The Evolution of Intraoperative Neuromonitoring in Ghana and West Africa.

Intraoperative neurophysiological monitoring (IONM) has emerged as a pivotal technology in neurosurgery, significantly enhancing patient safety and surgical outcomes by providing real-time monitoring of neurological functions. Despite its recognized benefits, the adoption and development of IONM in regions like West Africa have been relatively slow, with Ghana pioneering its introduction and utilization. This report explores the evolution of IONM in Ghana, initiated by FOCOS Hospital, and examines its expansion across the region. The report highlights key developments, including the first use of IONM during complex spine surgeries such as scoliosis, kyphosis and kyphoscoliosis deformity correction and brain tumor surgeries. Challenges, such as the scarcity of trained professionals, limited access to essential equipment, and the high cost of implementation are discussed. The future outlook of IONM in Ghana and potentially other West African and by extension, other low- and middle-income countries looks promising with planned expansions in training and certification programs to meet the growing demand. This report underscores the transformative potential of IONM in improving surgical care and patient outcomes in Ghana, West Africa, and other low- and middle-income countries advocating for increased regional support and investment in this crucial healthcare technology.