Abstract Background: Intraoperative neuromonitoring (IONM) serves as a critical tool in cervical spine surgeries. It aids in real-time surgical decision-making by detecting and preventing nerve injuries, thereby enhancing surgical safety and outcomes. Materials and Methods: This retrospective study analyzed 160 cervical spine surgeries with IONM performed by a single surgeon between 2018 and 2023. Eligible patients (>18 years) with myelopathy, multilevel stenosis, or neurological deficits were assessed using Nurick, modified Japanese Orthopedic Association, and medical research council scale (MRC) grading scales. Transcranial motor evoked potentials and electromyography monitoring were correlated with postoperative neurological outcomes over a minimum 6-month follow-up. Results: The sensitivity of IONM in predicting postoperative neurological changes was 75%, with a negative predictive value of 98.48%. About 1.25% patients without IONM changes developed symptoms such as severe pain or C5 palsy, which resolved during follow-up. Conclusion: IONM is a valuable adjunct in cervical spine surgeries, helping to detect intraoperative neural compromise and minimize postoperative deficits. Although not infallible, its high sensitivity and specificity support its use for enhancing surgical safety and outcomes.
Modi et al. (Fri,) studied this question.