Introduction: Complex spine surgeries carry a high risk of postoperative neurological deficits, making intraoperative neuromonitoring (IONM) an essential tool for enhancing surgical safety. This review synthesizes evidence on the efficacy, benefits, and limitations of IONM in preventing these deficits.
Methods: This narrative review comprehensively examined peer-reviewed literature from the past two decades, including randomized controlled trials, retrospective analyses, and expert consensus reports. Special focus was placed on monitoring modalities such as somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and electromyography (EMG), as well as their roles in intraoperative decision-making.
Results: Studies demonstrate that multimodal IONM, particularly the combination of SSEPs and MEPs, significantly reduces the incidence of postoperative motor deficits. Real-time feedback allows for timely corrective interventions, preserving neural function during complex procedures such as deformity corrections and tumor resections. However, challenges remain, including variability in interpretation, the need for experienced personnel, and the occurrence of false positives.
Conclusion : IONM is a proven adjunct that enhances patient safety in complex spine surgery by reducing postoperative neurological deficits. Standardized protocols and comprehensive training are needed to maximize its utility and address its limitations. Future research should focus on long-term outcomes and the cost-effectiveness of IONM to support its broader implementation.
.jpg)