Spinal cord monitoring in patients with spinal deformity and neural axis abnormalities: a comparison with adolescent idiopathic scoliosis patients.
METHODS
A retrospective review of spinal cord monitoring (SCM) results of patients with neural axis abnormalities (NAA) as compared with a control group of adolescent idiopathic scoliosis (AIS) patients.


OBJECTIVE
To analyze SCM on a group of patients who had a NAA undergoing spinal deformity surgery.


BACKGROUND
To our knowledge, only 1 report in the literature has analyzed the accuracy and reliability of SCM in patients with NAA.


METHODS
Over a 10-year period, 41 patients with NAA had SCM while undergoing surgery for spinal deformity. These patients were retrospectively compared with a group of 136 AIS patients.


RESULTS
The average ages were similar (14.4 vs. 14.6 years), but there were more males (48.8% vs. 19.1%) and greater preoperative curve magnitude in the NAA group (65.9 degrees vs. 59.8 degrees ) (P < 0.05). Good baseline values were achieved less often in the NAA group for somatosensory-evoked potentials (SSEP) (85.4% vs. 98.5%) and motor-evoked potentials (MEP) (82.6% vs. 100%) (P < 0.05). Significant deviations from baseline values were seen more often in the NAA group for SSEP (8.6% vs. 1.5%) and MEP (5.3% vs. 2.5%). There were no false negatives in either group.


CONCLUSIONS
SCM in patients who have NAA can be more difficult to obtain than in AIS but results in few false positives and does not miss neurologic injury.
El-Hawary
Ron
R
Isaac Walton Killam Health Centre, Halifax, Nova Scotia, Canada.
Sucato
Daniel J
DJ
Sparagana
Steven
S
McClung
Anna
A
Van Allen
Elizabeth
E
Rampy
Patricia
P
D000293:Adolescent; D002648:Child; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D009421:Nervous System Malformations / Q000503:physiopathology*; D012189:Retrospective Studies; D012600:Scoliosis; D013116:Spinal Cord / Q000503:physiopathology*; D013118:Spinal Cord Diseases / Q000503:physiopathology*; D013122:Spinal Diseases / Q000503:physiopathology*