Risk Factors and Exit Strategy of Intraoperative Neurophysiological Monitoring Alert During Deformity Correction for Adolescent Idiopathic Scoliosis

Abstract

Study Design: Retrospective cohort study. Objective: To elucidate the risk factors of intraoperative neurophysiological monitoring (IONM) alert during deformity correction surgery for adolescent idiopathic scoliosis (AIS) and to describe the outcomes of patients who underwent staged correction surgery due to IONM alert during the initial procedure. Methods: We reviewed 1 024 patients with idiopathic scoliosis who underwent deformity correction and were followed-up for ≥1 year. The pre-and postoperative Cobb angle of the major structural curve, operative time, estimated blood loss (EBL), number of levels fused, event that caused the IONM alert, and intervention required for the recovery of the signal were recorded. Patients who received IONM alerts (alert group) and those who did not (non-alert group) during the operation were compared. Results: Compared to the non-alert group, the alert group had a significantly greater preoperative Cobb angle of the major structural curve (P