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. An IONM system uses recordings of potentials such as EEG and EMG from the nervous system during a surgical procedure. The use of neuromonitoring is important during surgeries as it helps in the detection of injuries or possible impairment of nerve function before, they become so severe that they cause post-operative complications in the patients. Therefore, IONM reduces 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 as a result 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.
According to Scoliosis Research Society, US, around 200 mortalities were reported among 110,000 patients that had undergone neural surgery in 2018. Intraoperative neuromonitoring is used for a few medical specialties such as neurosurgery, ENT surgery, emergency surgery, visceral surgery, cardiothoracic surgery, orthopedics, vascular surgery, and general surgery.
The global intraoperative neuromonitoring market was worth $XX million in 2018 and is forecasted to reach $XX million by 2026, at a CAGR of 5.7% during the forecast period.
The major drivers fueling the growth of the market are increase in surgical procedures, high importance on patient safety and technological advancement.
According to the World Health Organization (WHO), approximately 230 million major surgical procedures are performed annually. The number of hospital admissions for varied surgeries increased at a rate of 27% during 2004–2014.
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.
Market Restraints
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.
Market Segmentation
The global intraoperative neuromonitoring market can be segmented by modality segment as Evoked Potential (EP) Market, Electromyography (EMG) Market and Electroencephalogram (EEG) Market, by service segment as In-source IONM and Out-source IONM and by application as Neurological surgeries, Orthopedic surgeries, ENT surgeries, Cardiovascular surgeries, and Other surgeries.
The Evoked Potential (EP) segment accounted for more than 50% of the market share in 2018. EP is an electrical signal generated by the CNS, which can be detected either by SSEP monitoring or TcMEP monitoring. SSEP monitoring involves the recording of the responses of the sensory pathways in the form of electrical stimuli. IONM is effective in improving surgical outcomes. Research studies by NCBI estimate that with the use of SSEP, there is a 60% reduction in complications associated with surgeries.
The Out-source IONM segment market was valued at $1540.9 million in 2017.
Hospitals partially or fully outsource IONM services to service providers. Biotronic NeuroNetwork, SpecialtyCare, Neuro Alert, Sentient Medical Systems, and Computational Diagnostics are the leading service providers in the US. These companies provide advanced IONM devices, technologists, and physicians to hospitals to assist surgeons during surgeries.
Geographical Analysis
Geographically, the global Intraoperative Neuromonitoring market is divided into North America, Europe, South America, Asia-Pacific and the Middle East and Africa.
North America accounted for more than 45% of the market in 2018. The US accounted for more than 85% of the market share of North America in 2018. Increase in disease prevalence leading to surgical intervention, increased patient safety post-surgical treatment, high adoption of telehealth services, including remote neuromonitoring are the key impacting factors for North America market growth.
South America market is expected to grow at a CAGR of 4.7% over the period of forecast. South America has a high prevalence of chronic diseases, the sizable installed base of IONM equipment in specialty hospitals, the high influx of medical tourists for low-cost surgeries when compared to other European and North America countries.
Competitive Analysis
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 strong foothold in the global Intraoperative neuromonitoring 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 strengthening the market presence by geographical expansion. For instance –
In July 2018, NuVasive Inc. received 510(k) clearance of 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.
Key Takeaways:
• The global intraoperative neuromonitoring market is expected to grow at a CAGR of 5.7% during the forecast period.
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• The Evoked Potential (EP) segment accounted for more than 50% of the market share in 2018.
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• The Out-source IONM segment market was valued at $1540.9 million in 2017.
• North America accounted for more than 45% of the market in 2018. South America market is expected to grow at a CAGR of 4.7% over the period of forecast.
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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.
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• Visualize the composition of Intraoperative Neuromonitoring market across each indication, in terms of source type, modality, application, highlighting the key commercial assets and players.
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