My 12 year old daughter is scheduled for surgery on December 22nd. She is healthy with the exception of having scoliosis (T45/L40 and probably fusing T5-L1). We have visited three surgeons and have settled on the second one since he and the third pretty much said the same thing. However, I just discovered that he is not scheduling a neurologist for the surgery. He performs hundreds of spinal surgeries per year and has not had any neurological complications from damaging a spinal cord. This was his response when I asked about spinal cord monitoring:
"With modern instrumentation techniques that do not use distraction, (rather translation and derotation) I only find monitoring useful for the very large scoliosis corrections and some congenital scoliosis corrections and have never had a neurologic complication. Years ago when most of the correction was done with Harrington rod distraction, the cord could potentially get stretched. The monitoring wires attached on the face and scalp do tend to cause the adolescent a lot of stress just before surgery. Sometimes you do get confusing data from the monitoring intra-op that can slow the progress of the surgery, resulting in prolonged "open wound" time. For these reasons, I do not routinely use the monitoring for routine adolescent and adult scoliosis."
Is spinal cord monitoring not a part of standard operating procedure for spinal fusion? Would I be crazy not to insist on it? Should I just TRUST the doctor?
"With modern instrumentation techniques that do not use distraction, (rather translation and derotation) I only find monitoring useful for the very large scoliosis corrections and some congenital scoliosis corrections and have never had a neurologic complication. Years ago when most of the correction was done with Harrington rod distraction, the cord could potentially get stretched. The monitoring wires attached on the face and scalp do tend to cause the adolescent a lot of stress just before surgery. Sometimes you do get confusing data from the monitoring intra-op that can slow the progress of the surgery, resulting in prolonged "open wound" time. For these reasons, I do not routinely use the monitoring for routine adolescent and adult scoliosis."
Is spinal cord monitoring not a part of standard operating procedure for spinal fusion? Would I be crazy not to insist on it? Should I just TRUST the doctor?
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