Neuromonitoring Changes in Spinal Deformity Surgery

Spinal cord injury is one of the most feared complications in spinal deformity surgery. The surgeon must be vigilant of direct and indirect sources of injury at all points during surgery. The incidence of complications has greatly decreased with the ability to monitor the motor and sensory pathways. Changes in signaling of these pathways provide context for what the insult is, and how to correct it before it becomes irreversible. There are well-established protocols that provide an algorithmic response to changes that can help all in the room determine the source of injury, and the appropriate reaction.