Intraoperative monitoring (IOM) is an array of neurophysiological tests used to assess the functional integrity of the spinal cord, nerve roots, and other peripheral nervous system structures during spinal surgery.
The underlying principle of IOM is to identify emerging insult, due to iatrogenic cause, to structures of the nervous system, pathways, and/or related vascular supply and to provide feedback regarding correlative changes in neural function before development of irreversible neural injury.
IOM data provides an opportunity for intervention to prevent or minimise devastating postoperative neurological deficit. Current multimodal 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.
Several neurophysiological modalities are currently available for monitoring various aspects of the central and peripheral nervous system, each offering a unique set of benefits, limitations, sensitivity and specificity as diagnostic techniques.
Bespoke Healthcare routinely use multimodal monitoring as standard to maximise the diagnostic efficacy in regard to sensitivity and specificity in the detection of impending neural injury. Combined use of these techniques is important during complex spinal and neuro surgery because these monitoring modalities provide important complementary information to the surgical team.