Neuromonitoring During Spine Surgery

Intraoperative neuromonitoring (IONM) is an increasingly used tool aiming to detect abnormal neural function and to prevent adverse outcomes in acute care environments. IONM application for traumatic spine injuries can add a specialized depth to the understanding of a patient’s functional status, in a real-time manner. Successful IONM implementation requires excellence in the areas of clinical application, technologist competence, information technology systems, and physician interpretation. The intraoperative modalities of transcranial electrical motor evoked potentials (TCeMEPs), short-latency somatosensory evoked potentials (SSEPs), and spontaneous and triggered electromyography (sEMG and tEMG) can be accurately applied to aid the surgeons’ intraoperative decision making and postoperative care. Future IONM challenges in spinal surgeries include the establishment of more rigorous evidence-based guidelines and better cost-to-benefit ratio.