Klippel-Feil syndrome for scoliosis surgery: management of a potentially difficult paediatric airway, and report of false-negative motor-evoked potential

A six-year-old girl with Klippel-Feil syndrome and throcacolumbar scoliosis was scheduled for growing rod insertion. Inhalational induction and tracheal intubation were carried out, with her neck in a neutral position. However, the patient woke up with paraplegia, despite normal intraoperative neurophysiological monitoring, which necessitated immediate revision surgery. Intravenous induction was performed for the second surgery. We discuss the management of a potentially difficult paediatric airway, and report on false-negative motor-evoked potential.