• IONM signal change strongly predicts worse postoperative outcome, with a highly significant association (χ 2 = 26.89, p = 6.2 × 10 −6 ) This retrospective study of 344 spinal tumor surgeries identifies histology, tumor location, resection extent, and perioperative complications as key predictors of clinical outcome and revision surgery.
Preoperative irradiation also showed a negative trend (OR 0.63, 95% CI: 0.3-1.2), though it was not a significant independent factor in this cohort (p = 0.8376).
Ultimately, despite this perceived discrepancy, the data showed that the use of IONM was associated with a slightly higher rate of clinical improvement (87.0%) than procedures without IONM (83.1%), although this difference did not reach statistical significance in the multivariate analysis.