Introduction Intraoperative electrophysiological monitoring is used to potentially avoid permanent injury as a result of surgical manipulation. During spine surgeries, standard monitoring of median or posterior tibial nerve somatosensory evoked potentials (SEPs) can be insensitive and fail to identify useful intraoperative changes in neural function. Dermatomal somatosensory evoked potentials (DSEPs) have previously been shown to be valuable in identifying specific nerve root dysfunction during surgeries involving spinal decompression, fusion, or tumor resections. Methods Between 2012 and 2017, 2785 spine surgeries were performed with intraoperative monitoring at our institution. Of these, 1884 cases utilized DSEP monitoring in addition to standard SEPs of the median and posterior tibial nerves. Results We highlight 7 cases during which intraoperative DSEPs were able to independently identify changes that were not observed through standard mixed nerve SEPs. During these cases, we observed improvements that correlated with adequate neural decompression, real-time changes in individual nerve root function, as well as provided intraoperative monitoring feedback to surgeons when reliable SEP signals were not obtained. Conclusion DSEP monitoring can serve as a useful and sensitive adjunct method for intraoperative monitoring that may provide additional information to surgeons and patients undergoing spine surgeries. The limitation of DSEP monitoring is that it requires coordination between anesthesiologists, surgeons, and skilled monitoring technicians.