Abstract
Purpose: A prospective study to determine the usefulness of the spinal cord monitoring (SCM) for predicting and preventing iatrogenic nerve injury during spinal surgery. Materials and Methods: We studied 27 cases with adolescent idiopathic scoliosis (AIS, 7), degenerative spinal deformity (DSD, 13), and spinal stenosis (7) who received decompression and SCM including MEP and EMG. Intravenous anesthesia was performed using propofol. We initially could not measure SCM because of the presence of muscle relaxants. But later could check SCM in 24 cases. We evaluated the success rate of SCM, the degree of electrical stimulus, and abnormal signals. Results: The success rate of SCM was 88.9%. MEP showed an increased stimulus indicating a normal neurologic response in: AIS (26.6%), DSD (24.3%), and spinal stenosis (15.7%). EMG showed abnormal signals in 4 cases. but 3 cases had no significant nerve damage. In one case, we reinserted the pedicle screw because we found nerve irritation by the probe. None of theses cases had neural deficits after the operation. Conclusion: MEP and EMG allow for correction and decompression without spinal cord or nerve root injury with appropriate anesthesia technique and interpretation of abnormal signals required for SCM.
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