Spinal Monitoring
 Introduction
IONM for orthopaedic and neurosurgical spinal surgeries is a well supported technique for the
reduction of neurological injuries.
Indications
Although any single spinal surgery may benefit from monitoring, it is
particularly useful in those surgeries with increased surgical risk or
complexity, such as those involving instrumentation or significant
correction of curvature or stenosis. For scoliosis surgery it is now the standard of care.
Monitoring, especially using multiple modalities together, may also be
beneficial in cervical surgeries and in lumbar surgeries in which the
surgeon wishes additional information about neural integrity. Monitoring
is recommended for complex surgeries such as disc replacement, dorsal rhizotomy and tethered cord release.
Modalities Used
SEP,
S-EMG, T-EMG, TceMEP, D
waves, H waves, F waves
R. O'Brien MD
Selected References
Macri S, De Monte A, Greggi T, et
al. Intra-operative spinal cord monitoring in orthopaedics. Spinal Cord
2000;38(3):133-9.
American Electroencephalographic Society.
Guideline eleven: guidelines for intraoperative monitoring of sensory
evoked potentials. American Electroencephalographic Society. J Clin
Neurophysiol 1994;11(1):77-87.
Celesia GG, Allison T, Bodis-Wollner I,
et al. American electroencephalographic society committee on guidelines
for intraoperative monitoring of sensory evoked potentials. Guideline
eleven: guidelines for intraoperative monitoring of sensory evoked
potentials. J Clin Neurophysiol 1994;11:77-87.
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