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Overview of Intraoperative Neurophysiological Monitoring During Spine Surgery

Shilian, Parastou; Zada, Gabriel; Kim, Aaron C.; Gonzalez, Andres A.

Journal of Clinical Neurophysiology: August 2016 - Volume 33 - Issue 4 - p 333–339
doi: 10.1097/WNP.0000000000000132
Original Research

Summary: Intraoperative neurophysiologic monitoring has had major advances in the past few decades. During spine surgery, the use of multimodality monitoring enables us to assess the integrity of the spinal cord, nerve roots, and peripheral nerves. The authors present a practical approach to the current modalities in use during spine surgery, including somatosensory evoked potentials, motor evoked potentials, spinal D-waves, and free-run and triggered electromyography. Understanding the complementary nature of these modalities will help tailor monitoring to a particular procedure to minimize postoperative neurologic deficit during spine surgery.

University of Southern California, Los Angeles, CA, U.S.A.

Address correspondence and reprint requests to Parastou Shilian D.O., Department of Neurology, University of Southern California, 1520 San Pablo, Suite 3000, Los Angeles, CA 90033; email:

© 2016 by the American Clinical Neurophysiology Society