Intraoperative Neuromonitoring (IONM) involves multiple modalities for identifying complications or risk of injury during complex surgeries, especially those involving the spine, brain, and nervous system. IONM allows the surgical team to receive data in real time and make adjustments based on the threat of potential damage, reducing the possibility of long-term impairment. 

Neurophysiologists are the IONM technicians who work with surgeons to create more layers of safety for the patient and improve outcomes. When patients are exposed to less risk, so are hospitals; IONM safety means fewer potential malpractice lawsuits and a better reputation for the hospital, which can lead to greater revenue opportunities.

Effectiveness of IONM for Safer Surgery

While IONM technology is relatively new, research has shown that IONM modalities are effective in detecting risks and enabling injury prevention. For example:

• Frontiers in Surgery revealed that in a study of 193 patients undergoing clipping of unruptured intracranial aneurysm, the patients who received IONM “had significantly lower rates” of postoperative neurological deficit. The modalities used in the study were motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs). The authors concluded that IONM demonstrated critical specificity and that it is “a useful and essential tool” for this type of surgery.

• The European Spine Journal showed that in a study of 2,728 patients undergoing spine surgery with neuromonitoring, 33.3% had IONM alerts. Out of those alerts, 107 were positive for risk of injury, 23 were false positives, and 8 were false negatives. Multimodal IONM had a 93% rate of sensitivity and a 99% rate of specificity. The authors recommended multimodal IONM in all complex spine surgeries.

• The Spine Journal published a study of 54 pediatric patients undergoing posterior spinal fusion for high-grade spondylolisthesis utilizing IONM. Approximately 22% of patients had IONM alerts, and 75% made a full recovery. The authors recommended multimodal IONM in all surgeries of this kind.

The Financial Benefits of IONM

The utilization of IONM during complex surgeries is increasing because of the rate of accuracy for improving safety and the reduced liability that it offers to surgical teams. The Journal of Spine Surgery notes that IONM use has risen by 296% over the last decade during spine surgery. They explain that the obvious benefit is the decrease in neurological morbidity without adding more risk to the operation. 

But other benefits are inherent in better outcomes — fewer malpractice suits pertaining to long-term injury, staff satisfaction and morale, and a positive reputation for the hospital or surgical center. More safety has benefits for everyone, and cost-effectiveness is key for both medical teams and patients. The good news is that studies have shown that IONM has a financial upside:

• In the use of IONM during cardiac surgery, The Journal of Stroke and Cerebrovascular Diseases stated, “We find considerable cost savings favoring the use of IONM under certain parameters corresponding to high-risk patients.”

• The North American Spine Surgery Journal found that, after reviewing 50,000 patient charts, IONM proved to be cost-effective in most scenarios. 

If your hospital or surgical center is seeking to increase its use of IONM, contact us today. We have a team of highly trained neurophysiologists who can assist your surgical teams by implementing IONM modalities, communicating data in real time, and providing opportunities for improved patient outcomes. We have the expertise and experience you need to implement IONM modalities in more ways, reducing liability and upholding your high standards of patient care. Get in touch with us today to find out more about how we can help!