Special Topic Issue: Intraoperative Neurophysiological Monitoring

With this special topic issue “Intraoperative Neurophysiological Monitoring,” we complement the last special topic issue “Brain Mapping” in a chronological way. As during neurosurgical procedures mapping techniques target to identify eloquent tissue, the aim of monitoring methods is to assess the functional integrity of the observed system. The choice of the intraoperative neurophysiologic technique may also depend on the intraoperative pathology, which needs to be treated. The topics of this edition, therefore, include a wide range of indications, from carotid endarterectomy to skull base surgery, supratentorial lesions, and intramedullary spinal cord tumors.

The included articles indicate that there are interesting advances in the field of intraoperative neurophysiology. Whereas some authors (re)evaluate established approaches, others introduce new techniques. During neurosurgery, risk stratification and intraoperative guidance of the surgical strategy depend on various tools. Thus, the correlation between imaging techniques such as intraoperative magnetic resonance imaging (MRI) or ultrasonography and monitoring paradigms seems to be a general trend.

Monitoring neuronal function contributed strongly to the approach of maximal safe surgery irrespective of the pathology to be treated. It not only provides the surgeon with valuable information when critical function is at risk but also gives the surgeon more confidence when proofing functional integrity during surgery. Thus, the perception that monitoring might prevent us from gross total resection or a maximum achievable extent of resection by stopping the surgery too early is mostly wrong. Those studies investigating the impact of monitoring mainly found more arguments for an increased confidence in continuing with a safe surgical procedure while avoiding harm when needed. With such data in mind, we highly welcome further applications of intraoperative neurophysiology and the refinement of existing techniques. With this special edition, we hope to open a new dialogue and interesting discussion on intraoperative monitoring and mapping techniques.

Publication History

Article published online:
14 July 2021