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Intraoperative Neuromonitoring


At WakeMed, our neurosurgical patients receive the highest level of care and benefit from specialized nervous system monitoring during surgical procedures. As a safeguard to reduce the risk of stroke or paralysis, we offer a type of monitoring during surgery called intraoperative neuromonitoring (IONM).

IONM is typically done during procedures, including:

  • Spinal surgery/scoliosis or tumors 
  • Aneurysms 
  • Vascular procedures
  • Acoustic neuroma surgery
  • Carotid endarterectomy
  • ENT surgeries involving facial nerves

Performed during and alongside the surgical procedure, these tests record electrical activity from the brain, spinal cord and peripheral nerves. IONM can include electroencephalogram (EEG), electromyography (EMG) and evoked potentials testing, depending on the surgical procedure being done, and on the location of the surgery and condition.

This close surveillance helps reduce the risk of damage to sensitive nerves, and provides additional guidance to our surgical team.

What to Expect from Intraoperative Monitoring

During surgery, electrodes are placed along the nerve pathway to the surgical site, or in some cases on the patient’s wrists, ankles, head and shoulders. As surgery progresses, the technologist stimulates the nerves using a small electric current to test if they are functional.

The impulses are transmitted and shown as waves on a screen, so the surgeon can track any changes in nerve function. If the waveforms change, the surgeon can adjust the procedure to protect from damaging the nerves.

More Information and Referrals

We welcome new patients. If you’d like to receive more information about our intraoperative neuromonitoring capabilities at WakeMed, please call us at 919-350-3734. If you are a physician referring a patient, please call us at 919-350-7000.

How to Find Us

Intraoperative neuromonitoring is performed in WakeMed’s specialized neurosurgical operating suites, as well as at other WakeMed locations where these surgical procedures are performed.