What is Neuromonitoring?

Intraoperative Neurophysiological Monitoring

Intraoperative Neuromonitoring (IONM) is a highly specialized role in the healthcare industry, involving the use of advanced technology in order to evaluate the integrity of a patient’s spinal cord and nerve root function. The goal of neuromonitoring is to detect changes in brain, spinal cord, and nerve root function before the damage becomes irreversible.


Prior to the establishment of IONM, the only way to evaluate function was to ask an awake patient to perform tasks and physically demonstrate unchanged spinal cord function. IONM allows evaluation of function while the patient is still asleep in surgery.


A trained IONM professional can reduce the rates of serious deficits following surgery such as paralysis, weakness, coordination issues and numbness in limbs. The surgeon relies heavily on the feedback from the Neuromonitorist, and the course of the operation can change based on the communication that the surgeon has with the neuromonitorist in the room. 

What does an IONM professional do?

A professional in this industry will typically service multiple hospitals in a region, and may travel to other states occasionally to provide coverage to hospitals that need it.


Typically, the IONM professional will speak to the patient prior to surgery to obtain a medical history. Once the patient is asleep in the operating room, multiple electrodes will be placed depending on the type of procedure that is being performed. During the operation, recordings are made by electrically stimulating and recording from various nerves as well as the brain itself. Communications are made with the surgeon regarding the integrity of these recordings.

Image courtesy of: Journal of Neuroanesthesiology and Critical Care

What kind of certifications are required?

While multiple paths are available, typically a bachelor’s in a science or healthcare related field is required. After training on 150 surgeries, a candidate is then able to take a board certification examination. The process takes around 1.5 years from start to certification.

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