Intraoperative Neurophysiological Monitoring in Spine Surgery

Intraoperative neurophysiological monitoring (IONM) encompasses a variety of neurological testing modalities used during surgery to monitor, identify, and potentially prevent iatrogenic complications to the nervous system and the blood supply to it or adjacent tissue. It has been used to monitor integrity of the neural pathway during spinal, neurological, cranial, and vascular procedures. Specific tests are designed to the clinical need of the surgery. Modalities may include: Somatosensory evoked potentials, motor evoked potentials, spontaneous or triggered electromyography, brainstem auditory evoked potentials, visual evoked potentials, electroencephalogram, and electrocorticography. During spinal surgery, a wide variety of procedures are utilized in which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk from iatrogenic injury. Multimodal IONM relies on the strengths of different types of neurophysiological modalities to maximize the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Thorough knowledge of the benefits and limitations of each modality helps in optimizing the diagnostic value of IONM during spinal procedures. As spinal surgeries continue to evolve, the value of neuromonitoring will also continue to become more prominent. How to cite this article Shaikh MA. Intraoperative Neurophysiological Monitoring in Spine Surgery. J Postgrad Med Edu Res 2017;51(2):89-94.