Intraoperative electrophysiological monitoring during surgery for cervical spondylotic myelopathy

Use of Intraoperative electrophysiological monitoring during surgery for cervical spondylotic myelopathy or cervical radiculopathy is not recommended as an indication to alter the surgical plan or administer steroids since this paradigm has not been observed to reduce the incidence of neurological injury (Level D class III)

Although the use of electrophysiological monitoring (EP) monitoring may serve as a sensitive means to diagnose potential neurological injury during anterior spinal surgery for cervical spondylotic myelopathy, the practitioner must understand that intraoperative EP worsening is not specific-it may not represent clinical worsening and its recognition does not necessarily prevent neurological injury, nor does it result in improved outcome (Class II). Intraoperative improvement in EP parameters/indices does not appear to forecast outcome with reliability (conflicting Class I data) ¹⁾.

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Resnick DK, Anderson PA, Kaiser MG, Groff MW, Heary RF, Holly LT, Mummaneni PV, Ryken TC, Choudhri TF, Vresilovic EJ, Matz PG; Joint Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Electrophysiological monitoring during surgery for cervical degenerative myelopathy and radiculopathy. J Neurosurg Spine. 2009 Aug;11(2):245-52. doi: 10.3171/2009.2.SPINE08730. PubMed PMID: 19769504.