Targeting nerve safety: an innovative era in minimally invasive sciatic and sacral surgery with real-time neuromonitoring for sensorimotor protection and foot drop prevention

Laparoscopic nerve decompression assisted by real-time multimodal neuromonitoring appears feasible and safe for selected patients with refractory pelvic neuropathic pain. In this preliminary series, neuromonitoring provided actionable intraoperative feedback that may help optimise the extent of decompression while minimising the risk of motor impairment. These data support further multicentre evaluation to confirm efficacy, refine indications, and standardise monitoring-guided algorithms.