Key Takeaways
- Intraoperative neurophysiologic monitoring (IONM) uses electrodes to track nerve signals in real time. IONM can be adapted to target different types of nerve signals.
- IONM lets NU-Spine surgeons locate nerves and change course when nerve signals change. This ability enables safer spine surgeries with reduced risk of nerve damage.
- Most spine surgeries at NU-Spine are performed under IONM guidance.
- IONM does not cause any pain or discomfort during treatment.
What Is Nerve Monitoring During Spine Surgery?
Intraoperative neurophysiologic monitoring, also called IONM, is a medical technique that tracks nerve signals in real time during surgery. Nerves use electrical impulses to convey information between the body and the brain. IONM uses advanced sensors, called electrodes, to detect these impulses and provide accurate information about nerve activity. Different types of IONM track different types of nerve signals. The following are frequently used during spine surgery:
- Somatosensory evoked potentials (SSEPs): These track the pathways that carry sensory information from the arms and legs to the brain.
- Motor evoked potentials (MEPs): These track the pathways that carry motor (movement) information from the brain into the muscles.
- Electromyography (EMG): These track specific nerves surrounding the brain and spinal cord.
Surgeons use IONM when they operate close to vital nerves. IONM helps them locate the nerves and monitor their function, preventing accidental disruptions. As a result, surgeries are safer than ever, causing less post-operative pain and a lower risk of long-term damage
What Procedures Involve IONM?
NU-Spine uses IONM for most spinal surgeries. Procedures we perform under IONM guidance include:
- Spinal fusion
- Spinal cord decompression
- Laminectomy
- Hemilaminectomy
- Discectomy
- Microdiscectomy
- Revision spine surgery
- Spine reconstruction surgery
- Spinal cord stimulator surgery
The spine houses the spinal cord, a thick bundle of nerves that carries information between the body and the brain. Any damage to the spinal cord can disrupt this flow of information, leading to chronic symptoms, such as pain, tingling, numbness, and loss of motor control. For this reason, NU-Spine takes every measure to prevent complications. IONM plays an important role in our practice, ensuring safe procedures for the long-term health of our patients.
What Patients Can Expect on Surgery Day
Patients at NU-Spine start by meeting our IONM team. Then, the process typically includes:
- The patient removes their clothing and puts on a loose surgical gown.
- Using a sanitizing solution, the NU-Spine team cleans the skin where the electrodes will be applied. Electrode sites may be on the scalp, arms, legs, or near the spine.
- The team may shave body hair to ensure the electrodes will stick securely.
- The team will apply a conductive gel to the skin at the electrode site.
- The team carefully places the electrodes, which are round, sticky pads connected to wires. They are not painful, and nerve monitoring does not cause any discomfort.
- The NU-Spine surgeon performs the procedure as normal.
The electrodes send information to a computer screen, allowing the surgeon to visualize nerve activity in real time. This helps them change course if the tools come close to the spinal cord or a root nerve. Once the surgery is complete, the electrodes are painlessly removed. The patient may transition into the recovery phase.
Why Choose NU-Spine?
Spine surgery is a major medical procedure, and it is normal to have questions or concerns about treatment. These concerns can be relieved by choosing a spine surgeon you trust. NU-Spine follows a safety-first approach to every spine procedure. Dr. Branko Skovrlj and Dr. Robert Rothrock use modern best practices and technologies, including IONM, to ensure patient safety and promote successful treatment.
NU-Spine also prioritizes clear communication. When planning a patient’s treatment, our team explains every aspect clearly. Open, honest communication helps patients feel confident about their care, allowing them to move forward with treatment in the knowledge that they are being served by the best.
Find Expert Spine Surgery Near You in New Jersey, Pennsylvania, and Florida
Choosing the right surgeon is essential to your peace of mind when undergoing spine surgery. NU-Spine: The Minimally Invasive Spine Surgery Institute offers the cutting edge in minimally invasive treatments, using nerve monitoring during spine surgery to improve your outcomes. Contact us today to learn more or schedule your appointment at one of our NU-Spine locations near you in New Jersey, Pennsylvania, and Florida.
Frequently Asked Questions About Intraoperative Neurophysiologic Monitoring
Is nerve monitoring during spine surgery always necessary?
Surgeons recommend nerve monitoring during most spine surgeries to make the procedures safer. IONM helps surgeons to monitor the brain, spinal cord, nerves, and other structures while the patient is under anesthesia. It also assists in mapping critical nerve pathways, guiding surgeons as they plan their approach for the procedure to avoid nerve damage.
Does IONM make spine surgery safer?
Yes, IONM makes spine surgery safer. IONM is meant to enhance the safety of surgical patients, especially those undergoing high-risk procedures that involve the nervous system. For instance, it can identify early indicators of nerve injury before permanent damage occurs, allowing the surgical team to modify their approach in real time.
Will I feel anything from nerve monitoring electrodes?
Because IONM is performed under anesthesia, you will not feel anything from nerve monitoring electrodes. They do not cause any pain or discomfort.