Intraoperative Neuromonitoring (IONM) is an innovation that creates more layers of safety during complex procedures that involve the nervous system. With IONM, the risk of neurological injury can be detected and prevented prior to severe neurological damage, which allows surgeons to make more informed decisions, decreases the chance of adverse outcomes, and protects the hospital and surgical staff from greater liability. According to StatPearls, “Studies have shown that with the use of IONM, there are significant improvements in neurological outcomes.”
IONM represents the cutting edge of safety in neurological surgery, and there are best practices that optimize the surgical experience. The work of the IONM neurophysiologist allows the surgical team to perform at their best while protecting the patient from potentially life-altering neural injuries. Surgeons can act with confidence knowing that the team is aligned and real-time data is being collected and interpreted for safety.
IONM involves the use of multiple diagnostic modalities that can measure neurological data and indicate when injury is possible or likely. These include somatosensory evoked potential (SSEP), motor evoked potential (MEP) and electromyography (EMG). They may be used on their own or together (multimodal). In a recent review from the Global Spine Journal, in which a total of 163 spinal surgery studies were assessed, the IONM modalities were found to yield reliable diagnostic results. Accuracy in sensitivity ranged between 48-90%, and accuracy in specificity ranged between 92-97%. Though accuracy between modalities varied, the researchers concluded that IONM diagnostic modalities “have diagnostic utility in successfully detecting impending or incident intraoperative neurologic injuries.”
When utilized appropriately by trained professionals, IONM increases the possibility of positive outcomes. The Asian Spine Journal reported that out of 317 cases utilizing IONM, 29 showed neural signal improvement compared with the baseline; it revealed that “all patients had a significant improvement in neurological function and subjective symptoms, and none had neurologic deterioration postoperatively.” Cureus stated that in a study of 62 patients undergoing intracranial and spinal neurosurgical procedures that included multi-modality IONM, most patients experienced no new deficits in neurological function post-procedure; it went on to say that “multimodality IONM during different surgical procedures could prevent devastating neurologic insults of neural structures at risk.”
IONM with SpecialtyCare
If your hospital or surgical team is looking into a greater use of IONM to reduce liability and increase the chance of positive outcomes for surgeries that involve the nervous system, contact us today. At SpecialtyCare, our job is to make surgery safer, which is why we place highly trained IONM professionals to be part of your team. As the nation’s largest provider of IONM, we serve 115,000 patients every year, with over 500 of our surgical neurophysiologists employed in 42 states across the country. Get in touch with us today to find out more about how we can help!
