Intraoperative electrophysiologic monitoring: considerations for complex spinal surgery.

Intraoperative neurophysiologic monitoring techniques have evolved as the complexity of spinal surgery has increased and the limitations of individual modalities have become apparent. Current monitoring strategies include a combination of techniques directed toward detecting changes in sensory, motor, and nerve root function. Close coordination and communication between the monitoring personnel, surgeon, and anesthesiologist is essential to effective intraoperative monitoring.