The impact of neck extension on intraoperative neuromonitoring alerts in cervical myelopathy: A neurophysiological analysis.

These events predominantly involved abrupt TcMEP amplitude reduction and were typically reversible with repositioning.

Patients with posture-dependent TcMEP changes demonstrated greater occipitocervical extension and preoperative MRI markers of cord compromise, while subaxial alignment did not differ.

Postoperative neurological deficits occurred only in cases with persistent, non-reversible TcMEP reduction at closure (3 events), whereas reversible changes were not followed by deficit.