Intraoperative Neuromonitoring (IONM) is a technique to monitor the neurological conditions of the boy during surgical procedures, reducing the risk of having any kind of neurological issue or damage during the surgery and also, providing guidance to the surgeon for better analysis and enhanced performance. The first use of IONM is reported to be as old as 1930s, but it was only in 1980s that the technique began gaining popularity. From 1980 to present day, the technique has been continuously improved by constant research and tests.
Intraoperative Neuromonitoring (IONM) involves monitoring the entire central nervous system of the patient undergoing surgery which may includecomplex surgeries such as spine surgery, neurosurgery, vascular surgery, otolaryngology, general orthopaedic surgery, cardiothoracic surgery, interventional neuroradiology and other radiologic procedures. IONM locates the neural structures such as the nervous tissue, spinal column, brain and peripheral nerve, carefully assesses the status and functioning of these structures and thereby, helps in early detection of any risk that might be caused during the surgery. This enablesthe surgeon to take immediate corrective measures if required and perform a safer and more precise procedure, resulting in better outcomes.
Depending on the neural structures which are at risk during the surgical procedure, different methods of Intraoperative Neuromonitoring is adopted. Among the various electrophysiological methods, Extracellular single unit and local field recordings, EEG, EMG, SSEP, Auditory Brainstem Response (ABR) and Transcranial electrical motor evoked potentials (TCeMEP) are the most prominent ones. Besides, Transcranial Doppler Imaging (TCDI) has also gained popularity in the recent times. It is commonly used with EEG during Vascular surgical procedures.
IONM techniques have resulted in safer and better surgical procedures, thereby, reducing the morbidity and mortality rates worldwide. This has significantly reduced the high costs usually incurred in healthcare. Therefore, more research in this field and further development of IONM procedures is encouraged.