{"id":"fc2c34ef-45d8-4af5-bc6b-c1417f8f95e9","slug":"the-role-of-intraoperative-neurophysiological-monitoring-in-spinal-surgery-a-focused-evidence-review-2015-2025","title":"The role of intraoperative neurophysiological monitoring in spinal surgery: A focused evidence review (2015–2025)","authors":["Kashaf Fatima","Manahil Irfan","Abdullah Aslam","Izaz Riaz","Ceemal Fareed Khan","Saad Khan","Muhammad Riaz"],"abstract":"Background: Intraoperative neurophysiology monitoring (IONM) has become a critical tool in spinal surgery, providing real-time feedback on neural integrity to help prevent postoperative neurological deficits. Despite its growing use, there remains variability in evidence regarding its effectiveness across diverse surgical contexts. Methods: A systematic search of PubMed, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, and Google Scholar identified studies assessing IONM in spine surgery. Risk of bias assessment was performed using ROBINS I tool. Results: Our review found that IONM is associated with lower rates of neurological injury in controlled cohorts, although larger registries showed higher crude deficit rates confounded by surgical complexity. Intraoperative alerts were common but usually transient, enabling timely corrective actions. Diagnostic accuracy was high, with excellent specificity and negative predictive value, supporting IONM’s role as an early-warning tool. Conclusion: IONM enhances patient safety in spinal surgery by enabling early detection of neural injury and minimizing postoperative neurological deficits. Evidence supports the use of multimodal IONM with standardized protocols to improve neurological outcomes.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/fc2c34ef-45d8-4af5-bc6b-c1417f8f95e9/featured/hero-1781558052264.png","publishDate":"2026-01-02T00:00:00.000Z","doi":"10.25259/SNI_1100_2025","categories":["Spine","Review Article"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2026/01/14204/SNI-17-5.pdf"}