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Intraoperative Neuromonitoring in Peripheral Nerve Stimulation.

Zinat S Annaev¹, Adam F Jackson¹, Konstantin V Slavin^2,3

¹Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, Illinois, USA.

The Neurodiagnostic Journal

|November 6, 2025

Summary

Peripheral nerve stimulation (PNS) uses electrical impulses to treat pain and other conditions. Intraoperative neurophysiological monitoring (IONM) is crucial for safely guiding PNS procedures and preventing nerve damage.

Keywords:

Dorsal root ganglion stimulation intraoperative neuromodulation neuromonitoring peripheral nerve stimulation

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Area of Science:

Neurology
Neurosurgery
Biomedical Engineering

Background:

Peripheral nerve stimulation (PNS) involves applying electrical stimulation to nerves for therapeutic purposes.
Initially used for pain management, PNS now addresses conditions like epilepsy, depression, sleep apnea, and respiratory insufficiency.
PNS modalities include conventional, percutaneous, and peripheral nerve field stimulation.

Purpose of the Study:

To review the utilization of intraoperative neurophysiological monitoring (IONM) during peripheral nerve stimulation (PNS) procedures.
To highlight the importance of IONM in enhancing the safety and efficacy of PNS interventions.
To discuss the role of IONM in preventing iatrogenic injuries and guiding surgical targeting.

Main Methods:

Review of current literature on IONM application in PNS.
Discussion of electrophysiological methods for real-time nerve assessment during surgery.
Analysis of IONM's contribution to surgical decision-making and nerve protection.

Main Results:

IONM provides critical real-time information during PNS procedures, complementing preoperative assessments.
IONM aids in detecting and minimizing iatrogenic nerve injuries.
IONM facilitates precise mapping of nervous structures and assessment of nerve functionality.

Conclusions:

IONM is a valuable tool for ensuring the safety and effectiveness of peripheral nerve stimulation.
Integrating IONM into PNS procedures improves surgical outcomes and patient safety.
Further research and adoption of IONM in PNS are recommended.