Real-Time Neurophysiological Monitoring During Scoliosis Correction Surgeries

Complex deformity treatment involves the mechanical, vascular, and neurological strain, there is a significant risk of iatrogenic spinal cord or nerve injury during scoliosis correction surgery. One essential tool for improving surgical safety and accuracy is real-time intraoperative neurophysiological monitoring, or RT-IONM. The concepts, processes, and data pertaining to RT-IONM during scoliosis correction surgeries are thoroughly reviewed in this chapter. The major goal of a systematic review and meta-analysis is to show that IONM is linked to less neurological sequelae following surgery; however, because of research heterogeneity and a lack of randomized data, the overall quality of the evidence is still moderate. Further evidence that multimodal IONM—combining motor evoked potentials (MEPs), somatosensory evoked potentials (SSEPs), and electromyography (EMG)—increases sensitivity and predictive value, especially in high-risk deformity cases, comes from scoliosis-specific data from recent multicenter studies, such as the Scoliosis Research Society database (2013–2023).