This work is licensed under Creative Commons Attribution 4.0 License ANN.MS.ID.000729. What Is Intraoperative Neurophysiological Monitoring?Intraoperative neurophysiological monitoring (IONM) consists of the continuous analysis of the patients' neurological status using a set of tools and methods that allows us to assess the functional state of the neurological systems and pathways of interest.Different techniques, such as somatosensory evoked potentials (SSEPs), motor evoked potentials (MEPs), and others are employed according to the type of surgery and neurological tissue to be monitored.

We present a rare case of fully penetrating spinal cord injury in an 8-year-old girl who accidentally stabbed herself with a crochet needle at L4-L5 level. She presented to the local Accident and Emergency Department without neurological deficit. This is the full account of her perioperative management resulting in total neurological preservation.

We present the case of a healthy 37-year-old male body builder champion who sustained a significant neck injury after diving into a shallow swimming pool whilst intoxicated during his holiday abroad. His severe cervical injuries were astoundingly missed at the local A&E Department and he was discharged to fly back home on a soft collar and analgesics. He presented to his General Practitioner two weeks later complaining of refractory neck pain and significant neurological signs and symptoms. Following spinal multidisciplinary discussion at the local specialised Unit, halo vest immobilisation was identified as the best treatment option. A 24-week period was required to achieve complete healing of the injuries and full return to normal functionality.