BACKGROUND: The use of intraoperative neurophysiological monitoring (IONM) during corrective spinal surgery is the gold standard. Maintaining the integrity of the nervous system during surgery is importance. We use various types of halo-traction in the preoperative period in patients with severe scoliotic spinal deformities also to reduce the risk of neurological complications. A comparative study of changes in IONM during operations to correct scoliosis in patients who underwent preoperative halo-gravity training and without it was conducted. AIM: A comparative analysis of the results of IONM during surgery to correct scoliosis with and without preoperative halo-gravity traction. MATERIALS AND METHODS: An observational monocenter retrospective uncontrolled study of the results of IONM was conducted in 88patients with severe scoliotic deformities who received surgical treatment to correct scoliosis using halo-traction. The patients were divided into 2groups. GroupI (52people) received halo-gravity traction as preoperative preparation. GroupII (36people) was operated under conditions of intraoperative halo-traction. A comparative analysis of signaling criteria with the threat of developing neurological deficit of the lower extremities during surgery, the values of the deformation angles before and after surgery, mobility indicators, the volume of blood loss and the time of surgery was performed. RESULTS: An intergroup comparison of the obtained parameters of changes in deformation angles, IONM data revealed that in group I patients had a more pronounced deformation in terms of the angles, their greater rigidity and a smaller number of patients with a normal indicator of the level of MEP, which is statistically reliably confirmed (p0.05). In 12patients signaling criteria with the threat of developing neurological deficits were registered: 7 in groupI, 5 in groupII. In two patients of group II, the recovery of the MEP indicators of the lower extremities did not occur and permanent neurological deficit could not be avoided. CONCLUSION: Preoperative halo-traction makes it possible to prepare nerve structures for the correction of severe deformities and reduce intraoperative effects on the nervous system, reducing the risks of neurological complications in patients with severe spinal deformities compared with simultaneous correction in conditions of intraoperative traction.
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