Neurophysiological Monitoring

IONM is the application of somatosensory-evoked potentials, motor-evoked potentials, brainstem auditory evoked potentials, electromyography and quantitative electroencephalographic recording techniques to detect changes in the functional status of neural structures at risk during surgery. IONM detects excessive or accidental retraction of anatomical structures that may cause neural damage and/or compression or encroachment of bony structures that may cause neural damage as well as verification of placement of instrumentation (pedicle screws).

IONM can also detect mechanical stretching of the spinal cord, brain stem and cranial or peripheral nerves. In addition, it can detect disruption in cerebral, brainstem, cranial or spinal cord blood flow. Monitoring is also very helpful in clarifying anatomy that has been distorted by degenerative disease, tumors or scar tissue. It is useful in cases involving congenital anomalies, revision surgery or severe inflammatory processes that may obscure normal anatomical structures and surgical landmarks. IONM can also identify or separate nervous system structures in and around tumors.

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