Application and Short-Term Clinical Outcomes of Neurophysiological Monitoring in Hemivertebra Resection for Pediatric Patients With Congenital Scoliosis

STUDY DESIGN: This study retrospectively analyzed clinical data from 82 pediatric patients with congenital scoliosis who underwent hemivertebra resection. OBJECTIVE: To analyze the application and short-term clinical outcomes of neurophysiological monitoring in hemivertebra resection for pediatric patients with congenital scoliosis. SUMMARY OF BACKGROUND DATA: All pediatric patients underwent a posterior approach for spinal pedicle screw insertion, hemivertebra resection, and corrective surgery under neurophysiological monitoring. MATERIALS AND METHODS: Preoperative and postoperative surgery-related indicators and complications in pediatric patients were compared, and preoperative and postoperative functional indicators, radiographic parameters in the spinal coronal and sagittal planes, stress responses, and quality of life changes were observed. RESULTS: Among 82 pediatric patients, the MEP elicitation rate was 95.12% (78/82), with 4 patients where the amplitude was not normally elicited, weighing <15 kg, and the SEP elicitation rate was 100.00% (82/82). In MEP monitoring, 6 patients showed gradual declines in amplitude exceeding the warning criterion after a hemivertebra resection, but the amplitude normalized upon temporarily halting the procedure, without any abnormal neurological symptoms. In SEP monitoring, 3 patients exhibited a unilateral decrease in amplitude exceeding the warning criterion, yet no acroparesthesias were observed. At 6 months postoperatively, JOA scores were significantly higher than preoperative values, while VAS scores, total scoliosis angles, segmental scoliosis angles, cephalic and caudal compensatory curves, and segmental kyphosis were all significantly decreased compared with preoperative levels (P < 0.05). At 6 months postoperatively, the PedsQL 4.0 scale scores were significantly higher than preoperative scores (P<0.05). The overall complication rate was 2.4% (2/82). Postoperatively, the VAS scores in the IONM alarm group were significantly higher than those in the non-alarm IONM group (P< 0.05). CONCLUSIONS: Neurophysiological monitoring during hemivertebra resection for pediatric congenital scoliosis is feasible, providing real-time neurological function information and prompting timely adjustments to surgical procedures when abnormalities are detected.