Monitoring Nervous-System Function During Surgery
Intraoperative Neuro Monitoring (IONM) uses neurophysiological recording equipment during selected surgical procedures. Its purpose is to observe the functional integrity of neurological structures such as the brain, spinal cord, nerve roots and peripheral nerves while surgery is taking place.
Monitoring Nervous-System Function During Surgery
Intraoperative Neuro Monitoring (IONM) uses neurophysiological recording equipment during selected surgical procedures. Its purpose is to observe the functional integrity of neurological structures such as the brain, spinal cord, nerve roots and peripheral nerves while surgery is taking place.
Changes in recorded signals can provide the surgical team with information that may allow them to assess and respond to a possible neurological risk during the procedure.
Why Is IONM Used?
IONM supports the surgical team but cannot remove every surgical risk or guarantee a particular outcome.
Procedures Where Monitoring May Be Considered
Procedures Where Monitoring May Be Considered
- Selected spinal procedures
- Brain and neurosurgical procedures
- Vascular procedures
- Orthopedic procedures
- Ear-, nose- and throat procedures
- Operations involving peripheral nerves
- Procedures where neural structures may be at risk
Possible Monitoring Techniques
- Somatosensory evoked potentials
- Motor evoked potentials
- Electromyography
- EEG
- Brainstem auditory evoked responses
- Cranial-nerve monitoring
- Nerve mapping
What Happens Before and During Surgery?
The planned operation is reviewed
The surgical and monitoring teams review the planned operation.
Monitoring electrodes may be inserted
Monitoring needle electrodes may be inserted into selected muscles after anesthesia.
Baseline recordings are obtained
Baseline recordings are obtained.
Monitoring continues during surgery
Recordings continue during key stages of the operation.
Significant changes are communicated
Significant changes are communicated to the surgical team.
Information the team may need before monitoring takes place.
- Provide a clear medical and surgical history where relevant.
- Tell the team about previous surgery involving the spine, brain or peripheral nerves if applicable.
- Share details of implanted devices, including pacemakers or neurostimulators.
- Inform the team about medication, allergies and other important medical conditions.
- Follow the hospital or surgical team’s instructions regarding fasting, admission and pre-operative preparation.
- Ask any questions about the planned surgery and monitoring process in advance if needed.
IONM forms part of a collaborative surgical environment.
Intraoperative neuro monitoring is performed in coordination with the surgeon, anaesthetist and the wider theatre team.
Monitoring information is considered in the context of the procedure being performed and the surgical team’s clinical objectives.
The type of monitoring being used may interact with anaesthetic management and is considered within the broader operative plan.
Different procedures may require different combinations of techniques depending on what needs to be observed during surgery.
Important note
IONM supports the surgical team but cannot remove every surgical risk or guarantee a particular outcome. Availability depends on the surgical setting and referral arrangements.
Need information about intraoperative neuro monitoring?
Contact MNeuro regarding service availability, referral arrangements and general enquiries related to intraoperative neuro monitoring.