ABSTRACT
Neurological deficit is the most feared complication of spine surgery. Although infrequent in the general spine surgery population, there is significant opportunity for neurological insult in patients undergoing corrective spine surgery for post-traumatic injury. Neurological injury is not simply a by-product of the surgery itself; rather, it can occur presurgically during transfer of the patient to the operating room table, neck extension for airway management during intubation or patient positioning for adequate operative exposure. From a surgical perspective, appropriate preoperative preparation, careful surgical planning, surgical execution, and constant surgical vigilance can minimize risk for neurological complications. An additional increasingly important means of injury prevention is continuous neurophysiological monitoring of spinal cord and spinal nerve root function. Development of better-defined methods for assessing spinal cord motor and nerve root integrity essentially in real time makes intraoperative neurophysiological monitoring (IONM) a particularly attractive means of reducing the prevalence of new or additional neurological impairment in this select patient population. It behooves the spine surgeon, therefore, to have at least basic understanding of neuromonitoring methodology and how best to apply the information presented in order to facilitate prompt reversal of impending neurological injury.
