Receptive music therapy as an intraoperative aid for neuro-monitoring during growth rod surgery in a 5-year-old girl with severe congenital scoliosis: A case report

Abstract

Neuromonitoring with sensory and motor evoked potentials is an essential tool during spinal correction surgeries to prevent any unforeseen cord injury intraoperatively and neurological deficit in the post-operative period. The muscle contraction and twitches resulting from cortical stimulation with a 200-250mA current are picked up by various subcutaneous/intradermal electrodes placed in the arms, hands, and legs creating a real-time assessment of any spinal cord injury caused by spinal implants or corrective maneuvers. During the neuromonitoring phase most anesthetic drugs such as volatile agents, neuromuscular blockers, and propofol may cause an interference with the electrode signals and therefore cannot be used. This could lead to significant risk of intraoperative awareness. Cases of intraoperative awareness have led to medical negligence and such incidents are the cause for 2% of the legal claims against anesthetists while patients with intraoperative awareness experience describe it as the worst thing they have ever suffered from. We therefore decided to use receptive music therapy, a novel aid in reducing chances of awareness during neuromonitoring.