Intraoperative
Neuromonitoring (IONM) is a technique to monitor the neurological conditions of
the boy during surgical procedures, reducing the risk of having any kind of
neurological issue or damage during the surgery and also, providing guidance to
the surgeon for better analysis and enhanced performance. The first use of IONM
is reported to be as old as 1930s, but it was only in 1980s that the technique
began gaining popularity. From 1980 to present day, the technique has been
continuously improved by constant research and tests.
Intraoperative
Neuromonitoring (IONM) involves monitoring the entire central nervous system of
the patient undergoing surgery which may includecomplex surgeries such as spine
surgery, neurosurgery, vascular surgery, otolaryngology, general orthopaedic
surgery, cardiothoracic surgery, interventional neuroradiology and other radiologic
procedures. IONM locates the neural structures such as the nervous tissue,
spinal column, brain and peripheral nerve, carefully assesses the status and
functioning of these structures and thereby, helps in early detection of any
risk that might be caused during the surgery. This enablesthe surgeon to take
immediate corrective measures if required and perform a safer and more precise
procedure, resulting in better outcomes.
Depending
on the neural structures which are at risk during the surgical procedure,
different methods of Intraoperative Neuromonitoring is adopted. Among the
various electrophysiological methods, Extracellular single unit and local field
recordings, EEG, EMG, SSEP, Auditory Brainstem Response (ABR) and Transcranial
electrical motor evoked potentials (TCeMEP) are the most prominent ones.
Besides, Transcranial Doppler Imaging (TCDI) has also gained popularity in the
recent times. It is commonly used with EEG during Vascular surgical procedures.
IONM
techniques have resulted in safer and better surgical procedures, thereby,
reducing the morbidity and mortality rates worldwide. This has significantly
reduced the high costs usually incurred in healthcare. Therefore, more research
in this field and further development of IONM procedures is encouraged.
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