Which aspect can complicate monitoring efficacy during scoliosis surgery?

During scoliosis surgery, the ability to accurately monitor neural function is crucial for preventing injury to the spinal cord and related structures. The potential complication of being unable to detect ischemia is particularly significant, as ischemia can lead to irreversible damage if not recognized and addressed promptly. This complication during surgical monitoring arises from the necessity to monitor real-time neural signals and blood flow to ensure that the spinal cord remains adequately perfused throughout the procedure.

The inability to detect ischemia can directly affect the monitor's efficacy because if there is a reduction or cessation of blood flow, it may not be apparent on the monitoring devices until significant damage has already occurred. Consequently, timely interventions may be delayed, increasing the risk of postoperative complications or neurologic deficits.

In contrast, while a patient's age and presence of comorbidities can influence recovery and overall surgical risk, they do not specifically complicate the accuracy of monitoring neural function in real-time. Electrode misplacement can certainly lead to misleading data during monitoring, but it is a technical issue that can generally be resolved before surgery begins. The focus on ischemia specifically highlights the critical nature of monitoring during such procedures, making it the most pertinent complication in terms of monitoring efficacy.