Although rare, one of the most problematic complications during spine surgery is neurologic injury and deficit. Intraoperative neuromonitoring provides real-time assessment of a patient’s neurological function during surgery. Neuromonitoring alerts triggered in the OR can notify the surgical team of a potential complication and allow them to take appropriate action. The effectiveness of these alerts is not fully known; we sought to undertake a prospective quality improvement initiative examining the correlation between neuromonitoring alerts and post-operative neurological complications in spine surgery patients. By studying when and why these alerts occur, and how they relate to complications, we hope to minimize post-operative neurological issues and improve patient safety and outcomes.