Sensitivity of intraoperative electrophysiological monitoring for scoliosis correction in identifying postoperative neurological deficits: a retrospective chart review of the Scoliosis Research Society morbidity and mortality database

BMC Musculoskeletal Disorders, 2025 · DOI: https://doi.org/10.1186/s12891-024-08115-4 · Published: November 26, 2024

Simple Explanation

Scoliosis surgery aims to correct spinal curvature, but a major concern is the risk of spinal cord injury during the procedure. Intraoperative electrophysiological monitoring helps detect potential nerve damage by measuring electrical signals in the nervous system. This study used a large database of scoliosis surgeries to evaluate how well intraoperative monitoring identifies postoperative neurological deficits. The goal was to find the most effective monitoring techniques or combinations to improve surgical safety. The study found that using four monitoring methods together provided the best results in identifying potential neurological problems. This suggests that a comprehensive approach to monitoring can improve the safety of scoliosis surgery.

Study Duration

2013 to 2023

Participants

6,577 scoliotic patients

Evidence Level

Retrospective chart review

Key Findings

1
Intraoperative monitoring was used in approximately 60% of scoliosis surgeries with reported complications.
2
Overall, intraoperative monitoring had a sensitivity of 45.2% in detecting postoperative neurological deficits.
3
The highest sensitivity (60.4%) was achieved when four monitoring techniques were used in combination, showing significantly better results compared to using one, two, or three methods.

Research Summary

This retrospective study assessed the effectiveness of intraoperative electrophysiological monitoring in detecting postoperative neurological deficits in scoliotic patients undergoing surgical correction. The data was sourced from the Scoliosis Research Society's morbidity and mortality database, spanning from 2013 to 2023. The study revealed that while intraoperative monitoring was utilized in approximately 60% of the surgical procedures, it had an overall sensitivity of 45.2% in detecting postoperative neurological complications. Neurogenic motor evoked potential showed the best outcomes among the individual monitoring methods. The use of four monitoring techniques yielded the most favorable outcomes, achieving a sensitivity of 60.4%. This suggests that a multimodal monitoring approach enhances the detection of potential neurological issues during scoliosis surgery.

Practical Implications

Enhanced Monitoring Protocols

Encourage the implementation of multimodal intraoperative monitoring, particularly the use of four monitoring techniques in combination, to improve the detection of potential neurological deficits during scoliosis surgery.

Resource Allocation

Allocate resources for specialized training in intraoperative monitoring techniques and the interpretation of results to improve the performance and reliability of the monitoring process.

Further Research

Conduct further research to identify the optimal combination of monitoring techniques, assess the cost-effectiveness of intraoperative monitoring, and investigate the impact of surgeon experience and standardization of monitoring procedures on outcomes.

Study Limitations

1
Retrospective design may introduce biases and inaccuracies in the data.
2
Possible confounding factors, such as surgeon experience, were not sufficiently accounted for.
3
Lack of in-depth information regarding the monitoring technique itself and the management of abnormalities detected during surgery.

Your Feedback

Was this summary helpful?

Back to Surgery