What is IONM?

IntraOperative Neurophysiological Monitoring (IONM) uses state-of-the-art monitoring equipment in order to evaluate the multiple functions of the spinal cord and nerves during surgery. The role of IONM is to provide the surgeon with immediate feedback and warning before permanent nerve injury has occurred. This has been shown to increase patient safety and improve outcomes in surgical procedures.


Why is IONM so important?

IONM has become the gold standard of patient care regarding spine, brain, vascular, and ENT surgeries. In recent years, the number of IONM cases has grown exponentially as a result of advances in IONM systems, improved monitoring procedures, and the surgeons’ increased awareness about the benefits of IONM. Our services offer significant benefits to the patient, surgeon, and hospital. IntraNerve provides immediate feedback on the functional integrity of the neural systems being monitored, thus aiding in critical decision-making and improving patient outcomes.



What happens during my surgery?

In the operating room, stick-on electrodes are placed on limbs that could possibly be affected by the surgery. Once the patient is asleep, small needle electrodes may be placed in the scalp, over the area of the brain where the impulse from the limb is received.  Additional electrodes are placed in the muscle groups that correspond to the area where the surgeons will be working. Baseline recordings are taken before surgery begins and are repeated throughout the procedure. A significant change in the wave alerts the surgeon and neuromonitoring technlogist that the nerve in the area could be vulnerable to damage. The surgeon can then take the appropriate action to prevent permanent neurological deficit.


Is there a risk of infection?

Surgeries progress with more confidence and less time is spent identifying neural structures since alerts will be given to the surgeon interactively.  Risk for infection is minimal as the skin is disinfected before needles are placed (needles are sterile and disposed of after single use).  Mild soreness following surgery may be experienced where the needles were placed.


How am I billed for IONM services?

Following our billing you may receive an Explanation of Benefits (EOB) from your insurance company that details our charges, their allowances and payments. In most cases your insurance company will pay us directly; however, in the case that they pay you, or in the cases of deductible or co-insurances, we will bill you directly for reimbursement.  For more information or to contact our billing department, please click here to visit our Billing Information page.