Study purpose. The purpose of our study was to evaluate the ability of the pyramid response scale developed by us to assist in evaluating the motor block in multimodal, in particular epidural anesthesia. Methods. We analyzed 178 protocols of intraoperative neuromonitoring of 158 patients (13.4±0.5 years) with spinal deformities of severe and medium severity of different etiology. Epidural administration of ropivacaine solution (0.375% in the amount calculated taking into account age and weight) was performed in 28 patients during operative intervention. We have developed a scale for estimating the extent of changes in motor evoked potentials, the rank values of which (0—7) are proportional to the degree of suppression of the pyramidal system function. Patients were divided into two groups, in which the change in the level of motor responses was compared. In the intervention group, epidural delivery of anesthetics was used. Results. The results of the study showed that the reaction of the pyramidal system to epidural blockade with ropivacaine varies widely from no changes to deep inhibition of motor responses. The use of neurophysiological control allows the surgeon and anesthesiologist to promptly correct the intervention. Conclusion: epidural delivery of ropivacaine allows to maintain electrophysiological monitoring of the spinal cord conduction pathways and to avoid the development of an irreversible reduction in their function due to ischemic damage to the spinal cord at critical moments of operative correction of the spinal deformity. The developed scale of changes in motor responses facilitates the analysis of information and accelerates the decision-making during the operative intervention.