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Observational Study
. 2020 Dec;8(6):1369-1374.
doi: 10.1007/s43390-020-00163-9. Epub 2020 Jun 24.

Is routine intraoperative neuromonitoring necessary in growing rod lengthening procedures? A retrospective, observational study

Bhavuk Garg  1 , Subrat Mohapatra  2 , Nishank Mehta  3
Affiliations
Observational Study

Is routine intraoperative neuromonitoring necessary in growing rod lengthening procedures? A retrospective, observational study

Bhavuk Garg et al. Spine Deform. 2020 Dec.

Abstract

Purpose: To investigate whether intraoperative neuromonitoring (IONM) may be avoided in growing rod lengthening procedures in early onset scoliosis (EOS).

Methods: A total of 636 primary growing rod surgeries and lengthening procedures were performed in 112 patients with EOS. Traditional growing rods (TGR) or magnetically controlled growing rods (MCGR) were implanted and subsequent lengthening procedures were done at stipulated intervals. Combined multi-modality IONM was used in all index surgeries-but was only used in lengthening procedures in patients with existing spinal cord abnormality or a history of neurosurgical procedure for the same, patients with prior history of a neuromonitoring alert in their index surgery and when lengthening was accompanied by an implant exchange/revision. All the remaining growing rod lengthening procedures were carried out without IONM. Hospital records and operation notes were retrospectively reviewed with focus on details of neurological events/complications.

Results: In 112 primary growing rod applications (TGR = 96, MCGR = 16) and 524 lengthening procedures (TGR = 444, MCGR = 80), intraoperative neuromonitoring 'alerts' were encountered in 6/112 index surgeries and temporary postoperative neurological deficits were seen in 2/112 index surgeries. No intraoperative neuromonitoring event or postoperative neurological complication was encountered in 524 lengthening procedures-irrespective of whether they were carried out along with implant exchange, or in patients with spinal cord abnormality or prior neuromonitoring event during index surgery.

Conclusion: While IONM should be used in primary growing rod application surgeries, its use may be avoided in lengthening and implant exchange procedures in a resource-limited setting.

Level of evidence: Level 3.

Keywords: Early onset scoliosis; Growing rods; Intraoperative neuromonitoring; Scoliosis; Spinal deformity.

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References

    1. Zeltner TB, Burri PH (1987) The postnatal development and growth of the human lung. II. Morphology. Respir Physiol 67:269–282 - DOI
    1. Hell AK, Campbell RM, Hefti F (2005) The vertical expandable prosthetic titanium rib implant for the treatment of thoracic insufficiency syndrome associated with congenital and neuromuscular scoliosis in young children. J Pediatr Orthop B 14:287–293 - DOI
    1. Ahmad AA (2020) Early onset scoliosis and current treatment methods. J Clin Orthop Trauma 11:184–190 - DOI
    1. Bess S, Akbarnia BA, Thompson GH et al (2010) Complications of growing-rod treatment for early-onset scoliosis: analysis of one hundred and forty patients. JBJS 92:2533–2543. https://doi.org/10.2106/JBJS.I.01471 - DOI
    1. Mendiratta A, Emerson RG (2009) Neurophysiologic intraoperative monitoring of scoliosis surgery. J Clin Neurophysiol 26:62–69 - DOI

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