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Catalog
2018 AANS Annual Scientific Meeting
524. Utility of Neuromonitoring During Lumbar Pedi ...
524. Utility of Neuromonitoring During Lumbar Pedicle Subtraction Osteotomy for Adult Spinal Deformity
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Video Transcription
Video Summary
Dr. Reed discusses the utility of intraoperative neuromonitoring during lumbar pedicle subtraction osteotomy (PSO) for adult deformity surgery. PSO involves bony cuts that increase the risks of surgery, including spinal cord injury and nerve root compression. Intraoperative neuromonitoring provides real-time information to prevent neurological injury. While it has been useful in pediatric spinal deformity surgeries, its effectiveness in adult deformity surgeries is lower due to physiological changes and differences in the nature of the deformities. The study evaluated motor evoked potentials (MEPs) in patients undergoing PSO and found that an 80% or greater decrease in MEPs correlated significantly with a higher rate of neurological deficits. However, the low incidence of deficits limited the analysis. In conclusion, neuromonitoring is limited in reliably detecting neurological changes in adult lumbar PSO surgeries.
Asset Caption
Patrick Charles Reid, MD
Keywords
intraoperative neuromonitoring
lumbar pedicle subtraction osteotomy
adult deformity surgery
motor evoked potentials
neurological deficits
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