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Volume 27, Issue 133, March 2023

Continuous neuromuscular monitoring during scoliosis correction surgery in a case of idiopathic kyphoscoliosis: A case report and anaesthetic challenges

Sambit Dash¹, Roshan Nisal², Vivek Chakole³, Aruna Chandak⁴

¹Junior Resident, Department of Anesthesiology, Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education & Research (Deemed University), Wardha, Maharastra, India
²Assistant Professor, Department of Anesthesiology, Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education & Research (Deemed University), Wardha, Maharastra, India
³Professor and Head of Department of Anesthesiology, Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education & Research (Deemed University), Wardha, Maharastra, India
⁴Professor, Department of Anesthesiology, Jawaharlal Nehru Medical College, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education & Research (Deemed University), Wardha, Maharastra, India

ABSTRACT

Scoliosis is a rotational deformity that affects the column in a sagittal plane, a coronal plane and an axial plane. It is a complicated condition that occurs in three dimensions. There are several possible causes, including congenital, neuromuscular or idiopathic. Back pain is the primary complaint; however, it is possible for it to be severe enough to induce additional symptoms, a deficiency in neurologic function or the requirement of surgical intervention. In situations like these, surgery poses a significant danger due to documented consequences, which include serious bleeding and harm to the nervous system, among other things. The preoperative assessment must be extremely thorough and the intraoperative preparation must concentrate on minimising the potential for complications. We present a case of a 20-year female with a complaint of idiopathic scoliosis with difficulty in walking and difficulty in breathing posted for scoliosis correction surgery. The patient was induced under general anaesthesia, the central and arterial line was secured and prone positioning was given, along with continuous neuromuscular monitoring during surgery, somatosensory evoked potential (SSEP) and motor-evoked potential (MEP) were used for monitoring in order to detect impending impairment of the functioning of cerebral and spinal cord motor pathways.

Keywords: Kyphoscoliosis, scoliosis correction surgery, neuromuscular monitoring, somatosensory evoked potential, motor-evoked potential