Intraoperative neuromonitoring in spine deformity surgery: modalities, advantages, limitations, medicolegal issues - surgeons' views.

In spine deformity surgery, iatrogenic neurologic injuries might occur due to the mechanical force applied to the spinal cord from implants, instruments, and bony structures, or due to ischemic changes from vessel ligation during exposure and cord distraction/compression during corrective manoeuvres.Prompt reaction within the reversible phase (reducing of compressive/distractive forces) usually restores functionality of the spinal cord, but if those forces continue to persist, a permanent neurological deficit might be expected.With monitoring of sensory pathways (dorsal column-medial lemniscus) by somatosensory-evoked potentials (SSEPs), such events are detected with a sensitivity of up to 92%, and a specificity of up to 100%.

Kyphosis - A risk factor for positioning brachial plexopathy during spinal surgeries.

Objective: The aim of this study was to evaluate the differences in transcranial electric motor-evoked potentials - TceMEP on upper limbs and the incidences of postoperative brachial plexopathy between patients with kyphotic and scoliotic trunk shapes.

Methods: In the period of January 2011-January 2017, 61 consecutive patients (mean age: 18.4 years ± 4.