Multimodal Intraoperative Neuromonitoring in Intradural Spinal Tumors: A Detailed Case Series Highlighting the Role of D‑Wave Monitoring

Multimodal Intraoperative Neuromonitoring in Intradural Spinal Tumors: A Detailed Case Series Highlighting the Role of D‑Wave Monitoring | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Multimodal Intraoperative Neuromonitoring in Intradural Spinal Tumors: A Detailed Case Series Highlighting the Role of D‑Wave Monitoring Harsh Patel, Preeti Singh, Abhaya Kumar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9052903/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Surgical management of intradural spinal tumors carries a significant risk of postoperative neurological deficits due to the compact organization of neural pathways within the spinal cord. Multimodal intraoperative neuromonitoring (IONM), including motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), and D‑wave monitoring, has emerged as an essential adjunct for functional preservation. Objective: To evaluate the role of multimodal IONM in guiding tumor resection and predicting postoperative neurological outcomes in patients undergoing surgery for intradural spinal tumors. Methods: A retrospective analysis of four patients undergoing intradural spinal tumor resection with multimodal IONM was performed. Intraoperative neuromonitoring changes were correlated with immediate and follow‑up neurological outcomes. Results: Transient MEP changes were observed in three patients. Preservation or recovery of D‑wave amplitude strongly correlated with favorable long‑term motor outcomes. Conclusion: Multimodal IONM, particularly D‑wave monitoring, plays a critical role in safe resection of intradural spinal tumors and in predicting postoperative neurological recovery. Intradural tumor Intramedullary tumor D‑wave MEP SSEP Intraoperative neuromonitoring Full Text Additional Declarations The authors declare no competing interests. Ethics Approval: The study protocol was reviewed by the Institutional Ethics Committee of [Kokilaben Dhirubhai Ambani Hospital and Research Institute ], and the requirement for formal ethical approval was waived due to the retrospective nature of the case series . Consent to Participate and Publish: Written informed consent was obtained from the patients for participation in the study and for publication of clinical details and images. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9052903","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":602039233,"identity":"31b51c42-73c2-4aa4-a961-5fda3e6a525b","order_by":0,"name":"Harsh 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17:26:14","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9052903/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9052903/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104782197,"identity":"3f59adaf-0515-4eef-bbfa-781c79430e3d","added_by":"auto","created_at":"2026-03-17 07:56:57","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1496417,"visible":true,"origin":"","legend":"","description":"","filename":"uuuuu.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9052903/v1_covered_b9d7025a-3d99-44a1-b1b5-4b83c1790062.pdf"}],"financialInterests":"\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eEthics Approval: The study protocol was reviewed by the Institutional Ethics Committee of [Kokilaben Dhirubhai Ambani Hospital and Research Institute ], and the requirement for formal ethical approval was waived due to the retrospective nature of the case series .\u003c/p\u003e\n\u003cp\u003eConsent to Participate and Publish: Written informed consent was obtained from the patients for participation in the study and for publication of clinical details and images.\u003c/p\u003e","formattedTitle":"\u003cp\u003eMultimodal Intraoperative Neuromonitoring in Intradural Spinal Tumors: A Detailed Case Series Highlighting the Role of D‑Wave 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neuromonitoring","lastPublishedDoi":"10.21203/rs.3.rs-9052903/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9052903/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eSurgical management of intradural spinal tumors carries a significant risk of postoperative neurological deficits due to the compact organization of neural pathways within the spinal cord. Multimodal intraoperative neuromonitoring (IONM), including motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), and D‑wave monitoring, has emerged as an essential adjunct for functional preservation.\u003c/p\u003e\u003ch2\u003eObjective:\u003c/h2\u003e \u003cp\u003eTo evaluate the role of multimodal IONM in guiding tumor resection and predicting postoperative neurological outcomes in patients undergoing surgery for intradural spinal tumors.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA retrospective analysis of four patients undergoing intradural spinal tumor resection with multimodal IONM was performed. Intraoperative neuromonitoring changes were correlated with immediate and follow‑up neurological outcomes.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eTransient MEP changes were observed in three patients. Preservation or recovery of D‑wave amplitude strongly correlated with favorable long‑term motor outcomes.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eMultimodal IONM, particularly D‑wave monitoring, plays a critical role in safe resection of intradural spinal tumors and in predicting postoperative neurological recovery.\u003c/p\u003e","manuscriptTitle":"Multimodal Intraoperative Neuromonitoring in Intradural Spinal Tumors: A Detailed Case Series Highlighting the Role of D‑Wave Monitoring","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-15 08:30:23","doi":"10.21203/rs.3.rs-9052903/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d5ca8a68-e202-4353-953c-83a5011548a3","owner":[],"postedDate":"March 15th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-15T08:30:23+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-15 08:30:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9052903","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9052903","identity":"rs-9052903","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}