Intraoperative Neurophysiology Monitoring and Anesthesia in Patients Undergoing Deformity Correction and Posterior Spinal Fusion Surgery (PSF) for Adolescent Idiopathic Scoliosis
DOI:
https://doi.org/10.65745/soj.v1.i1.9Keywords:
IONM, PSF, AIS, Evoked Potentials, Anesthetic ManagementAbstract
Adolescent idiopathic scoliosis (AIS), often requiring posterior spinal fusion (PSF), presents significant surgical challenges due to its complex three-dimensional deformity. Intraoperative neurophysiological monitoring (IONM) has become essential in safeguarding neural integrity during corrective spinal procedures. This case-based review discusses the integration of IONM modalities, motor evoked potentials (MEPs), somatosensory evoked potentials (SSEPs), and electromyography (EMG), in a patient undergoing deformity correction for thoracic scoliosis. The success of IONM is closely tied to anesthetic technique, as agents like propofol and dexmedetomidine must be carefully titrated to preserve signal integrity. Anesthetic-induced suppression of evoked potentials remains a key consideration, highlighting the importance of interdisciplinary collaboration among surgeons, anesthesiologists, and neurophysiologists. Alarm criteria were established to promptly detect and address potential neural compromise. This case emphasizes the role of IONM not only in enhancing surgical safety but also in guiding intraoperative decisions. With proper execution, IONM minimizes neurological risks and contributes to improved outcomes in complex spinal deformity surgeries. Its efficacy depends on protocol fidelity, careful anesthetic selection, and robust intra-team communication.
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