Neuromuscular Monitoring and Wake-Up Test During Scoliosis Surgery

A typical spine is straight and symmetrical, with all of the vertebrae facing forward when viewed from the posterior. Scoliosis is a term used to describe a lateral deviation of the spine's normal vertical line that is greater than 10° on an X-ray. More severe curves are sometimes accompanied by medical issues such as increased back discomfort and cardiorespiratory difficulties along with the cosmetic components of the deformity. The test for spinal cord integrity prior to the widespread adoption of intraoperative neurophysiologic monitoring (IOM) was the wake-up test. In this article, we review the challenges faced by anesthesiologists and surgeons during intraoperative monitoring and the importance of clinical assessment of surgical outcomes.