This chapter presents a case study of a 56-year-old male, American Society of Anesthesiologists Class III, scheduled to undergo T9-T12 laminectomy and microsurgical correction of a T10-T12 dural ateriovenous fistula. Central nervous system (CNS) function was monitored using somatosensory evoked potentials (SSEP), electromyography (EMG) and transcranial motor evoked potentials (MEP). The neurophysiologic monitors used in this case were monitors of CNS function, and can be described as follows: sensory evoked potentials (SEPs); motor evoked potentials; electromyography; and intraoperative changes. Sensory evoked potentials (SEPs) are measured electrophysiologic responses to somatosensory, visual, or auditory stimulation. Electromyography consists of monitoring muscle activity in response to either spontaneous or active nerve stimulation. In the immediate postoperative period a brief neurologic exam completed by the anesthetic team should be documented in the anesthetic record. In these ways morbidity and mortality in complex spine surgery using neurophysiologic monitoring can be reduced.