Temporomandibular Joint (TMJ) dislocation during spinal surgery is exceedingly rare, particularly in pediatric patients. We report a 16-year-old female who developed bilateral TMJ dislocation following posterior spinal fusion performed in the prone position with intraoperative neuromonitoring. Excessive masseter muscle contraction during motor-evoked potential stimulation was suspected to have contributed to the dislocation. Prompt recognition and manual reduction resulted in complete recovery without sequelae. This case highlights the importance of careful communication with neuromonitoring teams, optimized stimulation settings, and postoperative vigilance to prevent and promptly manage TMJ complications associated with motor-evoked potential monitoring.
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