The Evidence for Intraoperative Neurophysiological Monitoring in Spine Surgery

Based on strong evidence that multimodality intraoperative neuromonitoring (MIOM) is sensitive and specific for detecting intraoperative neurologic injury during spine surgery, it is recommended that the use of MIOM be considered in spine surgery where the spinal cord or nerve roots are deemed to be at risk, including procedures involving deformity correction and procedures that require the placement of instrumentation. There is a need to develop evidence-based protocols to deal with intraoperative changes in MIOM and to validate these prospectively.