Application of intraoperative neurophysiological monitoring in surgical correction for spinal deformity with different etiologies

Abstract

Iatrogenic nerve injury is one of the most severe complications of surgical correction for spinal deformity with different etiologies. The intraoperative neurophysiological monitoring (IONM) has been widely used to detect the nerve injury in spinal correction surgery. The commonly used IONM techniques involve somatosensory evoked potential (SEP), motor evoked potentials (MEP) and electromyography (EMG). All the IONM techniques have both advantages and disadvantages, while combing SEP, MEP and EMG in the spinal correction surgery could maximumly improve the accuracy and reliability of the IONM. The different pathophysiology of patients with spinal deformity due to different etiologies might significantly decrease the success rate, sensitivity, and specificity of IONM, which might further decrease the reliability of IONM. However, the IONM still serves as the most important monitoring method for the iatrogenic nerve injury in patients with different spinal deformity due to different etiologies. For those monitoring changes that cannot be distinguished, the wake-up test is still the gold standard.