Spinal surgery involves a wide spectrum of procedures during which the spinal cord, nerve roots, and key blood vessels are frequently placed at risk for injury. Neuromonitoring provides an opportunity to assess the functional integrity of susceptible neural elements during surgery. The methodology of obtaining and interpreting data from various neuromonitoring modalities—such as somatosensory evoked potentials, motor evoked potentials, spontaneous electromyography, and triggered electromyography—is reviewed in this report. Also discussed are the major benefits and limitations of each modality, as well as the strength of each alone and in combination with other modalities, with regard to its sensitivity, specificity, and overall value as a diagnostic tool. Finally, key clinical recommendations for the interpretation and step-wise decision-making process for intervention are discussed. Multimodality neuromonitoring relies on the strengths of different types of neurophysiological modalities to maximize the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Thorough knowledge of the benefits and limitations of each modality helps in optimizing the diagnostic value of intraoperative monitoring during spinal procedures. As many spinal surgeries continue to evolve along a pathway of minimal invasiveness, it is quite likely that the value of neuromonitoring will only continue to become more prominent.

As the epicenter for learning activities, the brain is the coordinator of all actions associated with collecting information, organizing it, storing it, and eventually re-organizing it for application in the real world. And yet, to date, little has been known about what happens within the brain during learning activities. We have operated based on a black box set of assumptions that results in researchers testing inputs and outputs but lacking a true understanding of what happens between those two endpoints. However, the fields of neuroscience and cognitive science, along with neuro-technology engineers, have simultaneously been studying the brain and developing apparatus that allow us to understand what is happening in the brain in real-time during learning. The implications of these capabilities and a deeper understanding of learning are boundless. Accordingly, this chapter will delve into four key areas: (1) research and theories, (2) cognitive readiness and comprehension, (3) neuro-technology data, and (4) the necessary evolution of teachers to facilitators.