Intraoperative neurophysiologic monitoring in high-grade spondylolisthesis

Intraoperative neurophysiologic monitoring during high-grade spondylolisthesis surgery has enabled surgeons to expand operative treatment while preventing iatrogenic nerve injuries. Studies show improvement in the safety profile of a multimodal approach to intraoperative neuromonitoring in high-grade spondylolisthesis procedures to prevent neurologic damage. Electromyography-inclusive monitoring, with or without additional monitoring techniques (somatosensory evoked potentials and motor evoked potentials), successfully alerts surgical teams to potential intraoperative nerve injury. The value of intraoperative neuromonitoring is high in high-grade spondylolisthesis reduction procedures, screw placement, and L5 vertebrectomies, allowing for immediate corrective maneuvers in the form of hemodynamic stabilization and suspension of manipulations.