To present the results of multi-modal IOM in 298 patients who underwent spinal deformity correction. We reviewed the notes, surgical and IOM charts of all patients who underwent spinal surgery with the use of cortical and cervical SSEPs, as well as upper/lower limb transcranial electrical MEPs under the senior author. We recorded IOM events which we categorised as true, transient true and false (+) or (−). We correlated the IOM events with surgical or anaesthetic incidents.Aim:
Method:
To assess the effectiveness of unilateral sublaminar and concave rib tethering with convex rib resection through the period of peak growth in lambs. Morphometric growth data from 10 experimental Scottish Blackface sheep were compared to those from 5 control animals (no intervention) over 12 months. Standardized AP and Lateral radiographs were taken before and at monthly intervals after scoliosis creation. The Cobb angle was measured in the coronal and sagittal planes. Rotational mal-alignment was assessed by axial CT 7 months post surgery. In the supine position the control animals had no coronal plane deformity and a mean 5° lordosis (T4-T12). These figures did not alter with growth (doubling of body weight). Tethering (at age 5 weeks) produced an immediate scoliosis of 22±11° and a lordosis of 24±8° (means(sd). The degree of scoliosis was maintained over 7 months (at 20°) but lordosis increased (to 59±11°, p<0.01). There was an associated change in vertebral rotation. Surgery had no influence on rate of growth or animal development. Two animals died from Clostridium associated enterocolitis. There were no deaths associated with the surgical intervention. This ovine model gives a progressive spinal deformity in the sheep but primarily in the sagittal plane. This fact should be considered in studies designed to evaluate the effectiveness of surgical implants.
