SPINAL CORD MONITORING IN OPERATIONS FOR NEUROMUSCULAR SCOLIOSISM. H. H. Noordeen, FRCS, Consultant Orthopaedic and Spinal Surgeon1; J. Lee, FRCA, Anaesthetic Registrar1; C. E. R. Gibbons, FRCS, Orthopaedic Registrar2; B. A. Taylor, FRCS, Consultant Orthopaedic and Spinal Surgeon1; and G. Bentley, FRCS, Professor of Orthopaedic Surgery1
1 The Institute of Orthopaedics and the Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, London HA7 4LP, UK. Correspondence should be sent to Mr M. H. H. Noordeen. We reviewed retrospectively the role of monitoring of somatosensory spinal evoked potentials (SSEP) in 99 patients with neuromuscular scoliosis who had had operative correction with Luque-Galveston rods and sublaminar wiring. Our findings showed that SSEP monitoring was useful and that a 50% decrease in the amplitude of the trace optimised both sensitivity and specificity. The detection of true-positive results was higher than in cases of idiopathic scoliosis, but the method was less sensitive and specific and there were more false-negative results. In contrast with the findings in idiopathic scoliosis, recovery of the trace was associated with a 50% to 60% risk of neurological impairment. Only one permanent injury occurred during the use of this technique, and any temporary impairment resolved within two months.
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