Intraoperative Neurophysiological Monitoring Department (IONM)

The Intraoperative Neurophysiological Monitoring (IONM) department at MUSC Health aims to educate, develop, and support advanced, evidence-based monitoring and mapping techniques.

Our team is dedicated to the highest standards of patient centered care through continuous education, research and innovation. Furthermore, the IONM team collaborates with multiple specialties and disciplines to work synergistically as a team, to provide premier clinical care and outcomes.

What is IONM?

Intraoperative neurophysiological monitoring (IONM) observes the neurological system by comparing baseline patient function to neurological alterations throughout a surgery. To decrease the likelihood of common neurological deficits from surgery, the IONM team communicates with real-time assessment and feedback to the surgeon performing the procedure. If a neurological change occurs, the team quickly provides the surgical team with critical information to immediately intervene in order to significantly reduce and prevent permanent neurological damage.

The IONM team at MUSC Health continuously works to develop and implement new surgical neuromonitoring methods to enhance patient care and provide innovative techniques throughout the community of surgical specialties and departments.

Why Choose MUSC Health?

MUSC Health has a carefully selected team of highly educated and skilled IONM specialists, who are dedicated to patient care and research. Each team member has accreditation through the national board of neurodiagnostic credentialing (ABRET) and holds a CNIM credential. The diversity and background of each team member provides IONM advancements in technology and monitoring techniques for multiple disciplines of surgery. The MUSC Health IONM team works directly with surgeons, the EEG department, neurologists, and technical equipment specialists to tailor and implement a plan for patient-specific needs.

The team communicates effectively to monitor the following:

• Cortical perfusion detection for vascular surgeries (EEG)
• Electromyography (EMG) to detect nerve root irritation in the face and spine
• Stimulation of specific nerve roots for identification during surgery as well as optimal pedicle screw placement (tEMG)
• Cranial nerve monitoring (sp/tEMG), lateral spread response (LSR) for facial nerve
• Recurrent laryngeal nerve (RLN) and laryngeal adductor reflex (LAR) monitoring (EMG, MEP)
• Facial nerve mapping for parotid tumor removal
• Brainstem auditory evoked potentials (BAERs/ABR) for preservation of hearing
• Sensory function via dermatomal and peripheral nerve stimulation via Somatosensory Evoked Potentials (DSSEP, SSEP)
  
  • Determination of motor versus sensory cortex of the brain via central sulcus identification
  • Dorsal Column Mapping (DCM) to identify a safe entry zone for removal of spinal cord tumors
  • Optimal Dorsal Root Ganglion (DRG) and Spinal Cord Stimulation SCS placement procedures for chronic pain
• Patient motor function via functional cortical and subcortical mapping, transcranial, transabdominal, corticobulbar and direct cortical motor evoked potentials (TcMEP, TaMEP, coMEP, and dcMEP, respectively)
• Language, speech, and comprehension through brain mapping and evaluation with Neuromapper technology
• Microelectrode recording (MER) for mapping in deep brain stimulator (DBS) placement
• Pre-operative Motor and Speech mapping via Transcranial Magnetic Stimulation (TMS) with Nextstim