IONM for orthopaedic and neurosurgical spinal procedures is a well-supported technique for reducing neurological injuries.

Although any spinal surgery may benefit from monitoring, it is particularly useful in high risk or complex surgeries, such as those involving instrumentation (medical devices), or significant correction of curvature, or stenosis (an abnormal narrowing of the structures containing the spinal cord or nerve roots). For scoliosis surgery, IONM is now the standard of care. Monitoring may also be beneficial in cervical surgeries (surgeries to correct neck pain) and in lumbar surgeries (surgeries that correct vertebrae in your lower back) when the surgeon wishes additional information about neural integrity. Monitoring is recommended for complex surgeries such as disc replacement, dorsal rhizotomy (neurosurgery that selectively severs problem nerve roots in the spinal cord for certain neuromuscular disorders) and tethered cord release (surgery to release the spinal cord when it becomes attached, or tethered, to the surrounding tissue, usually at the base of the back).

Select 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.

Learn more about scoliosis: http://www.srs.org/patients/

Learn more about lumbar surgery: http://www.mayoclinic.org/spinal-fusion/

Learn more about dorsal rhizotomy: http://yoursurgery.com/ProcedureDetails.cfm?BR=2&Proc=84