Intraoperative Monitoring for Spinal Surgery

Overall literature opinions on use of IOMN is divided. Clark and colleagues demonstrated a correlation between a decrease in intraoperative MEPs and new postoperative neurologic deficits in cervical or cervicothoracic myelopathy cases. The sensitivity and specificity of MEP monitoring as a diagnostic test varies based on risk factors such as patient comorbidities, age, and preoperative neurologic function.(21)& nbsp;To truly determine the effectiveness of IONM, we recommend the implementation of a standard procedure for neuromonitoring across several sites to gather data. One such checklist could come from Ziewacz and colleagues,(38 & nbsp;)who have created an effective checklist for the multidisciplinary response to significant intraoperative neuromonitoring alert in spine surgery. Although the initial implementation of a standardized IONM plan may be complicated, it may also lead to increased interdisciplinary cooperation among the surgeons, anesthesiologists, and neuromonitoring technicians of the surgical team and may contribute to further advancements in IONM.