Motor evoked potentials in 43 high risk spine deformities

Area of Science:

• Neurosurgery
• Orthopedics
• Spinal Cord Monitoring

Background:

• Pediatric spine deformities require complex surgical correction.
• Preventing paraplegia is a critical concern in these high-risk patients.
• Neurophysiological monitoring assesses spinal cord function and predicts outcomes.

Purpose of the Study:

• To evaluate the experience of monitoring motor evoked potentials (MEP) during corrective surgery for severe pediatric spine deformities.
• To identify critical aspects and risks associated with MEP monitoring in this population.

Main Methods:

• Analysis of MEP changes and postoperative neurological status in pediatric patients undergoing major spine surgery.
• Data collected from April 2011 to April 2014.

Main Results:

• Significant MEP changes occurred in 4.6% of patients (2 out of 43).
• Prompt reduction of surgical forces normalized MEP, preventing neurological deficits.
• Intraoperative neuromonitoring (IONM) reliably detects early, reversible signs of neurological compromise.

Conclusions:

• IONM, specifically MEP monitoring, is a valuable tool for safeguarding spinal cord function during pediatric spine surgery.
• While not providing complete protection, IONM significantly reduces the risk of paraplegia.
• This monitoring offers surgeons reassurance regarding patient neurological integrity during lengthy procedures.