title: Improving safety in spinal deformity surgery: advances in navigation and neurologic monitoring.
abstract: BACKGROUND
  The treatment of spinal deformities has rapidly changed during the past decade. The advent of new surgical techniques, particularly thoracic pedicle screws and spinal osteotomies, allow more aggressive deformity correction, and require an increased focus on safety.
  
  
  METHODS
  Review of the navigation systems and neuromonitoring techniques currently available.
  
  
  CONCLUSIONS
  Navigation systems today are where intraoperative neuromonitoring was 20 years ago: new, under investigation, not widely accepted, with concerns for cost, safety and efficiency. Navigation enhances the accuracy of pedicle screws placement in deformed spines, reducing the rate of misplaced screws and potential complications. With further use and investigation, navigation, like neuromonitoring, will soon become standard at major spine centers throughout the world.
authors.affiliation: Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Richard D Wood Center, 2nd Floor, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399, USA. flynnj@email.chop.edu
authors.forename: John M
authors.initials: JM
authors.lastname: Flynn
authors.forename: Denis S
authors.initials: DS
authors.lastname: Sakai
mesh_terms: D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D038361:Neuronavigation / Q000379:methods*; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D013131:Spine / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*