Abstract
Objective
The aim of this study is to analyze the use of intraoperative neurophysiological monitoring (MNIO) in idiopathic scoliosis correction surgery.
Methods
Retrospective study of 80 patients undergoing idiopathic scoliosis correction surgery between December 2008 and January 2015 using the MNIO. Among the patients, 85% were female (n = 68) and 15% males (n = 12), the average age on the day of surgery was 17 years and the prevalent type of scoliosis curve classification was Lenke 1-A-N (37.5%/n = 30). We reviewed the significant changes in MNIO, duration of surgery, number of pedicle screws needed to correct deformities, screw time, onset of neurological deficits, Coob angle and effectiveness of MNIO.
Results
There were significant changes or loss of the MNIO data in 15 patients (18.75%). Complete recovery after intervention was seen in 12 patients (80%). Three patients (20%) had some neurological deficit in the immediate postoperative period. The mean duration of surgery was 320.76 minutes and were used on average 18.84 screws to correct deformities, with an average time of 8.27 minutes for the passage of each pedicle screw. The thoracic curves averaged 52.80 degrees and 47.40 degrees for lumbar curves.
Conclusion
Long constructions, osteotomies and more severe curves are related to most of the changes found in evoked potentials. The joint use of somatosensory evoked potentials and motor allows a direct evaluation of sensory and motor functions of the spinal cord and dramatically increased the sensitivity and specificity in the detection of neurophysiological changes, helping in decision making during surgery. The interpretation in real time by neurophysiologist possible interruption of operations by temporarily verge of nerve injury with immediate change of the surgical strategy.