@article{ee860b4513de4cdcb64e30295915b335,
title = "Intraoperative Monitoring for Spinal Surgery",
keywords = "Intraoperative neuromonitoring, Motor evoked potentials, Somatosensory evoked potentials, Spine surgery",
author = "Nitin Agarwal and Saman Shabani and Jeremy Huang and Ben-Natan, {Alma Rechav} and Mummaneni, {Praveen V.}",
note = "Funding Information: SSEP can be monitored continuously but relies on signal averaging over time, so decreases may lag transcranial MEP changes. SSEP signal transmission can be affected by patient height, temperature, nerve compression, and anesthetic type and dose.10 Monitoring of MEP may provide earlier detection of neurologic injury, but MEP cannot be monitored continuously and may induce patient movement. For example, a multiphase method of monitoring MEP was developed to address MEP limitations from anesthesia but created alternative adverse effects in the form of patient tongue and lip lacerations.10 Both SSEP and MEP are frequently used to monitor neurologic function during spinal deformity surgery and are useful in evaluating the functional integrity of the spinal cord. Concurrent use of SSEPs and MEPs to monitor posterior spinal fusion cases has demonstrated overall improved sensitivity and specificity in neuromonitoring in scoliosis surgery.11 EMG is less well characterized as a standalone modality of IONM, because it is usually used in support of SSEP and MEP. However, it has unique applications in minimally invasive spine surgeries, especially posterior pedicle screw placements. Stimulating the screw can help in determining if there is a medial breach, and it minimizes the use of perioperative fluoroscopy by allowing for early trajectory correction.12 EMG is also less susceptible to the neurologic effects of anesthesia.10",
year = "2022",
month = may,
doi = "10.1016/j.ncl.2021.11.006",
language = "English",
volume = "40",
pages = "269--281",
journal = "Neurologic Clinics",
issn = "0733-8619",
number = "2",
}