What Is IONM?

bedWhat is IONM?
Intraoperative Neurological Monitoring (“IONM”) is the application of neurophysiological recording techniques for detecting changes in the functional status of nerve tissue that may be at risk during surgery.  The premise of IONM is that changes in electrical activity occur prior to permanent neurologic injury.

Why Use IONM?
Clinical research has shown that IONM reduces the risk of permanent nerve damage during surgery thereby greatly improving patient safety. IONM has become the standard of care for surgical procedures where meaningful risk is involved, and is medically recognized as an important surgical support service which aids the surgeon in avoiding injury to patients.
The goals of IONM are to:
  • Reduce the frequency and severity of injury to vital structures at a time when clinical examination is not possible (the patient being “asleep”).
  • Forewarn the surgeon and anesthesia team of changes in neural function, thereby enabling intervention or correction of the course of surgery to prevent both short or long term injury.

IONM is useful in the early detection of many potentially adverse events:

  • Excessive compression of anatomic structures
  • During positioning of patients with spinal instability
  • During the course of surgery
  • Excessive retraction upon anatomic structures
  • Infringement from bony structures upon critical structures
  • Mechanical stretching of the brainstem, spinal cord, cranial or peripheral nerves
  • Interruption of cerebral, brainstem, spinal cord, or peripheral blood flow

Important anatomical structures can often be distorted by degenerative disease, tumor, or scar tissue. In this regard, IONM may be used in identifying neural tissue.

IONM may also assess:

  • Physiologic parameters, such as hypotension/hypothermia
  • Anesthetic variables, such as burst suppression and depth of anesthesia

Ask Your Surgeon
Neuropath respects the decisions of your doctor, who is in the best position to determine the optimal plan for your surgery. It is normal to feel concerned, anxious, nervous, scared or stressed prior to a surgical procedure. The added safety net of Intraoperative Monitoring (IONM) during the procedure requested by your surgeon, can help alleviate some of these emotions, and lead to a safer surgery with reduced risk of negative outcomes. Neuropath recommends that you talk to your doctor or surgeon if you would like to learn more about IONM and your procedure.