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Topic:

Adolescent Idiopathic Scoliosis

Issue:

Spine

Category:

Developmental

Title:

Intraoperative Neuromonitoring for Spines at Risk During Nonspine Surgery: A 9-Year Review

Author:

Jackson, Madeleine E. MD; Galambas, Amanda K. MD; Bauer, Jennifer M. MD, MS

Journal:

Journal of Pediatric Orthopaedics

Date:

February 2024

Reference:

44(2): p e197-e202, DOI: 10.1097/BPO.0000000000002520

Level Of Evidence:

III

# of Patients:

3,453

Study Type:

Case series

Location:

Not specified

Summary:

This study reviews the use of intraoperative neuromonitoring (IONM) for patients with spinal anomalies at risk for spinal cord injury during nonspine surgeries. The aim was to assess the effectiveness of IONM in preventing potential spinal cord injuries in these patients.

Methods:

A retrospective review of the Spine at Risk (SAR) program from 2011 to 2019 was conducted. Data were analyzed on nonspine procedures performed with IONM and the number of IONM alerts.

Exclusions:

Not specified

Results:

33% of patients flagged for SAR review received precaution recommendations. 10% of flagged patients were recommended for IONM, with 57 patients undergoing 102 procedures under IONM. 10 IONM alerts occurred in 7 patients, leading to 2 aborted cases and 1 case with transient neurological deficits. No permanent neurological deficits were observed.

Conclusions:

IONM is beneficial in identifying and reacting to alerts in high-risk spinal anomaly patients during nonspine procedures, preventing potential permanent neurological injuries. This study represents the largest series of spinal cord-monitored nonspine pediatric cases.

Relevance:

Limitations:

Perspective:

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