Spinal cord monitoring

Neurophysiographic methods have been shown to decrease iatrogenic morbidity during spinal surgery. Somatosensory evoked potentials, spontaneous and evoked electromyography from relevant muscles, and pedicle screw stimulation techniques take advantage of well-described anatomic substrates to provide accurate information on spinal cord and nerve function. Attempts at monitoring motor function have been hampered by a sensory pathway that may be ectopically stimulated during spinal motor tract evaluations. Development of motor evaluation techniques that rely on known anatomic substrates, and exclude inadvertent ectopic responses, is progressing. (C) Lippincott-Raven Publishers.