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Overview of Intraoperative Neurophysiological Monitoring During Spine Surgery
Parastou Shilian1, Gabriel Zada, Aaron C Kim
1University of Southern California, Los Angeles, CA, U.S.A.
Summary
Intraoperative neurophysiologic monitoring advances spine surgery safety. Multimodality monitoring, including evoked potentials and electromyography, assesses neural integrity to minimize postoperative neurologic deficits.
Area of Science:
- Neurosurgery
- Neurophysiology
Background:
- Intraoperative neurophysiologic monitoring (INM) has significantly advanced.
- Spine surgery necessitates monitoring the integrity of the spinal cord, nerve roots, and peripheral nerves.
Purpose of the Study:
- To present a practical approach to current INM modalities used during spine surgery.
- To elucidate the complementary nature of these monitoring techniques.
Main Methods:
- Utilizing multimodality monitoring during spine surgery.
- Employing somatosensory evoked potentials (SSEPs).
- Employing motor evoked potentials (MEPs).
- Employing spinal D-waves.
- Employing free-run and triggered electromyography (EMG).
Main Results:
- Multimodality monitoring provides comprehensive assessment of neural structures.
- Specific modalities like SSEPs, MEPs, spinal D-waves, and EMG offer complementary data.
- Tailored monitoring strategies can be developed based on procedural needs.
Conclusions:
- Understanding the combined utility of various INM techniques is crucial.
- Optimizing INM selection minimizes the risk of postoperative neurologic deficits in spine surgery patients.
