Damage to spinal cord and subsequent neurological deficit may occur during surgery of spinal cord. Stagnara wake up test aims at recognizing early intraoperative warning of potential damage.
If the injury is recognized, steps can be taken to undo the process that might have caused it. For example if spinal injury signs are found following correction of the curves by distraction of instrumentation rods, the distraction can be reduced.
This test involves waking the patient during the surgery and asking them to move their feet.
The performance of wake-up tests requires an anesthetic regimen that provides for fast recovery and fast return of cognition to allow immediate examination. The drugs like desflurane and remifentanil are used for these regimens.
Stagnara testmonitors voluntary motor function. It is simple to perform and does not require sophisticated equipment
The wake-up test has been considered the gold standard of spinal monitoring.
It, however, can miss onset of injury or ischemia. Moreover, it does not identify isolated nerve injury or subtle changes.
Therefore, it is prudent to use the test in conjunction with electrophysiological methods.