n<jats:p>During anterior cervical spine surgery, carotid artery compression by the retractor can cause hemispheric ischemia and infarction in patients with inadequate collateral circulation. The primary purpose of SSEP monitoring during ACDF surgery is to detect compromise of the dorsal column somatosensory pathways within the cervical spinal cord, but intraoperative SSEP monitoring can also detect hemispheric ischemia. Concurrent recording of cervicomedullary SSEPs can help differentiate cortical SSEP changes due to hemispheric ischemia from those due to compromise of the dorsal column pathways. If there are adverse changes in the cortical SSEPs but no changes in the cervicomedullary SSEPs, the possibility of hemispheric ischemia due to carotid artery compression by the retractor should be considered.<\/jats:p>","DOI":"10.3171\/2016.4.spine151481","type":"journal-article","created":{"date-parts":[[2016,6,10]],"date-time":"2016-06-10T16:04:04Z","timestamp":1465574644000},"page":"566-571","source":"Crossref","is-referenced-by-count":10,"title":["Somatosensory evoked potential monitoring detection of carotid compression during ACDF surgery in a patient with a vascularly isolated hemisphere"],"prefix":"10.3171","volume":"25","author":[{"given":"Alan D.","family":"Legatt","sequence":"first","affiliation":[{"name":"Departments of Neurology,"},{"name":"Neuroscience, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avra S.","family":"Laarakker","sequence":"additional","affiliation":[{"name":"Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan P.","family":"Nakhla","sequence":"additional","affiliation":[{"name":"Neurosurgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rani","family":"Nasser","sequence":"additional","affiliation":[{"name":"Neurosurgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Altschul","sequence":"additional","affiliation":[{"name":"Neurosurgery, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-spine151481","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2230","DOI":"10.1097\/00007632-199410000-00020","article-title":"Internal carotid artery thrombosis after cervical corpectomy","volume":"19","author":"Chozick","year":"1994"},{"key":"b2-spine151481","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1001\/archneur.1979.00500390058005","article-title":"Spinal cord evaluation by cortical evoked responses","volume":"36","author":"Cusick","year":"1979"},{"key":"b3-spine151481","series-title":"Anesth Analg","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1213\/01.ane.0000195580.31382.38","article-title":"Cerebral ischemia as an apparent complication of anterior cervical discectomy in a patient with an incomplete circle of Willis","volume":"102","author":"Drummond","year":"2006"},{"key":"b4-spine151481","series-title":"Surg Neurol Int","doi-asserted-by":"publisher","first-page":"88","DOI":"10.4103\/2152-7806.74147","article-title":"A review of the management of posterior communicating artery aneurysms in the modern era","volume":"1","author":"Golshani","year":"2010"},{"key":"b5-spine151481","series-title":"Intraoperative Neurophysiology: Interactive Case Studies","first-page":"7","article-title":"Case 39","author":"Legatt","year":"2015"},{"key":"b6-spine151481","series-title":"Am J EEG Technol","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1080\/00029238.1995.11080516","article-title":"Intraoperative neurophysiologic monitoring: Some technical considerations","volume":"35","author":"Legatt","year":"1995"},{"key":"b7-spine151481","series-title":"Intraoperative Monitoring of Neural Function. 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