PURPOSE: Patients with neuromuscular scoliosis are at increased risk of neurological deficit post-operatively, but are a difficult population on whom to perform neurophysiological monitoring. We look here at a 7-year sample of our practice in the monitoring of neuromuscular patients. METHODS: A retrospective chart review was performed for 109 patients who underwent correction of neuromuscular scoliosis within our institution between 2005 and 2011. RESULTS: Of 109 patients who were identified, intraoperative monitoring was attempted in 66 cases. In eight cases (13 %), no reliable monitoring could be achieved and was therefore abandoned. On nine occasions, there was a significant drop in at least one modality intraoperatively. None of these nine suffered any clinically observable neurological deficit post-operatively. Of the 109 patients, 2 had clinically detectable deficits post-operatively, both of whom had undergone normal intraoperative monitoring. CONCLUSIONS: The two patients with observable deficit had their instrumentation left in situ after discussion with them and/or parents. Spinal cord monitoring in this population is possible but potentially unreliable. Surgeons will need to carefully consider the use of monitoring in their management of this challenging population.
PURPOSE:Patients with neuromuscular scoliosis are at increased risk of neurological deficit post-operatively, but are a difficult population on whom to perform neurophysiological monitoring. We look here at a 7-year sample of our practice in the monitoring of neuromuscular patients. METHODS: A retrospective chart review was performed for 109 patients who underwent correction of neuromuscular scoliosis within our institution between 2005 and 2011. RESULTS: Of 109 patients who were identified, intraoperative monitoring was attempted in 66 cases. In eight cases (13 %), no reliable monitoring could be achieved and was therefore abandoned. On nine occasions, there was a significant drop in at least one modality intraoperatively. None of these nine suffered any clinically observable neurological deficit post-operatively. Of the 109 patients, 2 had clinically detectable deficits post-operatively, both of whom had undergone normal intraoperative monitoring. CONCLUSIONS: The two patients with observable deficit had their instrumentation left in situ after discussion with them and/or parents. Spinal cord monitoring in this population is possible but potentially unreliable. Surgeons will need to carefully consider the use of monitoring in their management of this challenging population.
Authors: Nasir A Quraishi; Stephen J Lewis; Michael O Kelleher; Roger Sarjeant; Yoga R Rampersaud; Michael G Fehlings Journal: Spine (Phila Pa 1976) Date: 2009-06-15 Impact factor: 3.468
Authors: F Pastorelli; M Di Silvestre; F Vommaro; E Maredi; A Morigi; M R Bacchin; S Bonarelli; R Plasmati; R Michelucci; T Greggi Journal: Eur Spine J Date: 2015-10-19 Impact factor: 3.134
Authors: Jakub Godzik; Lawrence G Lenke; Terrence Holekamp; Brenda Sides; Michael P Kelly Journal: Spine (Phila Pa 1976) Date: 2014-07-01 Impact factor: 3.468