Intraoperative Neuromonitoring (IONM) also called as Intraoperative neurophysiological monitoring is a procedure that uses specialized equipment to evaluate function of nervous system including nerves and spinal cord during neural surgeries. The role of intraoperative neuromonitoring is to provide immediate feedback and warning to the surgeon for prevention of permanent nerve injury as a result of iatrogenic damage. The IONM is usually employed as it increases safety and improves outcomes during a spine surgery. The neural activity is measured in terms of electrically evoked potentials from the nerves with the help of an equipment called electroencephalogram (EEG). The intraoperative neuromonitoring is beneficial to the patient as it allows the assessment of nerve tissue function during surgery, making the surgery safe as compared to conventional hardware tests such as X-rays and CT scans. The IONM is also quick, painless, easy and inexpensive. It can record the nerve function multiple times or even throughout the entire process of surgery. Increasing number of mortality during spinal surgeries major factor driving the growth of global intraoperative neuromonitoring market. For instance, according to a research survey conducted by Scoliosis Research Society, U.S, a total of 197 mortalities was reported among 108,419 patients that had undergone neural surgery.
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The global intraoperative neuromonitoring market was valued at US$ 2,632.4 million in 2016 and is expected to witness a robust CAGR of 6.53% over the forecast period (2017 – 2025).
Figure 1. Global Intraoperative Neuromonitoring Market (US$ Mn), by Region, 2016
US$ 901.5 Mn
Source: Coherent Market Insights
Increasing number of surgical failure leading to iatrogenic damage is one of the prominent factor responsible for the growth of intraoperative neuromonitoring market. For instance, according to a research survey published by Laser Spine Institute LLC 2015, an estimated 400,000 people undergo a spinal surgery in the U.S. annually and 30-40% of patients were reported to be suffering from post-operative complications. Moreover, according to The American Laryngological, Rhinological and Otological Society 2013, an estimated 6% of the cases undergoing facial nerve injury suffered from iatrogenic facial nerve injury due to lack of care during surgical procedures. The benefits offered by the Intraoperative Neuromonitoring are leading to rise in the adoption of these units by various surgical facilities. For instance, according to the International Journal of Spine Surgery 2017, the use of IONM in scoliosis surgical procedures was recorded to be 27% in 2005 that has witnessed a rise of 46.9% in 2011. However, lack of skilled professionals and low awareness of IONM in emerging economies are expected to hinder the market growth.
In terms of region, North America dominated the global intraoperative neuromonitoring market. This is attributed to a consistently improving reimbursement scenario in the region and rising adoption of IONM in the surgical facilities. The Medicare has well defined CPT codes and reimbursement policies for various types of procedures that includes the use of intraoperative neuromonitoring as a part of revised CPT codes and guidelines released in 2017. Furthermore, increasing number of spinal cord surgeries in the North America is propelling growth of the market. According to the Pennsylvania Health Care Cost Containment Council, Statewide Statistics and Key Findings 2014, around 21,293 adults underwent spinal fusion surgery in 2014 witnessing a rise of 67.2% since 2004. The similar report states that 3.3% people who underwent spinal fusion in Pennsylvania experienced surgical complication during the fusion process. Asia Pacific is anticipated to witness a marginal growth in the global intraoperative neuromonitoring market, owing to rising medical tourism and increasing awareness of patient safety during the surgery. According to the Indian Brand Equity Foundation (IBEF) 2015, over 2,000,000 patients visited India in 2015 for medical procedures, which majorly include spinal procedures, liver transplant, and other cosmetic procedures.
Market players are adopting inorganic growth strategies to maintain leading position in the global intraoperative neuromonitoring market
Key players of the market are focused on acquisition of mid and small sized companies for expansion of manufacturing and distribution capacities to large geographical area. For instance, in December 2017, NuVasive, Inc. acquired SafePassage, a privately held intraoperative neurophysiological monitoring services provider for expanding neuromonitoring business. Moreover, companies are investing into research & development activities for development of better quality systems with improved performance and facilities. For instance, in 2012 Inomed Medizintechnik GmbH introduced a C2 Spine Software that provides automatic control for pharmacological relaxation status and offers effective and efficient neuromonitoring.
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Key players operating the global intraoperative neuromonitoring market include Accurate Monitoring, Inomed Medizintechnik GmbH, Neuromonitoring Technologies, Natus Medical Incorporated, Medtronic, Biotronic NeuroNetwork, NuVasive Inc., Sentient Medical Systems, and SpecialityCare.