Score evaluation of intraoperative neurophysiological monitoring results of spinal deformity surgical correction in genetically caused systemic skeletal pathology

Purpose Evaluate the dynamics of the pyramidal pathway functional state in spinal deformity surgical correction in patients with genetically caused systemic skeletal pathology based on the formal criteria of a significance degree of the electrophysiological response to a surgical intervention which were developed at the RISC RTO. Materials and Methods The analyzed sample of patients included two groups for comparison. Group 1 (main group) were 28 patients with spinal deformities due to systemic hereditary diseases. Group 2 (control group) consisted of 126 patients with spinal deformities (51 subjects with idiopathic scoliosis, 71 subjects with deformities of congenital genesis, and 4 subjects of other etiology). All the patients underwent instrumental deformity correction with further fixation of the cervical, thoracic, thoracolumbar spine using different variants of internal transpedicular fixation systems. The changes in motor evoked potentials (MEP) were evaluated as ranks 0 to 7 according to the severity of the response observed. Results All the variants of changes in MEPs were observed both in the main group and in the control one. Five types of steady (reproduced in different patients) rank combinations were identified which conformed to the main types of the patient’s motor system response to spinal deformity surgical correction. Conclusion The use of the technology of MEP recording during surgical correction of spinal deformities in patients with systemic genetically caused skeletal pathology is a highly effective tool of preventing the development of intraoperative neurological complications. The proposed system of formal evaluation of the results of neuromonitoring allowed us to conduct a quantitative comparison of the character of intraoperative changes in the functional state of the pyramidal system in patients of different etiological groups depending on their age and intervention duration.