Published: 2019 April 09
Updated : 2023 January 10

Intraoperative Neuromonitoring Market

180 pages
Report Summary
Table of Contents
List of Tables & Figures

Intraoperative Neuromonitoring Market is segmented By Modality Segment (Evoked Potential (EP) Market, Electromyography (EMG) Market, Electroencephalogram (EEG) Market), By Service Segment (In-source IONM and Out-source IONM), By Application (Neurological Surgeries, Orthopedic Surgeries, ENT Surgeries, Cardiovascular Surgeries, Other Surgeries), and By Region (North America, Latin America, Europe, Asia Pacific, Middle East, and Africa) – Share, Size, Outlook, and Opportunity Analysis, 2023-2030.


Intraoperative Neuromonitoring Market is predicted to reach a CAGR of 6.53% during the forecast period (2023-2030). 

Intraoperative Neuromonitoring is a procedure that involves the hazard of neurological deficits after and during the surgery involving the nervous system. The major factors driving the growth of the market are the rising occurrence of chronic disorders, the increasing aged population, and risk management through IONM over complex surgeries. Furthermore, the trends of advanced devices, such as devices related to neurosurgery, ophthalmic surgical devices, surgical microscopes, and surgical robotics, are projected to drive market growth in the coming years. Rising government activities and increasing cognizance of products and services are additionally projected to boost the growth of the market

Intraoperative neuromonitoring market study analysis offers an in-depth outlook on the market containing quantitative and qualitative data. It gives an outlook and forecast of the global market based on market segmentation. It also provides global intraoperative neuromonitoring market size, and growth, along with the latest trends, opportunities, and forecast till 2029 for the global market with esteem to major countries such as the United States, Canada, Brazil, Germany, Italy, Spain, United Kingdom, Russia, European countries, United Arab Emirates, Saudi Arabia, South Africa, Japan, China, India, South Korea, Australia, and rest of the countries over the globe.

Among all regions, the North American Intraoperative neuromonitoring market is expected to hold the largest share of the global market over the forecast period. Whereas the European intraoperative neuromonitoring market is projected to continue its presence globally during the period of 2023-2030.

Intraoperative Neuromonitoring Market Report Scope



Market CAGR


Segments Covered

By Modality Segment, By Service Segment, By Application, and By Region

Report Insights Covered

Competitive Landscape Analysis, Company Profile Analysis, Market Size, Share, Growth, Demand, Recent Developments, Mergers and acquisitions, New Product Launches, Growth Strategies, Revenue Analysis, and Other key insights.

Fastest Growing Region

Asia Pacific

Largest Market Share 

North America

Intraoperative Neuromonitoring Market Growth Drivers, and Dynamics Insights

Intraoperative neuromonitoring (IONM) is an important procedure that helps to assess the functional integrity of the brain, brain stem, spinal cord, or peripheral nerves during and after complex surgical procedures. IONM reduces the risk of deficits such as muscle weakness, paralysis, hearing loss, and other normal body functions. IONM provides immediate feedback and warning to the surgeon for the prevention of permanent nerve injury because of post-surgical damage. IONM is quick, painless, easy, and inexpensive. It can record the nerve function multiple times or even throughout the entire process of surgery.

The major drivers fueling the growth of the market are the increase in surgical procedures, the high importance of patient safety, and technological advancement.

An increase in the number of surgical procedures will drive the market growth

The global surgical sutures market is expanding at a compound annual growth rate (CAGR) of 6.53% and is forecast to reach $XXbn by 2024. Emerging markets, especially large markets such as India and China, have significant untapped potential in expanding the worldwide surgical devices market. As incomes and living standards in these nations continue to rise, a greater segment of the world’s population will demand better healthcare.

The high Importance of patient safety is driving the market growth

Surgeons use IONM as an additional line of safety during surgeries. These systems play a vital role during critical surgeries such as spinal surgeries that involve the insertion of instruments near the nerves or the spinal area and may cause damage to the CNS. According to the WHO, statistical studies estimate that surgeons use IONM devices and services for about 750,000 surgeries annually in the US, particularly for neurosurgery, interventional neuromonitoring, and spinal, orthopedic, vascular, ENT, and cardiovascular surgeries. IONM also helps surgeons avoid or minimize common complications such as paraparesis, quadriplegia, and paraplegia that occur during surgeries.

Rising Incidences of Neurological Disorders

The growing prevalence of neurological disorders and increasing emphasis on patient safety during complicated surgeries are driving the growth of the intraoperative neuromonitoring market. Neurological diseases encompass the brain, spine, and nerve disorders. A defect in the system can impair function and become a life-threatening factor. Neurological complications include stroke and spinal cord ischemia. During recent years, the prevalence of neurological disorders has increased significantly. A cerebral aneurysm is one of the neurovascular diseases that is rising significantly worldwide. Nearly 30,000 people in the US suffer from brain aneurysm rupture every year.

The increasing number of fatal brain injuries

Moreover, traumatic brain injuries have also increased worldwide, leading to brain-related fatalities. A to the American Association of Neurological Surgeons, approximately 1.7 million cases of traumatic brain injuries (TBI) occur every year in the US. Also, it costs around US$ 48-56 billion annually to the economy. There are approximately 235,000 hospitalizations for TBI every year in the US. Intraoperative neuromonitoring (IONM) is the only option to assess the early symptoms and conditions during emergency brain trauma. These benefits have made it mandatory in neurosurgeries. The rising prevalence of neurological diseases is anticipated to drive the need for the IONM, in turn, increasing demand for IONM products worldwide.

The high cost of surgery with IONM and competitive toughness are going to restrain the market in the forecast period.

The cost of surgeries with IONM is more than those without IONM. Surgeries with IONM involve the expenses of IONM devices, neuro technicians, neurophysiologists, and disposable materials. The high cost of surgeries restricts the acceptability of IONM technology among patients. Prolonged hospital stays and lengthy surgeries also add to the overall expenditure on surgeries. Though IONM systems play a crucial role in many critical surgeries such as spinal and cardiovascular surgeries, not all can afford them.

COVID-19 Impact Analysis

COVID-19 has impacted the market growth for IONM usage in surgeries. There is concern that the actual capacities together with the increased demand may not suffice timely surgical care for all patients in need. In regard to a recent study that estimates the total number of operations canceled due to COVID-19 at almost 30 million, it is imperative to implement procedures allocating operating room capacity based on medical priority. Hospitals cannot allot resources to IONM functionalities, but rather use them to treat the increasing number of COVID-19 patients. As a result of COVID-19, incomes have been affected significantly as well, hence patients cannot afford such treatments that are already expensive.

Insource and Outsource IONM segments show a healthy upward trend

Insource IONM segment held the largest share in the market owing to the rising number of surgeries, and the compulsory monitoring of vital stats during every procedure. Hospitals have adopted IONM systems and have trained technologists to perform, who are supervised by neurologists and physiologists during the procedures. Moreover, there are no defined guidelines for the use of these neuromodulation devices but growing demand and usage of the same is anticipated to trigger segmental growth.

Outsource IONM is gaining popularity as well and is anticipated to grow faster than all other segments. This can be attributed to the fact that outsourcing devices eliminate the need for hospitals to incur capital expenditure for the purchase of the equipment and bear its maintenance cost. Apart from this, nowadays, hospitals generally do not prefer insourced monitoring as they must appoint a full-time employee with the required skillset and they cannot offer the training standardization that is required to improve the quality of service. Thus, outsourced monitoring is in demand among hospitals and ASCs. In addition, IONM professionals also prefer to work for an outsourcing provider as they can work simultaneously for more than one hospital by working in an outsourcing IONM provider.

Revenues from spinal surgeries to grow at a CAGR of 6.53% over the forecast period

The spinal surgeries segment held the major share of the market in terms of revenue and is set to grow with a CAGR of XX% over the forecast period. The reason is set to be attributed to the fact that spinal surgery is widely used to treat spinal pathologies, and is the gold standard for correcting spinal deformities, but despite improvements in surgical techniques, the risk of neurological complications remains. Moreover, IONM is also utilized for other spine surgery indications: tethered cord injured spinal cord, intramedullary tumors, extramedullary tumors, minimally-invasive surgery, cervical myelopathy, as well in other fields of surgery: cranial, vascular, cardiothoracic, etc. and helps prevent perioperative peripheral nerve injury (PPNI) owing to excess mechanical pressure and torsion of the limbs and neck.

The North American region holds the largest market share in the global intraoperative neuromonitoring market

North America accounted for more than 45% of the market in 2019. The US accounted for more than 85% of the market share of North America in 2019. An increase in disease prevalence leading to surgical intervention increased patient safety post-surgical treatment, and high adoption of telehealth services, including remote neuromonitoring is the key impacting factors for North American market growth.

South America has many factors which make it a promising market as well. A high prevalence of chronic diseases, the preexisting sizable base of IONM equipment in specialty hospitals, and the high influx of medical tourists for low-cost surgeries when compared to other European and North American countries.

Market players are involved in product launches, product trial pipelines, product approvals, and acquisitions. Several business acquisitions and large investments were reported in this sector in North America. Hence, this region is expected to grow faster due to rising preclinical activities by pharmaceutical companies.

Some of the key players in the market are SpecialtyCare, Natus Medical Incorporated, NuVasive Inc., Medtronic Plc, Inomed Medizintechnik GmbH, Accurate Monitoring, Cadwell Industries Inc., Computational Diagnostics Inc., Nihon Kohden Corp., and Medsurant Health LLC.

Medtronic and Natus Medical together with their leading product and services hold a strong foothold in the global market. Most of the key companies in the market are focusing high on R&D, product innovation, an extension of the existing product line, and looking to strengthen the market presence by geographical expansion. For instance – In July 2018, NuVasive Inc. received 510(k) clearance for the Pulse™ surgical automation platform from the U.S. Food and Drug Administration (FDA). Pulse integrates multiple intraoperative technologies through an intuitive guided surgical workflow within a single device and footprint in the operating room.

NuVasive Clinical Services

Overview: NuVasive is a medical devices company based in San Diego, California. The company primarily develops medical devices and procedures for minimally invasive spine surgery. NuVasive's products include software systems for surgical planning and monitoring, access instruments, and implantable hardware. Conditions that NuVasive products help treat are degenerative disc disease, lumbar spinal stenosis, degenerative spondylolisthesis, cervical disc degeneration, early-onset scoliosis, and limb length discrepancy.

In the United States and internationally, most of NuVasive's products are marketed directly to doctors, hospitals, and other healthcare facilities. They focus on integrated systems for their surgeon partners.

Product Portfolio: NuVasive provides the following IOM services: SSEP, EMG, motor evoked potentials, BAER, deep brain stimulation, and cortical and brainstem nuclei mapping, among others.

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