Monitoring nervous-system function during surgery.
Intraoperative neuro monitoring, often called IONM, involves the use of neurophysiological monitoring techniques during selected surgical procedures to help monitor the functional integrity of neural structures.
A specialised service used in the operating theatre.
Intraoperative neuro monitoring may be used during certain surgical procedures where monitoring the nervous system is clinically relevant. Neurophysiological techniques are used to observe functional changes while surgery is taking place.
The specific techniques used depend on the procedure, the structures at risk and the clinical question. Monitoring supports the broader surgical process and is carried out in collaboration with the operating team.
Monitoring may support selected procedures where neural structures are important.
The use of intraoperative monitoring depends on the procedure being performed and the clinical need identified by the surgical team.
Monitoring is set up before and used throughout relevant parts of surgery.
Monitoring is planned in advance
The monitoring approach is matched to the planned surgical procedure and the relevant neuroanatomy.
Electrodes are positioned
Recording and stimulation electrodes may be placed before surgery begins, depending on the technique used.
Baseline responses are obtained
Initial recordings are captured so that later changes can be assessed meaningfully.
Monitoring continues during surgery
Neurophysiological signals are observed during key stages of the procedure.
Relevant changes are communicated
If significant changes are seen, they are relayed to the surgical team in real time.
Monitoring is completed at the end
The study concludes once the relevant phases of surgery are complete and the monitoring equipment is removed.
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
Intraoperative neuro monitoring is a specialised supportive service used during selected surgeries. It is not a routine patient appointment in the same way as EEG, EMG or NCV testing, and 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.