# Sensitivity of intraoperative electrophysiological monitoring for scoliosis correction in identifying postoperative neurological deficits: a retrospective chart review of the Scoliosis Research Society morbidity and mortality database

## TL;DR

This study evaluates how well intraoperative monitoring detects neurological issues after scoliosis surgery, finding that using four monitoring methods is most effective.

## Contribution

The study quantifies the sensitivity of intraoperative monitoring and identifies the optimal number of monitoring methods for detecting postoperative neurological deficits.

## Key findings

- Intraoperative monitoring had an overall sensitivity of 45% in detecting postoperative neurological deficits.
- Using four monitoring methods achieved the highest sensitivity of 60.4%.
- Neurogenic motor evoked potential showed the best individual monitoring outcomes.

## Abstract

Surgical intervention is the ultimate treatment for scoliosis, but iatrogenic spinal cord injury is one of the major concerns. Although intraoperative electrophysiological monitoring can aid in detecting and reducing postoperative neurological complications, its use is still controversial.

A retrospective chart review of 6,577 scoliotic patients who underwent surgery for curve correction with a reported complication was conducted. Our dataset was sourced from the morbidity and mortality database of the Scoliosis Research Society spanning the period from 2013 to 2023. The sensitivity of intraoperative monitoring was evaluated.

Intraoperative monitoring was used in 60% of surgeries, while 26% of the reported complications in the study cohort were new postoperative neurologic deficits. The overall monitoring performance indicated a sensitivity of 45%. Neurogenic motor evoked potential showed the best outcomes among the individual monitoring methods. The highest sensitivity (60.4%) was achieved using four monitoring methods, demonstrating significantly better results than one, two, and three methods.

The monitoring practice benefits in distinguishing postoperative neurologic deficits within the scoliosis population. Employing four monitoring techniques yielded the most favourable outcomes.