Intraoperative neuromonitoring.
BACKGROUND
Intraoperative neuromonitoring (IONM) has been a valuable part of surgical procedures for over 25 years. Insight into the nervous system during surgery provides critical information to the surgeon allowing reversal or avoidance of neural insults.


RESULTS
Electrophysiological tests including electroencephalography, electromyography, and multiple types of evoked potentials (somatosensory, auditory, and motor) are monitored during surgeries that involve risk to the nervous system. Deterioration of signals suggests a surgical insult and is associated with an increased risk of postoperative deficit. Intraoperative identification of this risk allows corrective action. In addition, IONM teams make use of their armamentarium of tests to evaluate anatomy or function of the nervous system in response to specific questions posed by the surgical team.


CONCLUSIONS
Intraoperative recordings are now a routine part of many surgical procedures. Their correct application leads to improved surgical outcome.
Minahan
Robert E
RE
Department of Neurology, Johns Hopkins University, Baltimore, Maryland 21287, USA. rminaha@jhmi.edu