Inclusion Criteria:  Patients must be ≥18 years of age Patients must be undergoing thoracic or lumbar spine surgery where quadriceps MEP recording would be the standard of care Patients should have normal preoperative quadriceps strength Patients are capable of understanding the informed consent and have signed the informed consent document prior to any study-specific screening procedures or evaluations being performed  Exclusion Criteria:  Patients with ongoing psychiatric concerns would be excluded. Patients who are non-English speakers.