Intraoperative neurophysiological monitoring for pediatric spine
소아 척추 수술의 수술중 신경생리 감시

Keewon Kim
2019 Journal of Intraoperative Neurophysiology  
Intraoperative neurophysiological monitoring (IONM) has long been shown to be effective for the spine surgery in adults. Pediatric spine surgery is also championed by IONM although disease entities are not the same as in adults. Major indications of IONM in children includes corrective surgery for scoliosis or other spine deformities, untethering for tethered cord syndromes, selective dorsal rhizotomy for spastic cerebral palsy, spine tumor surgery, or others. IONM of each condition, provided
more » ... ndition, provided with appropriate considerations and specific techniques, can enhance efficacy and reduce risk of functional deficit after surgery. In some diagnoses, application of IONM has enabled preemptive surgical treatment and revised standard management. However, it must be acknowledged that IONM for pediatric patients requires special methodology and interpretation which are different from those for adult patients because neurophysiology and anatomy of children are distinctive by age. Stimulation paradigms should be optimized for children and warning criteria warrants modification for children because the nervous system is immature and more vulnerable. Further research and judicious application of IONM for pediatric spine surgery will advance our knowledge and clinical outcomes.
doi:10.33523/join.2019.1.2.24 fatcat:3dsf4hwntjg43fzdfzlbphjy2q