Electrophysiology and Bioinstrumentation
Fundamental to intraoperative monitoring are the principles of electrical recording and stimulation of neural tissue. The monitoring clinician in the surgical suite will record neural activity that is both spontaneous and evoked by electrical stimulation in order to monitor and map the nervous system and ensure intact neural pathways. A conceptual understanding of these processes is one of the main pillars upon which the field of intraoperative monitoring is based. In the early history of intraoperative monitoring, neurophysiologists conceived of and built their own systems for electrically interfacing with the patient’s nervous system. Today, the equipment is purchased from companies that manufacture advanced monitoring devices. These devices automate many of the calculations that had to be performed manually in the past. Nevertheless, the monitoring clinician in the surgical suite must have a working understanding of bioinstrumentation and electrical stimulation and recording techniques in order to ensure valid testing of neural function.