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Does Spinal Cord Type Predict Intraoperative Neuro-Monitoring Alerts in Scoliosis Correction Surgery? A Systematic
Abdulrahman O Al-Naseem1,2, Abdulaziz O Al-Naseem3, Derek T Cawley4
1Division of Surgery & Interventional Science, University College London, London, UK.
Global Spine Journal
|March 1, 2024
Summary
Predicting intraoperative neuromonitoring (IONM) alerts preoperatively is crucial for surgical planning. This review identifies key spinal cord classifications and radiographic factors influencing IONM alerts during scoliosis surgery.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Preoperative prediction of intraoperative neuromonitoring (IONM) alerts aids patient counseling and surgical planning.
- Spinal cord classification systems, like the axial-MRI-based system by Sielatycki et al., aim to predict IONM alert risk in scoliosis correction.
- Identifying operative and radiologic factors associated with IONM alerts is essential for improving surgical outcomes.
Purpose of the Study:
- To systematically review and meta-analyze operative and radiologic factors associated with intraoperative neuromonitoring (IONM) alerts.
- To evaluate the predictive value of spinal cord classifications for IONM alerts in scoliosis surgery.
- To synthesize current evidence on factors influencing IONM alerts to enhance surgical safety and planning.
Main Methods:
- Systematic literature review and meta-analysis conducted following PRISMA guidelines.
- Inclusion of observational studies comparing patients with and without IONM alerts.
- Collection of patient demographics, radiological measures, and operative factors from included studies.
Main Results:
- Analysis of 11 studies involving 3040 patients revealed significant associations between spinal cord types and IONM alerts.
- Radiographic measures like coronal and sagittal Cobb angles, SDAR, and TDAR were significantly associated with IONM alerts.
- Increased operative factors, including operation duration and number of levels fused, were significantly greater in patients experiencing IONM alerts.
Conclusions:
- The study underscores the significant relationship between specific operative and radiologic factors and the occurrence of IONM alerts.
- Findings emphasize the importance of considering these factors in preoperative risk assessment for scoliosis surgery.
- Further research into novel spinal cord classifications may improve the prediction of IONM alerts and surgical outcomes.
Keywords:
adolescent idiopathic scoliosisalertdeformitymagnetic resonance imagingneuromonitoringspinal cord injuryspine
