Prevention of Neurological Damage in Severe Cervical Stenosis: The Role of Intraoperative Monitoring and Proactive Measures
Pedro Nogarotto Cembraneli, Julia Brasileiro de Faria Cavalcante, Italo Nogarotto Cembraneli, Renata Brasileiro de Faria Cavalcante, José Edison da Silva Cavalcante, Leonardo Taveira Lopes, Alessandro Fonseca Cardoso, Marco Daniel Xavier, Chrystiano Fonseca Cardoso
Cervical stenosis is a degenerative condition that causes compression of the spinal cord and nerve roots,
resulting in neurological symptoms such as pain, weakness, and loss of motor and sensory function.
Surgical treatment, such as spinal decompression, is indicated for severe cases, as untreated compression
may lead to irreversible damage. Intraoperative neurophysiological monitoring (IONM) has proven
essential for patient safety, allowing early detection of neurological changes and enabling immediate
intervention. This article discusses the importance of IONM in severe cervical stenosis surgeries,
highlighting preventive measures to minimize neurological damage. We report the case of a 57-yearold patient with severe cervical stenosis associated with myelopathy. A posterior surgical approach
was chosen, with decompression and fusion, utilizing IONM to monitor motor potentials. Proactive
measures, such as warm saline irrigation and maintenance of a mean arterial pressure (MAP) of 90
mmHg, were implemented to prevent neurological deterioration. After decompression, motor potentials
returned to baseline levels, and the patient recovered without new neurological deficits. We conclude
that IONM, combined with preventive strategies, is crucial in reducing the risk of neurological damage
during severe cervical stenosis surgeries, ensuring greater patient safety
