2018 AANS Annual Scientific Meeting-524. Utility of Neuromonitoring During Lumbar Pedicle Subtraction Osteotomy for Adult Spinal Deformity

524. Utility of Neuromonitoring During Lumbar Pedicle Subtraction Osteotomy for Adult Spinal Deformity

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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.

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Patrick Charles Reid, MD

Keywords

intraoperative neuromonitoring

lumbar pedicle subtraction osteotomy

adult deformity surgery

motor evoked potentials

neurological deficits