What is Intraoperative Neuromonitoring?
Intraoperative neuromonitoring protects a patient during spinal surgery by monitoring and evaluating the nervous system’s status when it’s at risk during the operation. It’s proven to reduce the risks of post-surgical complications such as paralysis, sensory deficits, muscle weakness, and other neurologic defects.
How is IONM Performed?
Electrodes are attached to different limbs, and the surgical team then measures the effects of the electrical impulses. They interpret data from various techniques that evaluate neural pathways, which include:
- Somatosensory Evoked Potentials (SSEPs),
- Transcranial Motor Evoked Potentials (TCMEPs),
- Electroencephalogram (EEG)
- Electromyography (EMG)
- Pedicle Screw Testing and Direct Nerve Root Stimulation (Triggered EMG)
These methods are quick and efficient to reduce risk during a patient’s spinal surgery. They’re also painless, inexpensive, and a surgeon can perform IONM as many times as needed throughout the surgery. Spinal surgery involves different procedures that intraoperative neuromonitoring is used for, which include:
- Spinal fusion
- Total disc replacement
- Scoliosis, kyphosis
- Pain stimulator placement
- Spinal tumor resection
Intraoperative neuromonitoring allows the surgical team to better monitor a patient’s health status during surgery beyond the traditional measures which can be limited.
Prioritizing Patient Safety with IONM
The primary initiative of any healthcare facility is to provide the highest quality patient care. While monitoring patients’ conditions during spinal surgery with IONM, surgeons can quickly address any changes in waveforms that might damage the neuromuscular system.
When patients are under anesthesia during spinal surgery, they cannot have face-to-face communication with their surgeons. Intraoperative neuromonitoring provides a safer, more reliable alternative to avoid waking patients from anesthesia and posing more severe damage. A person’s age or mental status can cause an adverse reaction to a wake-up test. Also, it can prolong surgery and doesn’t accurately monitor a patient’s nerve function.
Without IONM, a patient can suffer from spinal cord or nerve root damage. Surgeons used to rely on traditional x-rays and CT scans to monitor improper hardware placement, nerve tissue damage, and fractures in the vertebrae. However, this type of imaging cannot always detect those complications. Intraoperative neuromonitoring can more quickly and accurately identify neurological damage.
During spinal surgery, essential blood vessels, nerve roots, and the spinal cord are all at risk. With ever-evolving medical advancements and less minimally invasive surgeries, IONM has progressively become more valuable and critical for evaluating nervous function. Therefore, neuromonitoring teams that commonly consist of neurophysiology technologists and interpreting physicians should have extensive knowledge and undergo ample training to perform this job as IONM is only becoming more valuable and prominent in the surgical field.
Intraoperative Neuromonitoring Services at SpecialtyCare
SpecialtyCare is the largest provider of intraoperative neuromonitoring (IONM) services in the nation. We work alongside the world’s leading surgeons to help identify any early signs of neurological injury. We’re backed by a skilled team of IONM physicians, who provide additional support with real-time monitoring. At SpecialtyCare, the health of the patient always comes first. As a partner in IONM, we are your insurance policy against risk and the high cost of patient injury to help ensure patient safety.