and Kenneth J. Noonan, MD published their reviews on"Pediatric Orthopaedics".
They discuss about the recent advancements in the field of Pediatric Orthopadics
with emphasis on various spine deformity, neurological disorders in childrens with
appropirate surgical methods used. They have done an excellent review of the literature,
the 82 references listed can be useful for those in the Pediatric Ortho as well as for
Neurophysiologists. There is a section on basic science applications and in another
section on spine, they talk about effectiveness of Intraoperative monitoring
using motor evoked potentials.
The effectiveness of spinal cord monitoring during spinal deformity surgery was recently reported in two large studies (involving >1000 patients), with the incidence of spinal cord injury approaching 1%66,67. Transcranial motor-evoked potentials are exquisitely sensitive to threatened spinal cord function, andtheir use together with traditional somatosensory evoked potentials improves the accuracy of spinal cord monitoring. Somatosensory evoked potentials may not detect all problems and may not detect problems as rapidly as transcranial motor-evoked potentials do67, and the sensitivity of transcranial motor-evoked potentials has led some centers to abandon somatosensory evoked potentials in favor of motor monitoring alone. For instance, Hsu et al.68 reported 100% sensitivity for the detection of a clinically important neurological event in a consecutive series of 144 patients. The authors defined a neurological event as either a new postoperative deficit or a 50% decrease in the monitoring potential over a one-minute period. The rapidity with which motor monitoring detects spinal cord compromise makes it a valuable tool for sagittal plane correction, and prompt detection of a problem can lead to its resolution before a permanent deficit results69,70.The Journal of Bone and Joint Surgery (American). 2009;91:743-751.doi:10.2106/JBJS.H.01689
