Global Spine Journal

Identification and Management of Neurologic Complications in Adult Spinal Deformity Surgery

Jan 15, 2025

5 min

Objective

To review the identification, prevention, and management of neurologic complications associated with adult spinal deformity (ASD) surgery.

Methods

The authors conducted a comprehensive review of the literature using major medical databases. Relevant studies were selected to evaluate:

Incidence and types of neurologic complications
Risk factors
Intraoperative neuromonitoring (IONM) strategies
Postoperative management protocols

Results

Neurologic complications, while relatively uncommon, can result in significant morbidity.
Higher risk is associated with complex deformities, osteotomies, revision surgery, and pre-existing neurologic deficits.
Intraoperative neuromonitoring plays a critical role in early detection of neurologic compromise.
Prompt intraoperative intervention may reduce the risk of permanent injury.
Structured safety protocols and surgical checklists improve risk mitigation.

Conclusion

Adult spinal deformity surgery carries inherent neurologic risk. However, appropriate patient selection, meticulous surgical planning, intraoperative neuromonitoring, and rapid response to signal changes can significantly reduce the likelihood of permanent neurologic injury.

Clinical Relevance

This review provides practical guidance for spine surgeons to improve patient safety and optimize neurologic outcomes in complex deformity surgery.