ABOUT
IONM

What is Intraoperative Neuromonitoring? (IONM)

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Intraoperative neuromonitoring (IONM) is a technique used during surgery to continuously assess and monitor the function of the nervous system in real-time. The primary goal of IONM is to detect any potential damage to neural structures, such as the brain, spinal cord, or peripheral nerves, while the surgical procedure is underway. This enables the surgical team to take immediate corrective actions if needed, thereby enhancing patient safety and improving surgical outcomes.

 

Why your doctor requested IONM

 

Surgeons request intraoperative neuromonitoring (IONM) to enhance patient safety and optimize surgical outcomes by providing real-time assessment of neural function during complex procedures. IONM allows for continuous monitoring of critical nerve pathways, helping to detect and address potential issues immediately. This proactive approach minimizes the risk of neurological damage and ensures that the delicate structures involved are protected, ultimately contributing to a more successful and safer surgery.

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How Intraoperative Neuromonitoring Works

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1. Electrode Placement:

   • Surface Disk Electrodes: Placed on the skin over specific areas to measure electrical activity from the brain, spinal cord, or peripheral nerves.

   • Subdermal Needle Electrodes: In some cases, electrodes may be placed directly near or within neural structures, depending on the surgery.

2. Types of Monitoring:

   • Somatosensory Evoked Potentials (SSEPs): Measures the neurophysiological  activity in response to sensory stimulation, helping to monitor the sensory pathways.

   • Motor Evoked Potentials (MEPs): Assesses the motor pathways by stimulating the motor cortex or spinal cord and measuring muscle responses.

   • Electromyography (EMG): Monitors muscle activity to detect any potential nerve injury or dysfunction.

   • Direct Cortical Stimulation: Used during certain brain surgeries to map and monitor critical motor or sensory areas.

3. Real-Time Feedback:

   • Alerts: If significant deviations from normal neural activity are detected, the IONM team alerts the surgical team to take corrective measures.

   • All surgical neurophysiologists in the operating room are overseen by board certified audiologist or neurologist.

4. Continuous Monitoring: Provides ongoing data about neural function, allowing for immediate detection of any changes that could indicate potential damage.

5. Integration with Surgery:

   • Collaboration: The neuromonitoring team works closely with the surgical team to provide insights and guidance based on the real-time data, helping to ensure the procedure is performed safely and effectively.

 

Overall, intraoperative neuromonitoring is a crucial tool in modern surgery, particularly for complex procedures involving the nervous system, as it helps to safeguard against neurological complications and improve patient outcomes.