Transcranial electrical motor-evoked potential monitoring allowed successful intraoperative monitoring. The criterion of one recording showing a response amplitude decrease of more than 80% during a surgical action can be considered a valuable warning criterion for neurologic damage. The authors also consider that monitoring at six instead of two muscles improves the value of neuromonitoring.

Good follow-up results included a 100% follow-up rate, adequate corrections, little correction loss, lower Oswestry scores, and a high satisfaction rate in both groups. The anteroposterior treatment did not influence the curve morphometry more than posterior fusion only. In reducing postoperative sagittal malalignment, the authors believe that surgical management should aim at a correction within the high normal kyphosis range of 40 degrees to 50 degrees, consequently providing good results and, particularly in flexible adolescents and young adults, minimizing the necessity for an anterior release.

We conclude that C7 osteotomy with internal fixation has been shown to be a reliable and stable technique. When surgery is performed the in prone position, distal fixation can be optimally obtained allowing post-operative treatment by cervical orthosis instead of a halo-cast. TES-MEP monitoring has been shown to be a reliable neuromonitoring technique with high clinical relevancy during cervical osteotomy because it allows timely intervention before occurrence of permanent cord damage in a large proportion of the patients.

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Transcranial electrical motor-evoked potential monitoring allowed successful intraoperative monitoring. The criterion of one recording showing a response amplitude decrease of more than 80% during a surgical action can be considered a valuable warning criterion for neurologic damage. The authors also consider that monitoring at six instead of two muscles improves the value of neuromonitoring.