1.  What is IONM?

IONM is a battery of neurophysiologic tests used to assess the functional integrity of the spinal cord, nerve roots, and other peripheral nervous system structures (ex, brachial plexus) during spinal surgery. The underlying principle of IONM is to identify emerging insult to nervous system structures, pathways, and/or related vascular supply and to provide feedback regarding correlative changes in neural function before development of irreversible neural injury. IONM data provides an opportunity for intervention to prevent or minimize postoperative neurologic deficit. Current multimodality monitoring techniques permit intraoperative assessment of the functional integrity of afferent dorsal sensory spinal cord tracts, efferent ventral spinal cord motor tracts, and nerve roots. Combined use of these techniques is useful during complex spinal surgery because these monitoring modalities provide important complementary information to the surgery team.  IONM is quickly becoming the standard of care in the medical field, and is used extensively throughout the U.S.

2.  Why Monitor?

Visually identifying spinal nerves during surgery can be difficult in areas with poor visibility, even with a detailed knowledge or anatomy and surgical skill. Intraoperative nerve monitoring is recommended as a risk-minimizing tool to aid in the prevention of neurological deficits during procedures where the spinal nerves are at risk.

3.  What happens on the day of surgery ?

The day of your surgery you will be greeted by a NDM professional who will explain their role and answer any question you might have.  Once the patient is in the operating room and under anesthesia, electrodes will be specifically placed in some instances on the patients’: head, arms, hands, legs, and feet. These electrodes will be used to monitor vital nervous system data.  The data will then be monitored continuously not only by the NDM Technician, but also in real time by a physician trained in Neurophysiological Monitoring. The data will then be used to inform the surgeon as to the state of the patients’ nervous system. If significant changes were to arise the surgeon would be notified for immediate intervention, to insure the patients’ safety.

4.  What is the cost?

Neuro Diagnostic Monitoring (NDM) is an independent provider of IOM. The charges for our services are billed to your insurance provider and, in some instances, to the hospital where your surgery was performed.  Patients may receive a statement from our facility in regards to the insurance deeming the patient responsibility. (Example: Deductible not met, Co-Insurance, Out of Pocket not met, etc…)