Our Summary

This research paper looks at how effective a type of monitoring, called intraoperative somatosensory evoked potential (SSEP), is at predicting the risk of negative neurological outcomes after a type of surgery. This surgery is for the correction of idiopathic scoliosis (a type of spine curvature) in children and young people aged 21 or under.

The researchers reviewed the data from different studies on this topic, which included 3778 patients. They calculated how sensitive and specific this type of monitoring was at predicting neurological problems after surgery. They also looked at the differences between temporary and ongoing changes in SSEP, and complete SSEP loss.

The results showed that SSEP monitoring was pretty good at predicting these issues. The sensitivity (ability to correctly identify those with the condition) was 72.9% for SSEP changes and 41.8% for SSEP loss. The specificity (ability to correctly identify those without the condition) was very high for both - 96.8% for SSEP changes and 99.3% for SSEP loss.

The researchers concluded that this type of monitoring can help predict and potentially reduce the risk of neurological injury during scoliosis correction surgery in young patients.

FAQs

  1. What is the purpose of intraoperative somatosensory evoked potential (SSEP) monitoring during scoliosis surgery?
  2. How effective is SSEP monitoring at predicting neurological problems after scoliosis surgery?
  3. What is the difference between temporary and ongoing changes in SSEP, and complete SSEP loss?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to discuss the possibility of using intraoperative somatosensory evoked potential (SSEP) monitoring during the procedure. This type of monitoring can help predict and reduce the risk of neurological injury during surgery, particularly in children and young people with idiopathic scoliosis. It is important for patients to understand the potential benefits of SSEP monitoring and to discuss this option with their healthcare provider.

Suitable For

Patients who are typically recommended for scoliosis surgery are those with severe curvature of the spine that is causing pain, difficulty breathing, or affecting their quality of life. These patients may have tried other non-surgical treatments such as bracing or physical therapy without success. Additionally, patients who are still growing and have a curvature that is progressing rapidly may also be recommended for surgery to prevent further deformity. It is important for patients to undergo a thorough evaluation by a spine specialist to determine if surgery is the best course of treatment for their specific condition.

Timeline

Before scoliosis surgery, a patient typically undergoes a series of tests and consultations to assess the severity of their condition and determine the best course of treatment. This may include physical exams, imaging tests such as X-rays or MRIs, and consultations with orthopedic surgeons and other specialists.

After scoliosis surgery, the patient will likely experience a period of recovery in the hospital, which may involve pain management, physical therapy, and monitoring for any complications. Depending on the type of surgery performed, the patient may need to wear a brace or use assistive devices during the initial stages of recovery.

In the weeks and months following surgery, the patient will continue with physical therapy to strengthen their muscles and improve their range of motion. They may also have follow-up appointments with their surgeon to monitor their progress and make any necessary adjustments to their treatment plan.

Overall, scoliosis surgery is a major procedure that requires careful planning and monitoring to ensure the best possible outcome for the patient. With proper care and rehabilitation, most patients are able to return to their normal activities and enjoy improved quality of life after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. How common are neurological complications after scoliosis surgery in young patients?

  2. What is the role of intraoperative somatosensory evoked potential (SSEP) monitoring in predicting and preventing neurological complications during surgery?

  3. How sensitive and specific is SSEP monitoring in identifying potential neurological issues during scoliosis surgery?

  4. What are the differences between temporary and ongoing changes in SSEP, and complete SSEP loss in terms of predicting neurological outcomes?

  5. How can SSEP monitoring help improve the safety and success of scoliosis surgery in young patients?

  6. Are there any alternative monitoring techniques or strategies that can be used in addition to SSEP monitoring during scoliosis surgery?

  7. What are the potential risks and benefits of undergoing scoliosis surgery with SSEP monitoring compared to surgery without this type of monitoring?

  8. How will my medical team utilize the information provided by SSEP monitoring to ensure the best possible outcome for my surgery?

  9. Are there any specific precautions or post-operative care instructions I should follow after scoliosis surgery to minimize the risk of neurological complications?

  10. What is the expected recovery process and timeline for scoliosis surgery, and how will SSEP monitoring play a role in monitoring my progress during this time?

Reference

Authors: Gorijala VK, Reddy RP, Anetakis KM, Balzer J, Crammond DJ, Shandal V, Shaw JD, Christie MR, Thirumala PD. Journal: Eur Spine J. 2024 Apr;33(4):1644-1656. doi: 10.1007/s00586-023-08063-y. Epub 2024 Jan 29. PMID: 38285275