Tibial Nerve Injury from Intraoperative Neuromonitoring Needle Electrode During Cervical Disc Arthroplasty: A Case Report

Case Report

Volume 5, Issue 2

Tibial Nerve Injury from Intraoperative Neuromonitoring Needle Electrode During Cervical Disc Arthroplasty: A Case Report

Lisa S Liff¹, Dena M Mistichelli² and Michael J. Dorsi^1*

¹Department of Neurosurgery, UCLA Health, Los Angeles, CA, USA
²University of Notre Dame, Notre Dame, IN, USA

^*Corresponding author: Michael J. Dorsi, MD, Department of Neurosurgery, UCLA Health, Los Angeles, CA, USA. E-mail: mjdorsi@mednet.ucla.edu

Received: May 14, 2026; Accepted: June 02, 2026; Published: June 15, 2026

Citation: Liff LS, Mistichelli DM, Dorsi MJ. Tibial Nerve Injury from Intraoperative Neuromonitoring Needle Electrode During Cervical Disc Arthroplasty: A Case Report. Case Rep Orthop Surg J. 2026; 5(2): 163.

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Tibial Nerve Injury from Intraoperative Neuromonitoring Needle Electrode During Cervical Disc Arthroplasty: A Case Report

Abstract

We report a case of a patient who underwent a C6/7 anterior cervical disk arthroplasty with standard IONM protocol who was found to have permanent tibial nerve injury due to subdermal needle placement. Through extensive rehabilitation, ultrasound, and podiatric care it was discovered he had an anatomical variation of his tibial nerve which likely predisposed him to the iatrogenic injury. We recommend use of surface gel electrodes as a cost-effective and time-conscious prevention of similar injuries. We also discuss the role different podiatric interventions had and their efficacy at symptom management and improvement.

Keywords: Tibial nerve injury; Iatrogenic complication; Orthotics; Platelet rich plasma (PRP) injections; Intraoperative neuromonitoring; Peripheral nerve injury

Article Details

Tibial Nerve Injury from Intraoperative Neuromonitoring Needle Electrode During Cervical Disc Arthroplasty: A Case Report