The purpose of intraoperative neuromonitoring (IONM) is to detect and reduce
neuronal deficits during critical surgeries. The neurophysiologist uses
monitoring techniques to assess a patient's nervous system function during
these surgeries where the nervous system is at risk. If signal changes occur that are abnormal, the
neurophysiologist performing IONM informs the surgeon and corrective actions
are made to reduce nerve damage that otherwise may go unnoticed. IOM
provides a safety margin for
the patient by minimizing complications leading to better patient outcome
and reduced short and long-term medical costs.
IONM has been shown to
reduce patient complications during complex surgeries. For example, Epstein et al.
(1993) assessed the clinical usefulness of IONM during cervical spine
decompression by comparing 218 patients that were not monitored with 100
patients that were. There was a 3.7% incidence of quadriplegia and a 0.5%
incidence of death in the unmonitored patients, whereas there was no incidence of
quadriplegia or death in the monitored group (Epstein et al., 1993, SPINE
18(6): 737-74). Numerous
studies
have demonstrated that using IONM during surgery results in a significant
reduction of patient complications, medical costs, and mortality. IONM is
the standard of care for many surgical procedures.
IONM utilizes various techniques (listed below)
to monitor the integrity of a patient's nervous system
throughout the surgery. Some surgeries dictate
that a multitude of these techniques be used simultaneously to ensure the
safety for the patient as well as achieving the best possible outcome after
surgery. At ADI, we strive to provide each patient with the safest and
most effective monitoring achievable.