What is an advantage of referential recording compared to bipolar recording for SSEPs?

The advantage of referential recording compared to bipolar recording for somatosensory evoked potentials (SSEPs) primarily lies in the ability to avoid cancellation of the potentials when recording from adjacent levels. In referential recording, the signals from multiple locations can be compared against a common reference point, which helps in accurately assessing the potential generated from targeted areas of interest. This is particularly important when analyzing responses from neighboring regions where potentials may overlap.

In contrast, bipolar recording relies on measuring the difference between two electrodes placed close to each other. This arrangement can sometimes lead to a situation where signals from adjacent sources may interfere, causing potential cancellation or attenuation of the recorded response, thereby making it less reliable in environments where overlapping signals are expected.

When it comes to assessing the integrity of the ascending sensory pathways during surgery, maintaining the clarity of the evoked potentials is crucial, and referential recording optimally facilitates this by minimizing interference, an essential factor in intraoperative monitoring.