The Use of Intraoperative Neuromonitoring for Cervical Spine Surgery: Indications, Challenges, and Advances

Intraoperative neuromonitoring (IONM) has become an indispensable surgical adjunct in cervical spine procedures to minimize surgical complications. Understanding the historical development of IONM, indications for use, associated pitfalls, and recent developments will allow the surgeon to better utilize this important technology. While IONM has shown great promise in procedures for cervical deformity, intradural tumors, or myelopathy, routine use in all cervical spine cases with moderate pathology remains controversial. Pitfalls that need to be addressed include human error, a lack of efficient communication, variable alarm warning criteria, and a non-standardized checklist protocol. As the techniques associated with IONM technology become more robust moving forward, IONM emerges as a crucial solution to updating patient safety protocols.

Automated summary

Intraoperative neuromonitoring (IONM) has become an essential tool in cervical spine surgeries to reduce complications. Understanding its development, indications, pitfalls, and recent advancements can optimize its utilization. Although IONM shows promise in complex cases, its routine use in moderate cervical spine pathologies is debated. Addressing issues such as human error, communication efficiency, alarm criteria, and checklist standardization is necessary. As IONM technology continues to advance, it plays a crucial role in enhancing patient safety protocols.