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REVIEW ARTICLE
Year : 2023  |  Volume : 24  |  Issue : 1  |  Page : 4-10

The relevance of the wake-up test in scoliosis surgery: A narrative review


1 Additional Professor, Department of Anaesthesia and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
2 Associate Professor, Department of Anaesthesia and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
3 Department of Orthopaedics, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
4 Department of Anaesthesia and Intensive Care, ESIC Medical College, Hospital and Super Specialty Hospital, Sanath Nagar, Hyderabad, Telangana, India

Correspondence Address:
Dr. Sapna Annaji Nikhar
Department of Anaesthesiology and Intensive Care, Nizam's Institute of Medical Sciences, Hyderabad - 500 082, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/TheIAForum.TheIAForum_25_23

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The corrective scoliosis surgery is associated with many complications; the neurologic complication is one of them. It is very important to assess spinal cord integrity intraoperatively to avoid postoperative damage and have a good outcome. Wake-up test was the standard of care in old generations but now with the availability of advanced neurophysiologic monitoring somatosensory and motor-evoked potentials; the relevance of wake-up test is questionable. This review aimed to assess the relevance of wake-up test in scoliosis surgery with availability of advanced technology. Comprehensive literature search was performed in PubMed, Google Search and Scopus, EndNote X6 version, and the keywords used for the search were scoliosis, neurophysiologic monitoring, and wake-up test. The different study results were interpreted to come to conclusion. This review gives us a detailed idea of the different tests available and pitfalls with each and finally what should be our stand. The review highlighted the good collaboration between surgeon, anesthesiologist, and neurologist to conclude the results of the tests of neurophysiologic monitoring. Intraoperative neurologic monitoring improves postoperative outcome. Wake-up test is only and strongly recommended, in case of unavailability of advanced monitoring, confusion on test results, and persistent signal reduction.


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