There are a variety of different surgeries where IOM is indicated and its use supported by the scientific literature. There are some surgical procedures that should not be attempted without
monitoring. The list of surgical procedures where IOM is
indicated or may be highly useful include:
surgery
of the aortic arch, its branch vessels, or thoracic aorta,
including carotid artery surgery, when there is risk of cerebral
ischemia
resection
of epileptogenic brain tissue or tumor
resection
of brain tissue close to the primary motor cortex and requiring
brain mapping
protection of cranial nerves:
Tumors that affect optic,
trigeminal, facial, auditory nerves, cavernous sinus tumors,
microvascular decompression of cranial nerves, oval or round
window graft, endolymphatic shunt for Meniere's disease,-
vestibular section for vertigo
correction of scoliosis or deformity of spinal cord involving
traction on the cord
protection of spinal cord where work is performed in close
proximity to cord as in the placement or removal of old hardware
or where there have been numerous interventions
spinal
instrumentation requiring pedicle screws or distraction
decompressive procedures on the spinal cord or cauda equina
carried out for myelopathy or claudication where function of
spinal cord or spinal nerves is at risk
spinal
cord tumors
neuromas
of peripheral nerves of brachial plexus, when there is risk to
major sensory or motor nerves
surgery
for intracranial AV malformations
surgery
for arteriovenous malformation of spinal cord
cerebral
vascular aneurysms
surgery
for intractable movement disorders
arteriography, during which there is a test occlusion of the
carotid artery
circulatory arrest with hypothermia [does not include
surgeries performed under circulatory bypass (e.g., CABG,
ventricular aneurysms)]
distal
aortic procedures, where there is risk of ischemia to spinal
cord
leg
lengthening procedures, where there is traction on sciatic nerve
or other nerve trunks
basil
ganglia movement disorders
surgery
as a result of traumatic injury to spinal cord/brain
PHYSICIANS
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