Intraoperative Neuromonitoring

IntraNerve Neuroscience (INN) is a respected national Telehealth services provider committed to patient safety, supporting surgeons and the various types of healthcare facilities across the United States. Whether you are a healthcare system, university, surgery center, or a small, medium, or large hospital, we customize to your specific needs. Since our inception, INN has grown organically, providing a patient-centric operations support model and staffing our facilities with local, competent teams of surgical neurophysiologists. Established in 2007, our presence quickly expanded across the U.S. We now provide IONM across the country in support of over 100 facilities and 300+ surgeons.

Our neuromonitoring company provides diverse technical staff members who come from all different educational backgrounds, including M.D., AuD, PhD, DC, MS, CNIM, BS, BA, R. EEGT, and R.EP.T.

What is IOM?

IONM stands for IntraOperative Neurophysiological Monitoring. It is also commonly referred to as intraoperative neuromonitoring, IOM, and “monitoring”. IONM has been clinically proven to reduce the patient’s risk of iatrogenic damage to the nervous system and provide functional guidance to the surgeon and surgical team. IOM neuromonitoring can be used to localize and test the function of neural structures.

IONM consists of both a technical and professional component. The monitoring is performed by a certified or board eligible Surgical Neurophysiologist in the operating room (technical component) and is overseen remotely in real-time by a fellowship-trained physician or doctor of audiology (professional component). Together, a qualified, experienced Surgical Neurophysiologist along with certified, experienced professional interpretation melds the high-level technology and specialized neurological background needed to provide patient safety and positive outcomes.

IntraNerve Neuroscience

How do we work?

Hospital schedules case with IntraNerve.

Hospital schedules case with IntraNerve Neuroscience (INN).

IntraNerve notifies regional team and neurophysiologist is assigned.

INN notifies regional team and neurophysiologist is assigned.

IntraNerve Neuroscience Provides Solutions for Hospitals

Surgical Neurophysiologist arrives at hospital, talks with patient and surgical team, and sets up equipment.

Secure HIPAA compliant screenshare and chat

Surgical Neurophysiologist connects to remote real-time professional interpretation via a secure HIPAA compliant screenshare and chat.

Neurophysiologist notifies surgeon of alerts during surgery.
Surgeon is kept informed of the patient’s status throughout the procedure.
IntraNerve Neuroscience Provides Solutions for Patients

Patient leaves surgery with improved outcome and experience.

What procedures do we commonly monitor?

  • Spinal Cord Cases, Cervical, Thoracic & Lumbar
  • Spinal Instrumentation Cases, Total Disk Replacement, Scoliosis Correction,
    Discectomy/Laminectomy, Corpectomy & Decompressions
  • Neurosurgical Procedures
  • Craniotomies: Brain Tumor, Microvascular Decompression, Acoustic Neuroma & Skull Base Procedures
  • Sensory / Motor Cortex Mapping, Language Mapping & Awake Craniotomy
  • Spinal Cord Tumor, Tethered Cord, Rhizotomy & XLIF/Far Lateral
  • Thyroidectomy & Parathyroidectomy
  • Parotidectomy, Submandibular Gland Removal & Neck Dissection
  • Tympanoplasty, Mastoidectomy, Cochlear Implants & Atresiaplasty
  • Auditory Brainstem Implants
  • Carotid Endartectomy
  • Brain Aneurysm & Aortic Aneurysm
  • Arteriovenous Malformation & Arteriovenous Fistula
  • Peripheral Nerve Procedures
  • EC-IC Bypass
  • Trans Carotid Artery Revascularization (TCAR)
  • Transcatheter Aortic Valve Replacement (TAVR)
  • Brachial Plexus, Nerve Release, Carpal Tunnel Revision & Peripheral Tumor Removal
  • Acetabular (Hip) Fractures & Hip Arthroplasty Revisions
  • Sensory & Motor Re-innervation
  • Craniotomies: Brain Tumor, Microvascular Decompression,
    Acoustic Neuroma & Skull Base Procedures
  • Sensory / Motor Cortex Mapping, Language Mapping & Awake Craniotomy
  • Spinal Cord Tumor, Tethered Cord & Rhizotomy
  • Prostate Surgery

In 1989, the U.S. Food and Drug Administration (FDA) first approved SCS to relieve chronic neuropathic pain. It’s estimated as many as 50,000 neurostimulators are implanted worldwide every year. The device delivers a low-voltage electrical current continuously to the spinal cord to block the sensation of pain. Research shows using IONM during SCS placement allows for shorter operating time, better paresthesia coverage of painful areas post-op, mitigates most anesthesia concerns with awake testing, real-time feedback on lead coverage through 2 IONM mapping techniques, reduces need for revision surgery, and provides real-time feedback regarding the integrity of the sensory and motor pathways allowing for faster surgical intervention should pathway(s) become compromised during the procedure. At IntraNerve, we believe in protecting your neural pathways and aiding surgeons where we can to help improve your quality of life!

INN is proud to have diversified services in the OR by providing Audiology Services specific to Otology and Neurotology. Surgeries including cochlear implants (CI surgery), middle ear, skull base, auditory brainstem implants, and other cranial procedures increase patient safety and outcomes through properly delivered IONM.

IntraNerve is proud to have diversified our IONM services by providing Audiology Services in the OR. INN provides staff Audiologists with specialized training and emphasis on the skills required in this specialty. An INN staff Audiologist recently participated in a National Institute of Health funded study on Auditory Brainstem Implants (ABI) in conjunction with surgeons from Keck School of Medicine of USC, Children’s Hospital Los Angeles, and the Huntington Medical Research Institutes (HMRI). See this amazing story from the LA Times and how IntraNerve is supporting medical research for patients benefiting from ABI surgery.

For a 3 Year-Old Boy, Risky Operation May Mean a Chance to Hear
INN was fortunate to have a staff Audiologist independently involved in this study, along with the opportunity to gain direct knowledge of this life-changing advancement in technology.

Robotics, Prosthetics & IONM

In 2015 INN provided services on a groundbreaking procedure using target sensory reinnervation (TSR) and targeted muscle reinnervation (TMR). When a surgeon asked if INN’s Director of Education could help assist in reestablishing not only the motor but sensory functions to a patient with an amputated arm; INN began researching the feasibility and logistics. After successfully mapping out the sensory nerves in the patients arm and connecting them to a robotic prosthetic, this patient was given back valuable functions of her life. Today this patient has been touted as the “Worlds most advance amputee” by People Magazine and seen on the TV show “The Doctors”. Contact INN to learn more about our High-Performance Difference in Neuroscience.

Grand Rounds in IONM

We place high value on Continued Medical Education (CME) within INN. As a service to our employees and customers, we offer Grand Rounds education quarterly. Below are some topics we have covered in the past and will cover in the future.

Previous Grand Rounds Topics

  • Alert Communication Grand Rounds
  • Monitoring Lateral Lumbar Fusions (XLIF, DLIF, LLIF, OLIF)
  • Monitoring for Scoliosis Procedures
  • Monitoring for Anterior Cervical Discectomy and Fusion Procedures (ACDF)
  • SSEP Best Practices

Upcoming Grand Rounds Topics

  • IONM Billing
  • Recurrent Laryngeal Monitoring (RLN)
  • Monitoring for Spinal Cord Stimulator Placement