Abstract： Objective:To investigate the protective role of conventional motor evoked potentials (MEP) and somatosensory evoked potentials (SEP) in combination with D wave monitoring and potential reversal techniques for patients′ neurological function during spinal cord intramedullary tumor resection.Methods:We conducted a historical control study on clinical data of 76 patients who underwent spinal cord intramedullary tumor resection at the Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University from July 2019 to December 2020 (preoperative McCormick grade Ⅰ to Ⅱ). All patients were divided into conventional monitoring group (using conventional electrophysiological techniques for interoperative monitoring, including MEP and SEP, 38 cases) and combined monitoring group (using the conventional electrophysiological techniques combined with D wave monitoring and potential reversal technique, 38 cases). Patients′ preoperative McCormick rating and its changes at 2 weeks post operation, as well as during postoperative follow-up period, postoperative intensive care duration, length of hospital stay, tumor resection rate, Short Form 36 (SF-36) score, and other indicators were compared between the two groups to examine the protective effects of different monitoring methods on patients′ neurological function.Results:There were no statistically significant differences between the two groups of patients in terms of gender, age, location of tumor, and initial symptoms and preoperative McCormick rating (all P>0.05), while the McCormick grade of the combined monitoring group was superior to that of the conventional monitoring group 6 months after operation ( χ2=5.68, P=0.017). The McCormick grade 2 weeks after the operation did not differ between the two groups ( χ2=0.26, P=0.642). No significant differences were found in postoperative intensive care duration, hospital stay, or total/subtotal tumor resection rate (all P>0.05). SF-36 scores significantly differed between the two groups at 6 month post operation ( t=3.10, P=0.003). For the electrophysiological indicators used in each group, the negative and positive predictive rates of the conventional monitoring group were 86.7% and 25.0% respectively, and those of the combined monitoring group were 93.9% and 40.0% respectively. Conclusion:The application of routine electrophysiological monitoring (SEP+ MEP) combined with D wave and potential reversal technology during spinal cord intramedullary tumor resection can help protect the patients′ nerve function and my play a role in predicting the nerve function.