Neuromonitoring

Neuromonitoring (also intraoperative neurological monitoring/IONM or surgical neurophysiology or simply intraoperative monitoring/IOM) is the practice of recording nerve signals and brainwaves during surgeries to reduce the risk of significant neuronal damage. Surgical procedures that most often require neuromonitoring include but are not limited to the following: carotid endarterectomy, anterior cervical diskectomy, instrumentation for spinal instability including pedicle screws, scoliosis correction, spinal cord untethering, and treatment of cranial base tumors, posterior fossa, microvascular decompression, intracranial aneurysms and arteriovenous malformations.

Methods
Neuromonitoring employs the use of somatosensory evoked potentials, muscle evoked potentials, EEG, EMG and auditory brainstem response depending on what is required for the given surgery. Electrodes are attached to the patient, which lead to a computer where a trained neurophysiologist can observe the results. Transcranial doppler imaging is also a method becmoing more widely used as it detects vascular emboli and can be used in tandem with EEG for vascular surgeries. Any abnormalities can be immediately reported to the surgeon, who can then take corrective action. These techniques have significantly reduced the rates of morbidity, mortality and health care costs and have virtually no side effects.