What is Intraoperative Neurophysiological Monitoring?

Intraoperative Neurophysiological Monitoring (IONM) is a diagnostic tool used by surgeons to prevent surgically induced neurological damage (i.e. paralysis). Information is recorded from your nervous system continuously throughout your procedure and any change to your nervous system function is relayed to your surgeon so prompt counter-measures can be taken to avoid permanent neurological damage.

Neurophysiology (from Greek νεῦρον, neuron, "nerve"; φύσις, physis, "nature, origin"; and -λογία, -logia) is a branch of physiology and neuroscience that is concerned with the study of nervous system function.

Intraoperative Neurophyisiology - is the study of nervous system function during surgery.

When would your surgeon request our services? 

Your surgeon will request us if they feel that your nervous system can be harmed in any way during your procedure.
Below is list of some of the surgeries we may be involved with:

  • Skull base tumors

  • Posterior fossa tumors

  • Intracranial aneurysms

  • Intracranial arteriovenous malformations

  • Fronto-temporal tumors

  • Temporo-parietal tumors

  • Carotid endarterectomies

  • Anterior cervical disectomies

  • Anterior corpectomies

  • Anterior vertebrectomies

  • Thoracic laminectomies

  • Transpsoas Lateral approaches to the spine (XLIF)

  • Lumbosacral decompressions

  • Instrumentation for spinal instability

  • Stabilization of odontoid/dens fractures

  • Intramedullary or extramedullary spinal cord tumors

  • Spinal arteriovenous malformations

  • Cauda equina tumors

  • Syringomyelia

  • Spinal cord untethering

  • Brachial plexus or distral peripheral nerve injuries

  • Scoliosis correction

  • Acoustic neuromas

  • Carotid body tumors

  • Subclavian-carotid bypass

  • Radical head & neck surgeries

  • Correction of coarctations

  • Repair of thoracic aortic aneurysms

  • Repair of abdominal aortic aneurysms

  • Cardiopulmonary bypass and hypothermia

  • Carotid stenting

  • Embolization of cerebral and spinal aneurysms

  • Embolization of cerebral and spinal arteriovenous

  • malformations

  • Embolization of traumatic cavernous sinus fistula

  • Spinal angiography and transvascular therapeutic

  • embolization

  • Percutaneous coronary intervention

  • Microvascular decompressions

  • Vestibular nerve sections

  • Rhizotomy/ganglionectomies

  • Selective dorsal rhizotomies

  • Peripheral neuromas

  • Femoral lengthening

  • Pelvic/hip arthoplasty

  • Peripheral nerve surgeries

  • Extracranial vascular reconstructions

  • Epilepsy surgeries

  • Revision mastoidectomies

  • Cochlear implants

  • Parotidectomies

  • Thyroidectomies

How does NPS monitor?

With backgrounds in neuroscience, bio-medical engineering, life and health sciences, and neurodiagnostics, the experienced clinicians at NPS use state of the art computer systems to monitor the integrity of your nervous system throughout your procedure. Electrodes are placed on different parts of your body and then connected to the clinician's computer system. Nerve signals are recorded continuously while you are asleep under general anesthesia. These recorded signals let the neurophysiologist know that your nervous system function is working correctly while you are under general anesthesia. 

You will meet a Board Certified or Board Eligible Neurophysiologist while you are in the hospital ambulatory surgery unit or in the operating room holding area. They will explain in detail their role and how they will monitor your nervous system during your procedure.

 

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