EFFICACY OF SPINAL-CORD MONITORING IN NEUROMUSCULAR SCOLIOSIS

Somatosensory cortical evoked potentials (SCEPs) monitoring in neuromu scular scoliosis surgery was evaluated in a large consecutive series o f spinal reconstructions to define its role in the detection and preve ntion of spinal cord injury; 141 procedures in 101 patients were evalu ated. In 28% a reliable tracing could not be obtained. Two postoperati ve neurologic deficits were missed by SCEP monitoring. Diagnosis (Duch enne muscular dystrophy and polio) was the only significant factor fou nd to correlate with a reliable tracing. The use of sublaminar wires w as associated with a higher rate of change in tracing. Transient chang es were common. SCEPs are unreliable and nonspecific in neuromuscular scoliosis surgery and are not efficatious in preventing or detecting s pinal cord injury when used alone. Adjunctive techniques using epidura l and MEPs must be studied in these patients.