{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T17:03:51Z","timestamp":1780938231016,"version":"3.54.1"},"reference-count":10,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIntraoperative neuromonitoring (IONM) is widely used in spine surgery to detect neurological injury. However, rising healthcare costs necessitate an evaluation of the value of IONM, given the added expense and time associated with its use. Here, we identified risk factors contributing to significant IONM changes during anterior versus posterior versus circumferential cervical surgery.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nThis retrospective study at a Level I trauma center (2012\u20132016) involved 663 trauma patients with myelopathy or radiculopathy who underwent anterior, posterior, or circumferential cervical surgery utilizing IONM. We focused on when significant changes occurred during these procedures and correlated them with neurological outcomes.<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nOf the 663 patients, averaging 54.8 years of age, 51 (7.7%) patients developed statistically significant IONM changes; in descending order, they occurred during posterior (10.8% [27\/249]), circumferential (9.1% [2\/22]), and anterior (5.6% [22\/392]) operations. Notably, 5 (9.8%) of the 51 patients developed new postoperative neurologic deficits; 4\/5 (80%) occurred following posterior and 1 (20%) after an anterior cervical procedure.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nOf 663 patients, 51 (7.7%) patients developed statistically significant IONM changes that were most frequent (i.e., in descending order), following posterior (10.8% [27\/249]), circumferential (9.1% [2\/22]), and anterior (5.6% [22\/392]) operations.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_841_2025","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T06:02:40Z","timestamp":1758261760000},"page":"402","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Postoperative consequences of intraoperative neuromonitoring changes during cervical spine surgery"],"prefix":"10.25259","volume":"16","author":[{"given":"Amy","family":"Phan","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Japa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Washington Hospital Center, Washington, DC, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalin","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashim JF","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lancelot","family":"Benn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Missouri-Kansas City, Kansas, Missouri, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haddas","family":"Ram","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Washington Hospital Center, Washington, DC, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Ehioghae","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, MedStar Washington Hospital Center, Washington, DC, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addisu","family":"Mesfin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, MedStar Orthopaedic Institute, Washington, DC, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"10.25259\/SNI_841_2025\/ref-1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/BRS.0000000000001662","article-title":"Routine use of intraoperative neuromonitoring during ACDFs for the treatment of spondylotic myelopathy and radiculopathy is questionable: A review of 15,395 cases","volume":"42","author":"Ajiboye","year":"2017","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_841_2025\/ref-2","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2013.4.FOCUS13121","article-title":"Intraoperative neuromonitoring with MEPs and prediction of postoperative neurological deficits in patients undergoing surgery for cervical and cervicothoracic myelopathy","volume":"35","author":"Clark","year":"2013","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_841_2025\/ref-3","doi-asserted-by":"crossref","first-page":"E349","DOI":"10.1097\/BSD.0000000000001739","article-title":"Utilization of neuromonitoring in surgical cervical spondylosis patients with the presence or absence of myelopathy: Is it standard?","volume":"38","author":"Gonzalez","year":"2025","journal-title":"Clin Spine Surg"},{"key":"10.25259\/SNI_841_2025\/ref-4","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/j.wneu.2024.06.057","article-title":"Neuromonitoring signal changes in degenerative cervical myelopathy: An analysis of risk factors for signal drops during posterior cervical decompression","volume":"190","author":"Iyer","year":"2024","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_841_2025\/ref-5","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2014.8.FOCUS14449","article-title":"A socioeconomic analysis of intraoperative neurophysiological monitoring during spine surgery: National use, regional variation, and patient outcomes","volume":"37","author":"James","year":"2014","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_841_2025\/ref-6","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.cnp.2021.01.001","article-title":"Neurophysiological monitoring during anterior cervical discectomy and fusion for ossification of the posterior longitudinal ligament","volume":"6","author":"Kim","year":"2021","journal-title":"Clin Neurophysiol Pract"},{"key":"10.25259\/SNI_841_2025\/ref-7","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.spinee.2021.01.010","article-title":"What is the predictive value of intraoperative somatosensory evoked potential monitoring for postoperative neurological deficit in cervical spine surgery?-a meta-analysis","volume":"21","author":"Reddy","year":"2021","journal-title":"Spine J"},{"key":"10.25259\/SNI_841_2025\/ref-8","doi-asserted-by":"crossref","first-page":"E283","DOI":"10.1097\/BSD.0000000000001723","article-title":"The prevalence of intraoperative neuromonitoring in anterior cervical discectomy and fusion: Trends, variances, and value appraisal","volume":"38","author":"Rowe","year":"2025","journal-title":"Clin Spine Surg"},{"key":"10.25259\/SNI_841_2025\/ref-9","doi-asserted-by":"crossref","first-page":"E1185","DOI":"10.1097\/BRS.0000000000004070","article-title":"Combined motor and sensory intraoperative neuromonitoring for cervical spondylotic myelopathy surgery 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