Positioning-Related Neuromonitoring Change During Anterior Cervical Discectomy and Fusion

Background Intraoperative neuromonitoring (ION) signal changes during spine surgery may portend a potentially catastrophic neurologic injury that, if identified and addressed expediently, may allow the surgeon to take correction actively and prevent permanent neurologic injury. Case Description We report a case of transient loss in somatosensory evoked potentials signals during anterior cervical discectomy and fusion (ACDF) C4-7, which was mainly attributed to shoulder traction using a special device. The signal loss returned immediately after the release of should traction. Conclusions The use of multimodality ION is recommended for ACDF with shoulder traction to prevent postoperative neurologic deficit associated with a position-related injury. Baseline ION should be established before positioning.