Intraoperative neuromonitoring in pediatric spinal deformity surgery

Pediatric spinal deformity includes a broad range of disorders with differing causes, natural histories, and treatments. Spinal deformity surgery is performed to arrest the progression of and correct coronal and sagittal plane deformities including scoliosis and kyphosis. It is also undertaken to improve cosmesis and decrease the pain that can be associated with certain types of spinal deformity. Iatrogenic spinal cord injury remains the most feared complication of corrective spine surgery. Intraoperative neuromonitoring may be the single innovation that has had the greatest impact in lowering neurological complication rates over the last 2 decades. It is currently recommended in pediatric spinal deformity surgery whenever cord-level spinal instrumentation is planned and reliable signals can be anticipated. This article will briefly discuss common types of pediatric spinal deformity and corrective spine surgery. The use of intraoperative neuromonitoring in pediatric spine surgery will also be reviewed. As our abilities to correct more complex spinal deformities continue to improve, the importance of more advanced methods to decrease the risk of intraoperative neurological complications will also continue to increase.