What are the advantages of intraoperative neuromonitoring (IONM)?
Advantages
Intraoperative neuromonitoring (IONM) offers added value for various areas, particularly the possibility of promoting a nerve-sparing surgical strategy.
>> This is achieved firstly by localising (mapping) nerves or neuronal structures using electrical stimulation.[1]
>> Secondly, IONM allows intermittent or continuous functional monitoring of nerve pathways during the entire surgery.
>> This can reduce the risk of nerve damage and thus help prevent postoperative consequential damage.[2]
>> The result is a significant contribution to maintaining the patients’ quality of life.
>> In addition to the nerve-sparing surgical approach, IONM enables more effective resection of pathological tissue with less impact on healthy tissue.[3]
>> By storing and documenting the recorded data, IONM also aids in assessing possible postoperative consequences.
>> The documentation enables quality assurance and provides a basis for argumentation in a legal context.
In addition to the medical and legal advantages, IONM also offers economic advantages for the administration and hospital. Most IONM procedures can be billed for reimbursement and less perioperative complications mean shorter hospitalisation times and therefore lower costs.
Advantages of IONM at a glance:
>> Intraoperative monitoring, function control and thus increased protection of the integrity of the patient’s central and peripheral nervous system[2][4]
>> Better prevention of neurological consequential damage such as paresis, paralysis and plegia[2][4]
>> IONM offers a reliable, reproducible, objective measuring method
>> More effective resection of pathological tissue with less impact on healthy tissue[3]
>> Documentation for the course and postoperative assessment of the patients
>> Quality assurance also in a legal context
>> Promoting faster recovery and lower number of neurological rehabilitations
>> IONM can reduce costs and improve profitability in the medium and long term
References
1. Mangano, A. et al. Evidence-based analysis on the clinical impact of intraoperative neuromonitoring in throid surgery: State of the art and future perspectives. Surg Technol Int 25, 91–6 (2014).
2. Angeletti, F., Musholt, P. B. & Musholt, T. J. Continuous Intraoperative Neuromonitoring in Thyroid Surgery. Surg Technol Int 27, 79–85 (2015).
3. Raabe, A., Beck, J., Schucht, P. & Seidel, K. Continuous dynamic mapping of the corticospinal tract during surgery of motor eloquent brain tumors: evaluation of a new method: Clinical article. J. Neurosurg. 120, 1015–1024 (2014).
4. Sala, F. et al. Motor Evoked Potential Monitoring Improves Outcome after Surgery for Intramedullary Spinal Cord Tumors: A Historical Control Study: Neurosurgery 58, 1129–1143 (2006).