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Neurophysiological monitoring of spinal cord function during spinal deformity surgery: 2020 SRS neuromonitoring information statement

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Abstract

The Scoliosis Research Society has developed an updated information statement on intraoperative neurophysiological monitoring of spinal cord function during spinal deformity surgery. The statement reviews the risks of spinal cord compromise associated with spinal deformity surgery; the statement then discusses the various modalities that are available to monitor the spinal cord, including somatosensory-evoked potentials, motor-evoked potentials, and electromyographic (EMG) options. Anesthesia considerations, the importance of a thoughtful team approach to successful monitoring, and the utility of checklists are also discussed. Finally, the statement expresses the opinion that utilization of intraoperative neurophysiological spinal cord monitoring in spinal deformity surgery is the standard of care when the spinal cord is at risk.

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, OP31, Portland, OR, 97239, USA

    Matthew F. Halsey

  2. Department of Orthopedic Surgery, Indiana University Riley Hospital for Children, 705 Riley Hospital Drive, ROC 4250, Indianapolis, IN, USA

    Karen S. Myung

  3. British Columbia Children’s Hospital, 1D71 4480 Oak Street, Vancouver, BC, V6H3V4, Canada

    Arvindera Ghag

  4. Clinical Pediatric Orthopaedic Surgery, Children’s Hospital of NY Presbyterian, 3959 Broadway, 8th Floor North, New York, NY, USA

    Michael G. Vitale

  5. Department of Orthopedics, Rady Children’s Hospital, 3020 Children’s Way, MC 5062, San Diego, CA, USA

    Peter O. Newton

  6. Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, The Netherlands

    Marinus de Kleuver

Authors
  1. Matthew F. Halsey
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  2. Karen S. Myung
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  3. Arvindera Ghag
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  4. Michael G. Vitale
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  5. Peter O. Newton
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  6. Marinus de Kleuver
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Contributions

All listed authors made substantial contributions to this information statement and were responsible for specific content areas and critical revisions. Furthermore, all listed authors have approved this document as written and agreed to be accountable for all aspects of the work. The authors did make specific types of contributions and these are noted as follows: MFH and MGV: design, acquisition, and analysis; drafted and critically revised the article; approved and agreed to be accountable to all aspects of the work. KSM and AG: acquisition and analysis; drafted the article; approved and agreed to be accountable to all aspects of the work. PON and MK: conception and design; critically revised the article; approved and agreed to be accountable to all aspects of the work.

Corresponding author

Correspondence to Matthew F. Halsey.

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Conflict of interest

Drs. Halsey, Myung and Ghag have no conflicts of interest. Dr. Vitale reports receiving grants from the Pediatric Orthopedic Society of North America (POSNA), the Scoliosis Research Society (SRS), from the Orthopedic Research and Education Fund (OREF), and the Children’s Spine Foundation (CSF) during the writing of this review. Dr. Vitale reports receiving personal fees from Zimmer Biomet, Stryker, and NuVasive that are outside the scope of the submitted work. Dr. Newton reports receiving grants from Setting Scoliosis Straight Foundation, during the writing of this review. Dr. Newton also reports receiving grants, personal fees and/or non-financial support from DePuy Synthes Spine, the SRS, EOS imaging, Thieme Publishing, NuVasive, Electrocore, Cubist, International Pediatric Orthopedic Think Tank, Orthopediatrics, K2M, Alphatech, Mazor Robotics, that are outside the scope of the submitted work. Dr. de Kleuver reports support from Medtronic that is outside the scope of the submitted work. AOSpine Knowledge Forum Deformity: steering committee member.

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Halsey, M.F., Myung, K.S., Ghag, A. et al. Neurophysiological monitoring of spinal cord function during spinal deformity surgery: 2020 SRS neuromonitoring information statement. Spine Deform 8, 591–596 (2020). https://doi.org/10.1007/s43390-020-00140-2

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