Anesthesia Management for Scoliosis Correction Surgery at the Level of Thoracic Vertebra 4 - Lumbar Vertebra 3 with Intraoperative Neurophysiological Monitoring

Abstract

Background: Scoliosis correction surgery in cases of adolescent idiophatic scoliosis (AIS) with the help of intraoperative neurophysiological monitoring (IOM) is an operative technique that aims to increase the safety of surgery in spinal correction by providing a real-time assessment of the underlying nerve structure risk. The management of anesthetic techniques for osteotomy and posterior spinal fusion (PSF) with the help of this IOM requires the expertise of an anesthesiologist to understand influence of anesthetic drugs/ agents on IOM, especially in spinal surgery, the anesthetic technique to be chosen, as well as the selection of drugs and doses that support the operative implementation with this IOM. However, it is important because intraoperative neurophysiocial monitoring can prevent intraoperative neurological injury.Case: A 14-year-old girl with AIS lenke I who will undergo scoliosis correction surgery for thoracic vertebrae 4 to lumbar vertebra 3 with monitoring using IOM.Discussion: Neurological injury is the most feared thing that occurs during spinal surgery.The use of intraoperative neurophysiological monitoring (IONM) in spinal surgery is widely used by surgeons to increase safety during direct surgery. Another advantage of using IOM is that it is very sensitive and specific, has a fast response time, and can detect damage at an early stage.Conclusion: Management of AIS with posterior spine fusion can improve the patient's quality of life, but this must be accompanied by safety during surgery, one of which is the use of IOM.