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Yukihiro Matsuyama - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy of Anal Needle Electrodes for Intraoperative Spinal Cord Monitoring with Transcranial Muscle Action Potentials.
    Asian Spine Journal, 2018
    Co-Authors: Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama
    Abstract:

    STUDY DESIGN: Retrospective study. PURPOSE: To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative Spinal Cord Monitoring with transcranial muscle action potentials (Tc-MsEP). OVERVIEW OF LITERATURE: Spinal surgery for spina bifida, Spinal Cord tumor, and Spinal tethered Cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during Spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the Monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. METHODS: Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS Monitoring using a needle electrode. RESULTS: The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p

  • efficacy of anal needle electrodes for intraoperative Spinal Cord Monitoring with transcranial muscle action potentials
    Asian Spine Journal, 2018
    Co-Authors: Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama
    Abstract:

    STUDY DESIGN Retrospective study. PURPOSE To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative Spinal Cord Monitoring with transcranial muscle action potentials (Tc-MsEP). OVERVIEW OF LITERATURE Spinal surgery for spina bifida, Spinal Cord tumor, and Spinal tethered Cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during Spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the Monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. METHODS Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS Monitoring using a needle electrode. RESULTS The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p <0.01). In patients with baseline waveform detection, the sensitivity and specificity for postoperative BBD were similar in the two groups. With needle electrodes, a cutoff amplitude of Tc-MsEP for the EAS at the end of surgery of 25% of the baseline amplitude had a sensitivity of 89% and specificity of 82% for the prediction of postoperative BBD aggravation. CONCLUSIONS The significantly higher waveform derivation rate using needle electrodes suggests that these electrodes are effective for Monitoring the EAS in Spinal surgery in cases with preoperative BBD.

  • what is the best multimodality combination for intraoperative Spinal Cord Monitoring of motor function a multicenter study by the Monitoring committee of the japanese society for spine surgery and related research
    Global Spine Journal, 2016
    Co-Authors: Zenya Ito, Yukihiro Matsuyama, Shigenori Kawabata, Muneharu Ando, Tsukasa Kanchiku, Naoya Yamamoto, Kazunobu Kida, Yasushi Fujiwara, Kei Yamada, Sho Kobayashi
    Abstract:

    Study Design  Surgeon survey. Objective  To analyze multimodal intraoperative Monitoring (MIOM) for different combinations of methods based on the collected data and determine the best combination. Methods  A questionnaire was sent to 72 training institutions to analyze and compile data about Monitoring that had been conducted during the preceding 5 years to obtain data on the following: (1) types of Monitoring; (2) names and number of diseases; (3) conditions of anesthesia; (4) condition of stimulation, the monitored muscle and its number; (5) complications; and (6) preoperative and postoperative manual muscle testing, presence of dysesthesia, and the duration of postoperative motor deficit. Sensitivity and specificity, false-positive rates, and false-negative rates were examined for each type of Monitoring, along with the relationship between each type of Monitoring and the period of postoperative motor deficit. Results  Comparison of the various combinations showed transcranial electrical stimulation motor evoked potential (TcMEP) + Cord evoked potential after stimulation to the brain (Br-SCEP) combination had the highest sensitivity (90%). The TcMEP + somatosensory evoked potential (SSEP) and TcMEP + Spinal Cord evoked potential after stimulation to the Spinal Cord (Sp-SCEP) combinations each had a sensitivity of 80%, exhibiting little difference between their sensitivity and that obtained when TcMEP alone was used. Meanwhile, the sensitivity was as low as 50% with Br-SCEP + Sp-SCEP (i.e., the cases where TcMEP was not included). Conclusions  The best multimodality combination for intraoperative Spinal Cord Monitoring is TcMEP + Br-SCEP, which had the highest sensitivity (90%), the lowest false-positive rate (6.1%), and the lowest false-negative rate (0.2%).

  • a new alarm point of transcranial electrical stimulation motor evoked potentials for intraoperative Spinal Cord Monitoring a prospective multicenter study from the Spinal Cord Monitoring working group of the japanese society for spine surgery and related research
    Journal of Neurosurgery, 2014
    Co-Authors: Sho Kobayashi, Yukihiro Matsuyama, Kenichi Shinomiya, Shigenori Kawabata, Muneharu Ando, Tsukasa Kanchiku, Takanori Saito, Masahito Takahashi, Zenya Ito, Akio Muramoto
    Abstract:

    Object Although multimodal intraoperative Spinal Cord Monitoring provides greater accuracy, transcranial electrical stimulation motor evoked potential (TcMEP) Monitoring became the gold standard for intraoperative Spinal Cord Monitoring. However, there is no definite alarm point for TcMEPs because a multicenter study is lacking. Thus, based on their experience with 48 true-positive cases (that is, a decrease in potentials followed by a new neurological motor deficit postoperatively) encountered between 2007 and 2009, the authors set a 70% decrease in amplitude as the alarm point for TcMEPs. Methods A total of 959 cases of Spinal deformity, Spinal Cord tumor, and ossification of the posterior longitudinal ligament (OPLL) treated between 2010 and 2012 are included in this prospective multicenter study (18 institutions). These institutions are part of the Japanese Society for Spine Surgery and Related Research Monitoring working group and the study group on Spinal ligament ossification. The authors prospecti...

  • usefulness of multi channels in intraoperative Spinal Cord Monitoring multi center study by the Monitoring committee of the japanese society for spine surgery and related research
    European Spine Journal, 2013
    Co-Authors: Zenya Ito, Yukihiro Matsuyama, Kenichi Shinomiya, Shigenori Kawabata, Muneharu Ando, Tsukasa Kanchiku, Takanori Saito, Masato Takahashi, Shinichiro Taniguchi, Naoya Yamamoto
    Abstract:

    Object The purpose of this study is to analyze the data in terms of the number of channels employed to examine the usefulness of multi-channels in intraoperative Spinal Cord Monitoring.

Kazuyoshi Kobayashi - One of the best experts on this subject based on the ideXlab platform.

  • evaluation of a combination of waveform amplitude and peak latency in intraoperative Spinal Cord Monitoring
    Spine, 2018
    Co-Authors: Kazuyoshi Kobayashi, Kei Ando, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Ryuichi Shinjo, Naoki Ishiguro
    Abstract:

    STUDY DESIGN Retrospective study. OBJECTIVE The goal of the study was to investigate the significance of a change in latency in Monitoring of transcranial muscle-action potential (Tc-MsEP) waveforms. SUMMARY OF BACKGROUND DATA Tc-MsEP has become a common approach in spine surgery due to its sensitivity and importance in motor function. Many reports have defined the alarm point of Tc-MsEP waveform as a particular decrease in amplitude, but evaluation of the waveform latency has not attracted as much attention. METHODS The subjects were 70 patients who underwent spine surgery using intraoperative Tc-MsEP Monitoring. The peak latency was defined as the period from stimulation until the waveform amplitude reached its peak. Relationships with postoperative paralysis were examined separately for latency delays of 5% or more and 10% or more, and in combination with a decrease in amplitude of 70% or more from baseline. RESULTS Acceptable baseline Tc-MsEP responses were obtained from 1225 of 1372 muscles in the extremities (89.3%). Seven of the 70 patients (10%) had postoperative paralysis. A decrease in intraoperative amplitude of 70% or more from baseline occurred in 25 cases, with sensitivity 100%, specificity 71%, false positive rate 29%, and positive predictive value (PPV) 28% for prediction of postoperative paralysis. Compared to baseline, 15 cases had a latency delay of 5% or more, which gave a sensitivity of 100%, specificity of 87%, false positive rate of 0%, and PPV 47%, and 8 cases had a delay of 10% or more, which gave a sensitivity of 86%, specificity of 97%, false positive rate of 3%, and PPV 75%. A combination of a decrease in amplitude of 70% or more from baseline and a delay in latency of 10% or more from baseline had a sensitivity of 86%, specificity of 98%, and a false positive rate of 2%, and PPV 86%. CONCLUSION Combined use of latency and amplitude could lead to reduction of false positives and increase of PPV in Br(E)-MsEP Monitoring. LEVEL OF EVIDENCE 3.

  • Efficacy of Anal Needle Electrodes for Intraoperative Spinal Cord Monitoring with Transcranial Muscle Action Potentials.
    Asian Spine Journal, 2018
    Co-Authors: Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama
    Abstract:

    STUDY DESIGN: Retrospective study. PURPOSE: To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative Spinal Cord Monitoring with transcranial muscle action potentials (Tc-MsEP). OVERVIEW OF LITERATURE: Spinal surgery for spina bifida, Spinal Cord tumor, and Spinal tethered Cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during Spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the Monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. METHODS: Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS Monitoring using a needle electrode. RESULTS: The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p

  • efficacy of anal needle electrodes for intraoperative Spinal Cord Monitoring with transcranial muscle action potentials
    Asian Spine Journal, 2018
    Co-Authors: Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama
    Abstract:

    STUDY DESIGN Retrospective study. PURPOSE To examine the relationship between postoperative bowel bladder disorder (BBD) and the efficacy of needle electrodes for the external anal sphincter (EAS) in intraoperative Spinal Cord Monitoring with transcranial muscle action potentials (Tc-MsEP). OVERVIEW OF LITERATURE Spinal surgery for spina bifida, Spinal Cord tumor, and Spinal tethered Cord syndrome has a high rate of postoperative BBD. Monitoring of the EAS with Tc-MsEP is frequently performed during Spinal surgery. We initially used plug-surface electrodes for this purpose, but have more recently switched to needle electrodes for the Monitoring of the EAS. To date, there has been no comparison between the utility of these electrodes. METHODS Waveform derivation, exacerbation of postoperative BBD, and sensitivity and specificity for prediction of BBD by 70% amplitude reduction of EAS activity using needle and plug-surface electrodes were investigated in 239 spine surgeries. The cut-off for the % drop in amplitude for BBD prediction was determined for EAS Monitoring using a needle electrode. RESULTS The overall rate of postoperative BBD aggravation was 7.1% (17/239 cases), with the individual rates using needle and plug-surface electrodes being 6.9% (8/116) and 7.3% (9/123), respectively. The waveform derivation rate was significantly higher using needle electrodes (91.3% [106/116] vs. 76.4% [94/123], p <0.01). In patients with baseline waveform detection, the sensitivity and specificity for postoperative BBD were similar in the two groups. With needle electrodes, a cutoff amplitude of Tc-MsEP for the EAS at the end of surgery of 25% of the baseline amplitude had a sensitivity of 89% and specificity of 82% for the prediction of postoperative BBD aggravation. CONCLUSIONS The significantly higher waveform derivation rate using needle electrodes suggests that these electrodes are effective for Monitoring the EAS in Spinal surgery in cases with preoperative BBD.

  • prevention of Spinal Cord injury using brain evoked muscle action potential br e msep Monitoring in cervical Spinal screw fixation
    European Spine Journal, 2017
    Co-Authors: Kazuyoshi Kobayashi, Shiro Imagama, Zenya Ito, Kei Ando, Tetsuro Hida, Naoki Ishiguro
    Abstract:

    The goal of the study was to examine waveform deterioration in intraoperative Monitoring during posterior fusion with a cervical screw. This surgery is useful for alignment correction, but worsening of neurological symptoms may occur in association with screw insertion and rod installation. Therefore, Spinal Cord Monitoring is important for safe surgery. The study included 25 cases treated with posterior fusion with a cervical screw. Waveform deterioration was defined as an intraoperative amplitude <50% of the control waveform. Comparisons were made between cases with normal and deteriorated waveforms. Intraoperative waveform deterioration occurred in nine cases, including after screw insertion in 8 and after rod installation in one. The nine patients with deteriorated waveforms had a significantly lower preoperative JOA score (8.8 vs. 11.2, P < 0.05) and a tendency for more frequent high signal intensity on MRI [67% (6/9) vs. 31% (5/16), P = 0.087]. Cases in which stenosis was greatest at the apex of the cervical lordosis had significantly more frequent intraoperative waveform deterioration [46% (6/13) vs. 0% (0/8), P < 0.05]. In cases in which the narrowest segment was at the apex of the cervical lordosis, screw insertion before compared to after decompression significantly increased waveform deterioration [67% (6/9) vs. 0% (0/4), P < 0.05]. Intraoperative waveform deterioration in posterior cervical screw fixation is associated with severe preoperative symptoms, location of the narrowest segment, and screw insertion before decompression. It is particularly desirable to perform decompression before screw insertion in cases with the narrowest segment at the apex of the cervical lordosis.

Marc R. Nuwer - One of the best experts on this subject based on the ideXlab platform.

  • Spinal Cord Monitoring
    Handbook of Clinical Neurology, 2019
    Co-Authors: Marc R. Nuwer, Lara M Schrader
    Abstract:

    Spinal Cord surgery carries the risk of Spinal Cord or nerve root injury. Neurophysiologic Monitoring decreases risk of injury by continuous assessment of Spinal Cord and nerve root function throughout surgery. Techniques include somatosensory evoked potentials (SEPs), transcranial electrical motor evoked potentials (MEPs), and electromyography (EMG). Baseline neurophysiologic data are obtained prior to incision. Real-time signal changes are identified in time to correct compromised neural function. Such Monitoring improves postoperative neurologic functional outcomes. Challenges in neurophysiologic intraoperative Monitoring (NIOM) include effects of anesthetics, neuromuscular blockade, hypotension, hypothermia, and preexisting neurological conditions, e.g., neuropathy or myelopathy. Technical factors causing poor quality data must be overcome in the electrically noisy operating room environment. Experienced Monitoring teams understand tactics to obtain quality reCordings and consider confounding variables before raising alarms when change occurs. Once an alert is raised, surgeons and anesthesiologists respond with a variety of actions, such as raising blood pressure or adjusting retractors. In experienced hands, NIOM significantly reduces postoperative neurological deficits, e.g., 60% reduction in risk of paraplegia and paraparesis. A technologist in the operating room sets up the NIOM procedure. An experienced clinical neurophysiologist supervises the case, either in the operating room or remotely on-line continuously in real time.

  • somatosensory evoked potential Monitoring
    2014
    Co-Authors: Marc R. Nuwer, Lara M Schrader, Pedro Coutinchurchman
    Abstract:

    Somatosensory-evoked potentials (SEPs) are an excellent modality for Spinal Cord Monitoring during surgery. They cover much territory, including the peripheral, Spinal, brain stem, thalamic, and cortical levels of sensory pathways. They are used for Monitoring for both Spinal Cord and cerebral injury during various types of surgery.

  • somatosensory evoked potential Monitoring with scalp and cervical reCording
    Handbook of Clinical Neurophysiology, 2008
    Co-Authors: Marc R. Nuwer, James W Packwood
    Abstract:

    Publisher Summary This chapter explores the most common technique for Spinal Cord Monitoring that uses somatosensory evoked potentials (SEPs) with stimulation at the ankles, and reCording over the neck and the scalp. A similar technique is used for Monitoring the intracranial lemniscal sensory system as it traverses the brainstem and cerebral hemispheres. For cervical or intracranial procedures, wrist stimulation often substitutes for or supplements the ankle stimulation techniques. The chapter reviews that Monitoring provides services beyond simply warning of the complications. With Monitoring, a surgeon can feel reassured about the Spinal Cord or lemniscal sensory pathway integrity and therefore, extend the surgical procedure to a greater degree than would have been done without Monitoring. It discusses that patients and families can be reassured that certain feared complications are screened for during surgery. As such, Monitoring provides an added dimension to surgical cases even when the SEP itself is unchanged throughout the procedure.

  • Spinal Cord Monitoring
    Muscle & Nerve, 1999
    Co-Authors: Marc R. Nuwer
    Abstract:

    Over the past two decades, intraoperative Spinal Cord Monitoring has matured into a widely used clinical tool. It is used when the Spinal Cord is at risk for damage during a surgical procedure. This includes orthopedic, neurosurgical, and certain cardiothoracic procedures. Both somatosensory evoked potential (SEP) and direct motor pathway stimulation techniques are available. The SEP techniques are used most widely, are generally accepted, and have been shown to reduce surgical morbidity. A large multicenter study has shown that SEP Monitoring reduces postoperative paraplegia by more than 50-60%. Techniques and literature on clinical applications are reviewed in this report.

  • somatosensory evoked potential Spinal Cord Monitoring reduces neurologic deficits after scoliosis surgery results of a large multicenter survey
    Electroencephalography and Clinical Neurophysiology, 1995
    Co-Authors: Marc R. Nuwer, Linda G Carlson, Linda E A Kanim, Edgar G. Dawson, John Sherman
    Abstract:

    Abstract Neurologic deficits were compared to somatosensory evoked potential (SEP) Spinal Cord Monitoring in a survey of Spinal orthopedic surgeons. Experienced SEP Spinal Cord Monitoring teams had fewer than one-half as many neurologic deficits per 100 cases compared to teams with relatively little Monitoring experience. Experienced SEP Monitoring teams also had fewer neurologic deficits than were seen in previous surveys of this group. Definite neurologic deficits, despite stable SEPs (false negative Monitoring), occurred during surgery in only 0.063% of patients. Factors independently associated with fewer neurologic deficits also included the surgeon's years of experience in orthopedic surgery and the use of the wake-up test. Other technical survey results are also presented here. These results confirm the clinical efficacy of experienced SEP Spinal Cord Monitoring for prevention of neurologic deficits during Spinal surgery such as for scoliosis.

Mitsuo Ochi - One of the best experts on this subject based on the ideXlab platform.

  • investigation of segmental motor paralysis after cervical laminoplasty using intraoperative Spinal Cord Monitoring with transcranial electric motor evoked potentials
    Journal of Spinal Disorders & Techniques, 2012
    Co-Authors: Toshio Nakamae, Nobuhiro Tanaka, Kazuyoshi Nakanishi, Naosuke Kamei, Bunichiro Izumi, Yuki Fujioka, Ryo Ohta, Mitsuo Ochi
    Abstract:

    Study DesignA retrospective study of segmental motor paralysis after cervical laminoplasty for cervical myelopathy.ObjectiveThe objective of this study was to use transcranial electric motor-evoked potentials during cervical laminoplasty, to monitor and investigate the intraoperative electrophysiolo

  • postoperative segmental c5 palsy after cervical laminoplasty may occur without intraoperative nerve injury a prospective study with transcranial electric motor evoked potentials
    Spine, 2006
    Co-Authors: Nobuhiro Tanaka, Yasushi Fujiwara, Kazuyoshi Nakanishi, Naosuke Kamei, Mitsuo Ochi
    Abstract:

    Study Design. Intraoperative neurophysiologic Monitoring with transcranial electric motor-evoked potentials was performed on patients who underwent cervical laminoplasty at a university hospital in a prospective study. Objective. To evaluate the usefulness of intraoperative Spinal Cord Monitoring with transcranial electric motor-evoked potentials for prediction of the occurrence of segmental motor paralysis after cervical laminoplasty. Summary of Background Data. Segmental motor paralysis occasionally occurs among patients who undergo expansive laminoplasty for cervical myelopathy, and it has been attributed to nerve root lesions caused by either a traumatic surgical technique or a tethering effect after decompression. Methods. Sixty-two consecutive patients (47 men and 15 women; mean age 64 years [range 32–89]) who were scheduled to undergo cervical laminoplasty under intraoperative Spinal Cord Monitoring with transcranial electric motor-evoked potentials were included in this study. Transcranial electrical stimulations were delivered through pin-type electrodes, and the evoked potentials were reCorded over the deltoid, biceps, and triceps muscles in the bilateral upper extremities and thoracic Spinal Cord. Results. Intraoperative evoked potentials were successfully reCorded in all muscles in 57 patients (92%), and incomplete evoked potentials were reCorded in the remaining 5 patients. No critical decrease in the amplitude of the evoked potentials was observed in any of the 62 patients. All patients showed sufficient postoperative recovery from their clinical symptoms; however, postoperative transient C5 palsy occurred in 3 patients. Conclusions. No abnormalities were observed on transcranial electric motor-evoked potential Monitoring, even in those patients who developed postoperative transient C5 palsy. These results suggest that the development of postoperative C5 palsy after cervical laminoplasty is not associated with intraoperative injury of the nerve root or the Spinal Cord, although the precise mechanism of its development is still unclear. Surgeons should be aware that C5 palsy is a possible complication of cervical laminoplasty, even in the absence of intraoperative nerve injury.

Scott J Luhmann - One of the best experts on this subject based on the ideXlab platform.

  • Spinal Cord Monitoring data in pediatric Spinal deformity patients with Spinal Cord pathology
    Spine deformity, 2015
    Co-Authors: Alexander W Aleem, Anne M. Padberg, Earl D Thuet, Michael Wallendorf, Scott J Luhmann
    Abstract:

    Abstract Study Design Retrospective. Objectives The purpose of this study is to review the efficacy of Monitoring data and outcomes in pediatric patients with Spinal Cord pathology. Summary of Background Data The incidence of Spinal Cord pathology in pediatric patients with scoliosis has been reported between 3% and 20%. Previous studies demonstrated that intraoperative Spinal Cord Monitoring (IOM) during scoliosis surgery can be reliable despite underlying pathology. Methods A single-center retrospective review of 119 Spinal surgery procedures in 82 patients with Spinal Cord pathology was performed. Diagnoses included Arnold-Chiari malformation, syringomyelia, myelomeningocele, Spinal Cord tumor, tethered Cord, and diastematomyelia. Baseline neurologic function and history of prior neurosurgical intervention were identified. Outcome measures included ability to obtain reliable Monitoring data during surgery and presence of postoperative neurologic deficits. Results were compared for 82 patients with adolescent idiopathic scoliosis (AIS). Results Usable IOM data were obtained in 82% of cases (97/119). Twenty-two cases (18%) had no lower extremity data. Patients with Arnold-Chiari malformation or syringomyelia pathologies, in isolation or together, had a significantly higher rate of reliable data compared to other pathologies (p Conclusions Spinal Cord Monitoring is a valuable tool in pediatric patients with Spinal Cord pathology undergoing Spinal deformity surgeries. When obtained, data allow to detect changes in Spinal Cord function. Patients with a diagnosis of Arnold-Chiari or syringomyelia have Monitoring data similar to those patients with AIS. Patients with other Spinal Cord pathologies have less reliable data, and surgeons should have a lower threshold for performing wake-up tests to assess Spinal Cord function intraoperatively.