Intraoperative neurophysiological monitoring (IONM) helps assess the integrity of neural structures and consciousness during surgical procedures. It includes both continuous monitoring of neural tissue as well as the localization of vital neural structures. The goal of IONM is to identify intraoperative neural insults that allow early intervention to eliminate or to significantly minimize irreversible damage to the neurological structure and prevent a postoperative neurologic deficit. The use of neurophysiological monitoring during surgical procedures requires specific anesthesia techniques to avoid interference and signal alteration due to anesthesia.
Different modalities of intraoperative neurophysiological monitoring (IONM) are available, each monitors a specific neural pathway, and they are:
Evoked potentials including somatosensory evoked potential (SSEP), motor evoked potential (MEP), brainstem auditory evoked potential (BAEP), visual evoked potential (VEP)
Electroencephalography (EEG)
Electromyography (EMG)
Multimodal intraoperative neuromonitoring (IONM) is recommended as an effective way to avoid permanent neurologic injury during surgical procedures.
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