Use of Intraoperative Neurophysiological Monitoring in Surgical Treatment of Spinal Diseases

Intraoperative neurophysiological monitoring (IONM) is a method, which uses different kinds of electrophysiological methods for monitoring and mapping of neural structures during surgical procedures with the aim to preserve them. If we know how important the function of the spine, spinal cord, nerve roots, and all other structures are, it is obvious how important it is to preserve them in surgical procedures where these structures are under risk. Although the frequency of neurological complications is not high, it is considered that these deficits are devastating complications of spinal surgery, which can have serious consequences on the quality of life and can increase health care costs. Because of that, the accent is on intraoperative neurophysiological methods development, which provide optimal monitoring of the spinal cord function during routine and complex spinal procedures and has high efficacy detecting possible neurological deficits. The concept of multimodal neuromonitoring, which is used today, relies on advantages of each modality separately and then in combination of these modalities it achieves a more reliable estimation of functional integrity. Today IONM is routinely used worldwide, but in Serbia, its use is still limited even though its advantages are well known.