Intraoperative Neuromonitoring (IONM)

What the procedure is

Intraoperative neuromonitoring is the continuous monitoring of nerve and spinal cord function during surgery, using electrical signals recorded from the limbs and scalp, to alert the surgical team in real time if nerve function is at risk.

Why it is performed

It provides an early warning if a nerve root or the spinal cord is being stressed during surgery, giving the surgical team a chance to adjust technique before a temporary change becomes a permanent injury.

Who may benefit

• Patients undergoing surgery with meaningful risk to the spinal cord or nerve roots — deformity correction, tumour surgery, cervical myelopathy surgery and complex revision cases
• Cases at the treating surgeon's discretion where the added safety margin is valuable

When it may not be appropriate

• Straightforward, low-risk decompression procedures where the added cost and setup time is unlikely to change management
• Facilities without IONM equipment and a trained neurophysiology technician available

Alternatives

• Careful surgical technique and clinical monitoring without electrophysiological monitoring, which remains standard for many lower-risk procedures

How it is performed

Electrodes are placed on the scalp and limbs before surgery begins, and a neurophysiology technician monitors signals continuously throughout the operation, alerting the surgeon to any significant change so technique can be adjusted immediately.

Anaesthesia: Same as the underlying procedure — certain anaesthetic agents are avoided or adjusted because they can interfere with monitoring signals  ·  Typical duration: Adds setup time of approximately 20–40 minutes before the underlying procedure begins  ·  Typical hospital stay: Same as the underlying procedure

Recovery

Same as the underlying procedure — IONM is a safety measure during surgery and does not change the recovery course.

Physiotherapy

Same as the underlying procedure.

Risks and complications

• Minimal risk from the monitoring itself; rare skin irritation at electrode sites
• A monitoring change may occasionally prompt the surgeon to modify or pause the procedure, which is the intended safety function

Expected follow-up

Same as the underlying procedure.

Indicative cost

Indicative cost: ₹0.15 – 0.45 lakh. This is not a quotation — see the full cost page for what's included and excluded.

What affects the cost

• This is typically an add-on to a base procedure's cost, not a stand-alone charge — the figure shown is the approximate addition, not a full procedure cost
• Duration of monitoring required
• Neurophysiology technician fees

Questions to ask

• Am I a suitable candidate for this specific procedure, or would an alternative be better for my case?
• What is your experience with this procedure?
• What does the quoted cost include and exclude?

Frequently asked questions