IOM Services: Understanding What Are They and How They Help

The practice of providing Intraoperative Neuromonitoring care is known, in short, as “IOM Services”. In surgical procedures, especially those involving delicate structures like the nervous system, precision and safety are of the most importance. Thus, one of the critical tools used in ensuring the safety of neural structures is Intraoperative Neuromonitoring (IOM). But what exactly are IOM services, and how do they contribute to the success of surgical interventions?

IOM refers to the real-time monitoring of the nervous system’s functional integrity during surgical procedures. This specialized IOM service involves the continuous assessment of neural structures, such as the brain, spinal cord, and peripheral nerves. Monitoring of the sensory and motor function of these neural structures can identify potential damage or dysfunction that may arise during surgery and allow for corrective action.

The primary objectives of IOM services are to prevent iatrogenic neurological injuries, which can have significant consequences for patients, ranging from temporary deficits to permanent impairment. By monitoring the electrical activity of efferent and afferent neural pathways in real-time, IOM enables surgical teams to make informed decisions and take immediate corrective actions to preserve neurological function. Surgeons often identify the need for IOM services on a case-by-case basis well before the date of your procedure. If IOM services have been requested on your surgery, an IOM neurophysiologist will do a pre-op assessment and answer any questions you may have the day of your procedure. 

So, how exactly do IOM services work? During surgery, electrodes are strategically placed either directly on central nervous system structures, above specific peripheral nerves, or on muscle groups associated with the surgical site. These electrodes record and analyze the electrical signals generated by the nervous system in response to various stimuli. These stimuli may be generated either by your IOM neurophysiologist, surgical manipulation and anesthetic or homeostatic physiologic changes.

The information gathered through IOM is continuously relayed to highly trained oversight physicians who interpret the data in real-time. Any deviations from baseline neural signals indicative of potential nerve compromise are promptly identified and communicated to the surgical team. Effective communication by your IOM team, allows for timely intervention and modification of surgical techniques to minimize the risk of neurological injury. 

Additionally, IOM services can also assist surgeons in performing complex procedures. By providing real-time feedback on the functional status of neural structures, IOM helps guide surgical decision-making, and minimize the risk of inadvertent nerve injury, ultimately leading to more successful surgical outcomes.

One of the key advantages of IOM services is the versatility and applicability across a wide range of surgical specialties. Whether it’s neurosurgery, orthopedic surgery, spine surgery, vascular surgery, or another surgical specialty, IOM services can be tailored to meet the specific needs of each procedure.

In conclusion, IOM services play a crucial role in modern surgical practice, offering real-time assessment and protection of the nervous system during procedures. By utilizing advanced technology and highly trained service providers, IOM helps surgeons mitigate the risk of neurological injury, improve surgical precision, and enhance patient outcomes. As surgical techniques continue to evolve, IOM remains a valuable tool in ensuring the safety and success of surgical procedures across various medical specialties.

Written by: Riley Ridge, MS, CNIM

IOM services being performed in the operating room.