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J Am Acad Orthop Surg, Vol 15, No 9, September 2007, 549-560.
© 2007 the American Academy of Orthopaedic Surgeons
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Intraoperative Neurophysiologic Monitoring During Spinal Surgery

Vincent J. Devlin, MD and Daniel M. Schwartz, PhD, D.ABNM

Dr. Devlin is Orthopaedic Spine Surgeon, Sonoran Spine Center, Mesa, AZ. Dr. Schwartz is Neurophysiologist, Surgical Monitoring Associates, Inc, Bala Cynwyd, PA.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Devlin and Dr. Schwartz.

Reprint requests: Dr. Devlin, Sonoran Spine Center, 1432 South Dobson Road, Suite 201, Mesa, AZ 85210.

Intraoperative neurophysiologic monitoring (IONM) is a battery of neurophysiologic tests used to assess the functional integrity of the spinal cord, nerve roots, and other peripheral nervous system structures (eg, brachial plexus) during spinal surgery. The underlying principle of IONM is to identify emerging insult to nervous system structures, pathways, and/or related vascular supply and to provide feedback regarding correlative changes in neural function before development of irreversible neural injury. IONM data provide an opportunity for intervention to prevent or minimize postoperative neurologic deficit. Current multimodality monitoring techniques permit intraoperative assessment of the functional integrity of afferent dorsal sensory spinal cord tracts, efferent ventral spinal cord motor tracts, and nerve roots. Combined use of these techniques is useful during complex spinal surgery because these monitoring modalities provide important complementary information to the surgery team.




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Correspondence
J. Am. Acad. Ortho. Surg., February 1, 2008; 16(2): 61 - 62.
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