VALIDITY AND RELIABILITY OF SPINAL-CORD MONITORING IN NEUROMUSCULAR SPINAL DEFORMITY SURGERY

Somatosensory evoked potentials (SSEPs) have become a standard of care in surgery for spinal deformity. Recent reports in the literature hav e suggested SSEP monitoring is not efficacious in surgeries for patien ts with neuromuscular disease. Electrophysiologic data were retrospect ively analyzed from 74 patients with various neuromuscular disorders u ndergoing spinal-deformity surgery from 1989 through February 1995 at this medical center. The monitoring protocol included SSEPs recorded f rom multiple sites located cortically, subcortically, and peripherally . Neurogenic motor evoked potentials (NMEPs) were also employed. Anest hetic regimens were controlled for compatibility with evoked potential monitoring. Use of this intraoperative monitoring protocol resulted i n reliable data for 95% of the patient population having baseline resp onses. Findings suggest that evoked potentials can be used effectively during surgery for neuromuscular spinal deformity. Use of a specific protocol allowed acquisition of reliable data intraoperatively, sugges ting these methods are a valid means of monitoring neurologic status.