MULTIMODAL NEUROMONITORING IS THE GOLD STANDARD IN SPINAL DEFORMITY SURGERY: A SINGLE CENTRE EXPERIENCE OF 320 CONSECUTIVE ADULT AND PAEDIATRIC SPINAL DEFORMITY OPERATIONS

Aim:An analysis of significant neuromonitoring changes (NMCs) and evaluation of the efficacy of multimodality neuromonitoring in spinal deformity surgery.Method:A retrospective review of prospectively collected data in 320 consecutive paediatric and adult spinal deformity operations. Patients were sub-grouped according to demographics (age, gender), diagnosis, radiographic findings (Cobb angles, MR abnormalities) and operative features (surgical approach, duration, levels of fixation). Post-operative neurological deficit was documented and defined as either spinal cord or nerve root deficit.Results:296 paediatric and adult patients were monitored in 320 consecutive spinal deformity operations between 2003 and 2013. Combined monitoring with SSEPs and MEPs was considered successful (296 of 320 operations), when it was able to produce reproducible signals with regards to SEP and / or MEP. SEP was attempted but unrecordable in 1 case, while MEPs were contraindicated in 23 cases due to epilepsy and/or medicati...