Since Vauzelle and associates first reported in 1973 on the functional
monitoring of spinal cord activity during surgery on the spine, we have
used intraoperative awakening routinely in patients undergoing surgery
involving distraction of the spinal column. Of the 166 consecutive patients
studied, three were discovered to have a neural deficiency when they were
awakened during surgery. These deficits disappeared immediately on release
of the distracting force. Although it is unlikely that all three patients
would have proceeded to paraplegia, we believe that this is a safe and
sensitive test which will identify patients in danger of neural
complications.