What is a disadvantage of using PTN SSEPs during scoliosis surgery?

Using PTN (posterior tibial nerve) somatosensory evoked potentials (SSEPs) during scoliosis surgery has a notable disadvantage in that they are not effective for detecting ischemia to the anterior spinal cord. This is primarily because PTN SSEPs predominantly reflect the function of the dorsal columns and do not directly assess the integrity of the anterior spinal artery, which primarily supplies the anterior part of the spinal cord. During scoliosis surgery, there is a risk of ischemic events affecting the anterior spinal cord, and the monitoring of PTN SSEPs will not give adequate information regarding this risk.

This limitation can have critical implications since ischemia in the anterior portion of the spinal cord may lead to significant morbidity, including motor deficits, that would not be picked up through PTN SSEPs. Therefore, while PTN SSEPs can provide information about sensory pathways, they do not offer comprehensive monitoring of the functional integrity of all spinal cord pathways during procedures that have the potential to disrupt blood flow to the anterior spinal cord.

Other potential disadvantages such as the risk of infection, poor signal quality, or increased surgical time are less specific factors related to the utility of PTN SSEPs specifically in this surgical context. The important issue remains the inadequate