Tongue Bite Injury Resulting from Intra-operative Neuromonitoring during Posterior Scoliosis Corrective Surgery Not an Uncommon Complication: Case Report and Literature Review

Review Data

Q: Is the topic relevant to the journal's area of interest? Is it contemporary and interesting for

researchers?

A: Good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Tools and Methods

Q: Are the methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments: The Discussion illustrates the significance of increased use of the intraoperative neuromonitoring (IONM) during spinal surgery. The authors put forth the bite injuries as the most common non-neurologic complication of trans-cranial motor evoked potential (TcMEP) monitoring, providing relevant literature. Further, it describes the surgical management of the tongue bite injury resulting from the use of intraoperative neuromonitoring (IONM) during spinal surgeries. The Conclusion underlines TBI as a distressing complication for patient and the medical team. Lastly, the authors indicate the importance of the precautions needed to be taken during surgical preparation.

Literature

Q: Does the author utilize relevant literature?

A: Good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Writing style

Q: Is it clear and understandable?

A: Good

Comments: There are few errors found in the manuscript, which are as follows:

·       Under Abstract, 5^th sentence, “We report on its management and reviewed the literatures … for prevention of this injury” is rewritten as “We report on its management and reviewed literatures … for the prevention of this injury.”

·       Under Discussion, 2^nd paragraph, 4^th sentence, “Long surgical time in prone position causing tongue oedema and gravity-induced protrusion, further triggers occurrence of the injury” is corrected as “Long surgical time in prone position causes tongue oedema and gravity-induced protrusion, which further triggers the occurrence of the injury.”

Further comments on the paper

Comments: The manuscript reports a case of a 20-year-old male presenting progressive spinal deformity noticed since 10-years-old. Physical imaging diagnosed adolescent idiopathic scoliosis and corrective spinal surgery was suggested, using multimodal intraoperative neuromonitoring (IONM) consisting of trans-cranial motor evoked potential (TcMEP). The surgery was followed by two lacerations of the oral cavity. The case report highlights the prognosis of tongue bite injury resulting from the intra-operative neuromonitoring during posterior scoliosis corrective surgery.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team