EFFICACY OF SPINAL-CORD MONITORING IN SCOLIOSIS SURGERY IN PATIENTS WITH CEREBRAL-PALSY

Although spinal cord monitoring is recommended during scoliosis surger y, a review from Rancho Los Amigos Medical Center stated that they wer e only able to obtain reproducible tracings in 53% of cerebral palsy p atients. To ascertain that monitoring is both feasible and reliable in these patients, we reviewed the records of 34 consecutive patients wi th cerebral palsy who had scoliosis surgery at our institution. Spinal cord function was monitored by recording peripheral nerve, cervical/b rainstem, and cortical somatosensory evoked potentials to posterior ti bial nerve stimulation. Reproducible tracings were achieved in 31 of t he 34 patients. Significant intraoperative changes were recorded in 12 of the 31 monitored patients, usually related to acid requiring some modifications of the instrumentation. We conclude that with careful te chnique, spinal cord monitoring using cervical/brainstem somatosensory evoked potentials can be reliably achieved in most patients with cere bral palsy undergoing scoliosis surgery.