Why are dural or direct cord recordings advantageous when monitoring SSEPs?

Dural or direct cord recordings provide advantages when monitoring somatosensory evoked potentials (SSEPs) primarily because the waveforms generated from these recordings are higher in amplitude. This increased amplitude allows for a clearer representation of the neural signals being monitored, making them easier to detect and analyze compared to those obtained from scalp leads, which may have lower signal strength due to the distance the signals must travel through various tissues.

Furthermore, having higher amplitude signals means that fewer responses may be needed to achieve a reliable trace. This is particularly beneficial in intraoperative settings where time is often of the essence, and reducing the number of trials can streamline the monitoring process while maintaining the integrity of the data.

While it is true that other considerations such as patient comfort and artifact reduction are relevant factors in monitoring practices, the significant advantage of dural or direct cord recordings lies in their ability to provide more robust and clearer waveforms, resulting in improved clinical decision-making during procedures involving the nervous system.