Spinal cord monitoring: current state of the art

The intraoperative application of evoked potential and electromyographic (EMG) monitoring has increased significantly over the last 2 decades. Cranial nerve monitoring is widely accepted and used by otologists, neurologic surgeons, and ophthalmologists. Direct and indirect techniques for assessing the peripheral nervous system are used by plastic and orthopedic surgeons when performing intraoperative nerve grafting. Myriad techniques and applications for monitoring the spinal cord and peripheral nervous system have been developed, evaluated, and used by orthopedic and neurologic surgeons involved in spinal surgery.