ID 136 – Accidental spinal cord contusions during spine deformity surgeries

Introduction Accidental spinal cord contusions are a rare event during the surgical correction of spinal deformities Methods Multicenter (5 centers), observational, retrospective study. 691 patients with spinal deformities who underwent surgical correction. Intraoperative neurophysiologic monitoring of spinal cord function was performed with motor (MEPs) and somatosensory (SSEPs) evoked potentials. Results 23 patients suffered a spinal cord contusion, which become evident by a neurophysiologic event with a constant pattern. Ipsilateral MEPs were lost in the first place. Following that, contralateral MEPs were lost, and finally, SSEPs dropped. In the 19 cases with MEPs lost and preserved SSEPs, MEPs recovered during surgery. 4 of these patients presented a transient post-operative paresis with complete recovery, and the rest were asymptomatic. In the four cases which presented complete loss of MEPs and significant changes in the SSEPs, these changes did not recover, and the four patients presented some degree of post-operative paraparesis. Three of them were completely recovered after a few months. Conclusion Intraoperative accidental spinal cord contusions which produce a selective MEPs loss with intraoperative recovery have an excellent prognosis. When the contusions also produce changes on the SSEPs, they have a worst outcome, and produce transient neurologic sequelae.