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Quadripolar Stimulation as an Adjunct to Neuromonitoring in Scoliosis Surgery: A Case Report
Matthew O'Hara1, Janse Schermerhorn1, Kareema Dudley2
1Walter Reed National Military Medical Center, Bethesda, Maryland.
Case:
A healthy 13-year-old adolescent girl with a normal spine magnetic resonance imaging underwent posterior spinal fusion for adolescent idiopathic scoliosis (AIS). Before surgery, she had abnormal baseline motor-evoked potentials (MEPs). After technical issues were ruled out, quadripolar stimulation yielded normal baseline MEPs and somatosensory evoked potentials. The surgery was completed without complication, and the patient awoke from surgery without signs of neurological deficits.
Conclusion:
Quadripolar stimulation with the use of an additional paired anode and cathode is a useful adjunct and should be used in troubleshooting abnormal baseline neuromonitoring in patients with AIS with normal spine imaging undergoing posterior spinal fusion.
