Application of intraoperative neurophysiological monitoring of motor and somatosensory evoked potentials for assessing spinal nerve root function during spinal surgeries

Abstract

The objective of this review is to assess the role and effectiveness of intraoperative neurophysiological monitoring (IONM) of evoked potentials in reducing the risk of radicular neurological complications during spinal surgeries, both in traditional and minimally invasive approaches.

An analysis of literature and clinical studies was conducted, encompassing the use of somatosensory (SSEP) and motor evoked potentials (MEP) for monitoring radicular injuries during spine operations. Special attention was given to comparing the effectiveness of these methods in the context of various surgical approaches, including discectomy, laminectomy, spinal fusion, and minimally invasive techniques. Literature data demonstrated that IONM significantly reduces the risk of neurological complications by providing real-time monitoring and the ability to promptly respond to potential nerve structure damages. MEPs exhibit high sensitivity in identifying motor nerve root damages, while SSEPs are effective in assessing sensory nerves. The application of multimodal IONM in minimally invasive surgery also reduces the risk of iatrogenic neurological damages, despite the limited visibility of the surgical field.

Thus, IONM is a valuable tool for enhancing patient safety and reducing radicular neurological complications in the surgical treatment of spine diseases. Further research is necessary to optimize IONM techniques, develop standardized protocols, and improve staff training for the most effective use of this technology in clinical practice.