Influence of intraoperative neurophysiologic monitoring on the development of surgical dissection techniques.

Intraoperative neurophysiologic monitoring (IONM) is essential in the preservation of function of nervous system. IONM is thus becoming the gold-standard method in nerve-sparing surgical procedures. Apart from spine and brain surgery, IONM is essential in significantly reducing morbidity in colorectal surgery, prostate and thyroid surgery, as well as in hip replacement, to name a few. IONM measures weak electric nerve potentials and, therefore, it is easily disturbed by other electromagnetic sources. Surgical dissection techniques and devices interfering with IONM make this technique useless because this is dissection that mainly endangers nerve structures. Therefore, there is a need to take into consideration the influence of various dissection techniques on IONM, and to develop or modify inert techniques that are currently not widely used.