Chief, Neuro Spine Surgery & Additional Director, Neurosurgery, Artemis Hospitals, Gurgaon, India
Part 5 of 13 in Making Spine Surgery 100% Safe
Intraoperative Neuromonitoring in Spine Surgery
August 6, 2026
Intraoperative neuromonitoring tracks the function of the spinal cord and nerves throughout spine surgery, allowing surgeons to detect and respond to potential nerve injury before it becomes permanent. Dr. S. K. Rajan, Chief and Unit Head, Orthopaedics and Spine Neurosurgery at Artemis Hospitals, Gurgaon, confirmed that this technology is used regularly as part of spine surgery in India at his centre.
Why Neuromonitoring Is Rare in India
During the question and answer session of his Jivo Masterclass, Dr. S. K. Rajan confirmed that Artemis Hospitals is one of the very few centres in the country to use intraoperative neuromonitoring regularly. This places it alongside the O-arm and keyhole instrumentation as part of what he calls a circle of safety that is rarely available together under one roof in India.
How Neuromonitoring Protects Patients During Surgery
By continuously monitoring nerve signals during spine surgery, the surgical team can identify early warning signs of nerve compression or injury in real time, before any damage becomes permanent. This is particularly valuable in complex spine surgery involving deformity correction, tumour removal or decompression near the spinal cord.
What This Means for Patient Safety
Dr. S. K. Rajan's combination of intraoperative neuromonitoring with O-arm navigation, spine navigation, the latest microscope, keyhole instrumentation and a special positioning frame is a major reason his spine surgery outcomes are described as achieving more than 99% safety, making this an important factor for patients to consider when researching spine surgery in India.
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This article is based on a Jivo Masterclass session conducted by Dr. S. K. Rajan, Chief and Unit Head, Orthopaedics and Spine Neurosurgery, Artemis Hospitals, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass — Dr. S. K. Rajan taught doctors across Africa on September 15, 2024.
FROM THE LIVE Q&A
Dr. Buffa
What about the cost of treatment, and the duration of treatment, for a spine problem?
Dr. S. K. Rajan
The cost of surgery in our hospital for spinal problems can range anything from $3,500 for a discectomy and decompression to $5,500 or $6,000 for fixation of the spine at one level, and even up to $10,000 for more complicated cases — that's usually the range of costs patients most commonly have to bear. Most of these patients, who come walking because of pain in the neck, arm, or lower back going into the legs, usually stay in the hospital for about three to four days, and in the country for about two weeks.
Frequently Asked Questions
Do you use intraoperative neuromonitoring?▼
Yes, we do use intraoperative neuromonitoring — we are one of the very few centres in the country who have been using this quite regularly. We were focusing on minimally invasive spine surgery and spine navigation in this talk because of limited time, but yes, we do have neuromonitoring available to us as well.
Do you have provisions for doing spine surgeries for children with neural tube defects?▼
Yes, we have specialist spine surgeons and pediatric surgeons also, and I myself do a lot of spine surgery in children — whether they have neural tube defects such as meningocele, Chiari malformation, or tethering of the spinal cord which can cause weakness of the legs. In all those patients we do spine surgeries, also in children who've got scoliosis or hemivertebra deformities, or tumours of the spine. All those patients we have been tackling from the age of 6 months to 18 years of age.
What about the cost of treatment, and the duration of treatment, for a spine problem?▼
The cost of surgery in our hospital for spinal problems can range anything from $3,500 for a discectomy and decompression to $5,500 or $6,000 for fixation of the spine at one level, and even up to $10,000 for more complicated cases — that's usually the range of costs patients most commonly have to bear. Most of these patients, who come walking because of pain in the neck, arm, or lower back going into the legs, usually stay in the hospital for about three to four days, and in the country for about two weeks.
What does intraoperative neuromonitoring do during spine surgery?▼
It tracks the function of the spinal cord and nerves throughout the operation, allowing surgeons to detect and respond to potential nerve injury before it becomes permanent.
Why is intraoperative neuromonitoring considered rare among spine centres in India?▼
Dr. Rajan confirmed that Artemis Hospitals is one of the very few centres in the country to use it regularly, forming part of a circle of safety that is rarely available together under one roof.
In which types of spine surgery is neuromonitoring especially valuable?▼
It is particularly valuable in complex procedures involving deformity correction, tumour removal or decompression near the spinal cord.
How does neuromonitoring contribute to overall surgical safety outcomes?▼
Combined with O-arm navigation, spine navigation, the latest microscope and keyhole instrumentation, it is a major reason Dr. Rajan's spine surgery outcomes are described as achieving more than 99% safety.
In This Series: Making Spine Surgery 100% Safe
- 1.Making Spine Surgery 100% Safe
- 2.Cement Augmentation for Osteoporotic Spinal Fractures
- 3.Cost of Spine Surgery in India
- 4.Why an Integrated Spine Clinic Matters: Team-Based Spine Care
- 5.Intraoperative Neuromonitoring in Spine Surgery
- 6.Keyhole (Minimally Invasive) Spine Surgery Explained
- 7.Lumbar Canal Stenosis: Keyhole Surgery and Recovery
- 8.What Is the O-Arm and How Does It Make Spine Surgery Safer?
- 9.Pediatric Spine Surgery in India: Conditions Treated
- 10.Scoliosis Correction Surgery in India
- 11.Treating Spinal Tuberculosis in India
- 12.What Causes Spine Surgery Complications, and How They're Prevented
- 13.When Is Spine Surgery Actually Needed? Signs You Shouldn't Ignore