Multimodal Intraoperative Neurophysiological Monitoring in Corrective Spine Surgery for Idiopathic Kyphoscoliosis, Our Early Methodological Expriences in 3 Cases

Surgical correction of kyphoscoliosis may result in spinal cord injury and neurologic deficits. Multimodal intraoperative monitoring (MIOM) may allow for early detection and reversal of spinal cord and nerve roots potential injuries. In three consecutive kyphoscoliosis corrections، MIOM were performed. In all cases Somatosensory evoked potentials (SSEPs)، transcranial electrical motor evoked potentials، corticospinal evoked potentials، spinal descending D motor waves، free run and/or stimulated electromyography were performed when required. None of the 3 patients had significant SSEPs changes or postoperative radiculopathies distinct from their preoperative presentations. In our cases، tceMEPs were obtained in 78. 3% of the applied transcranial stimulations. Propofol or Propofol/Ketamine mixture plus narcotic is suitable to obtain stable reproducible tceMEPs. MIOM is recommended to be used in patients with scoliosis who undergo surgery for spinal deformity. Monitoring can practically reduce possibilities of neurologic deficit.