American Society of Neurophysiological Monitoring

American Society of Neurophysiological Monitoring Founded in 1990, ASNM serves as the leading organization for intraoperative neurophysiology Its mission is protection of the patient’s nervous system.

The American Society of Neurophysiological Monitoring was founded in 1990 to serve the emerging field of neurophysiologic monitoring. As defined by the Society, neurophysiologic monitoring includes any measure employed to assess the ongoing functional integrity of the central or peripheral nervous system in the operating theatre or other acute care setting. Intraoperative neurophysiological monito

ring (IONM) has evolved over the last several decades. Neurophysiologic signals are monitored continuously during surgery for adverse changes, detection of which enables corrective action. Risk of postoperative neurological deficit, such as weakness, loss of sensation, hearing loss and impairment of other bodily functions is thereby reduced. In addition to detection of change, surgical guidance can be offered in specialized circumstances. Members of the IONM team include but is not limited to: technologists, surgeons, nurses, anesthesiologists, neurophysiologists, and the supervising person. Team members are those who generate the setting & monitor the patient (technologists), identify the changes (technologists and monitoring personnel), institute management plans that involve surgical maneuvers (surgeons), physiological, pharmacological and anesthetic management (anesthesiologists), moving and repositioning of electrical equipment (nurses), and repositioning of the patient (surgeon, anesthesiologists, nurses). The Society is dedicated to the advancement of quality neurophysiologic monitoring services for neuroprotection. Disclaimer: The content presented on this LinkedIn page by the American Society of Neurophysiologic Monitoring (ASNM) is for informational and educational purposes only. It is not intended as professional or medical advice and should not replace professional medical consultation or treatment. We strive to share reliable and accurate information, but we cannot guarantee its currency or applicability to specific situations. Any links or references to external sources are for informational purposes and do not imply endorsement or responsibility for their content. Users should consult with IONM professionals for personalized advice. ASNM and its representatives disclaim any liability for damages or losses resulting from the use or interpretation of the information provided on this page. Please be aware that ASNM does not endorse or take responsibility for the content posted by other individuals or entities on this page.

Considering spine surgery? Here’s what you should know.In a recent Forbes article, Dr. Richard Menger breaks down just h...
07/25/2025

Considering spine surgery? Here’s what you should know.

In a recent Forbes article, Dr. Richard Menger breaks down just how much safer spine surgery has become—with one major contributor being intraoperative neuromonitoring (IONM). This technology allows surgeons to track nerve function in real time during procedures, helping prevent serious complications like paralysis or nerve injury.

* Surgery isn’t the first step—exhaust non-surgical options first
* Ask your surgeon about risks, recovery time, and if a minimally invasive approach is possible
* Don’t forget to ask if nerve-monitoring will be used—your nerves will thank you

Empowered patients make informed choices. Read the full breakdown in Forbes.

https://www.forbes.com/sites/richardmenger/2025/06/17/how-safe-is-spine-surgery-what-to-know-and-what-to-ask-your-surgeon/


07/24/2025

Reminder: Have You Enrolled Yet?
There’s still time to register for our CNIM Test Prep & IONM Foundational Concepts Webinar – your path to CNIM success starts here!
When: September 13–14, 2025
Time: 10:00 AM – 2:30 PM EST
Earn 9 ABRET-Recognized CEUs!
Join expert educators James A. Wyatt Jr., Kristina Young, and Julie Trott for a dynamic, interactive learning experience designed to build your confidence and knowledge in IONM.
Live Q&A with seasoned IONM instructors
Lecture handouts, polls & sample review questions
Great for CNIM exam prep or renewal
Whether you're just starting or reviewing for recertification, this course is built for you.
Register today and be ready to elevate your expertise!

07/23/2025

ASNM 2025 Outstanding Publication Winner
Setting the Standard: Neuromonitoring That Predicts What Matters Most

We’re closing out our nominee spotlight series with this year’s winning publication—a game-changer in sacral neuromonitoring and predictive accuracy for one of the most critical postoperative complications: bowel and bladder dysfunction (BBD).

Award-Winning Article:
“The Diagnostic Accuracy of Neuromonitoring for Detecting Postoperative Bowel and Bladder Dysfunction in Spinal Oncology Surgery”
Lead Author: Justin W. Silverstein, DO | Northwell Health

What This Study Did:
In a 60-case series involving spine tumor surgeries, this team compared various neuromonitoring modalities to evaluate their diagnostic accuracy in predicting BBD after sacral procedures.

Key Results:
Sacral Reflexes (BCR & EUSR):

100% specificity, 73.3% sensitivity (64.7% at 1-month follow-up)

Most reliable tool for predicting BBD

TCMEP (AS/EUS recordings):

Missed all cases of BBD

Spontaneous EMG (AS/EUS):

14.3% sensitivity, 97.1% specificity

What It Means:
Sacral reflex monitoring isn’t just supplemental—it’s predictive. With high specificity and solid sensitivity, it offers real-time guidance that could prevent life-altering complications in high-risk spinal oncology cases.

As BBD can profoundly affect quality of life, this research shines a light on the clinical power of precise neuromonitoring to truly change outcomes.

Congratulations to the authors on this well-earned recognition!

Get the article: email danielle.stewart@axisneuro.com

07/22/2025

Congratulations to Danielle Stewart – 2024 ASNM Outstanding Committee Award Winner!
The ASNM Outstanding Committee Award honors a member who goes above and beyond in their committee service — showing exemplary leadership, dedication, and drive to push our mission forward.
This year’s well-deserved recipient is Ms. Danielle Stewart!
Danielle, a 2011 graduate of Florida Atlantic University with a degree in Social Science and Anthropology, has made a lasting impact on the ASNM community. Over the past year, she has transformed the ASNM’s digital presence as Chair of the Digital Engagement Committee — revamping the team, elevating our content, and thoughtfully curating posts across platforms.
From member spotlights and ASNM history to educational content and global neuroscience celebrations, Danielle has brought new energy and visibility to our society.
Thank you, Danielle, for your outstanding service and visionary leadership. You’ve made a difference!

07/16/2025

TONIGHT!️
Struggling with suppressed signals? Confused by conflicting anesthesia plans?

Join us TONIGHT for a rapid-fire webinar on:
Neuromuscular Blockade in Intraoperative Neuromonitoring
Learn how to manage NMB like a pro and protect your data in the OR.

7-830PM EST | Free & Virtual

Grab your spot now: www.asnm.org/webinars

Don’t miss this—your MEPs will thank you.

07/16/2025

Glioblastoma (GBM) is an aggressive, fast-growing brain tumor with a poor prognosis and limited treatment options. It accounts for nearly half of all malignant brain tumors. Despite standard treatment — surgery, radiation, and chemotherapy — median survival remains around 12–15 months.

Glioblastoma cases represent some of the most complex and high-stakes procedures we support. Intraoperative neuromonitoring plays a critical role in mapping and protecting functional pathways — including motor, sensory, and language networks — during tumor resection. Our data guides surgical decisions in real time, helping reduce postoperative deficits and improve patient outcomes.

Awareness drives research. Research drives progress.
Today we support patients, families, clinicians, and scientists working toward safer procedures, earlier detection, and, ultimately, a cure.

07/15/2025

Congratulations to Maddie Thornton – 2024 Mary Stecker Travel Scholarship Recipient!
In 2007, ASNM Past President Dr. Mark Stecker created the Mary Stecker Travel Scholarship to support rising stars in IONM. This award helps early-career professionals attend the ASNM Annual Meeting and grow through world-class education and networking.
We’re thrilled to recognize Ms. Maddie Thornton as this year’s second scholarship winner! Maddie is one of only a few individuals to have earned the CNIM Complex Spine Microcredential, marking her as a standout in the field.
She graduated summa cm laude with a BA in Psychology from the University of Arkansas in 2019, earned her CNIM in 2020, and added the CS microcredential in 2024. Her leadership at Advanced Monitoring Services — from QA lead and auditor to Training Manager — reflects her dedication and excellence.
Way to go, Maddie! Your drive and achievements are an inspiration to the IONM community.

07/14/2025

ASNM 2025 Outstanding Publication Nominee Spotlight
Making the Case: IONM in Cardiac Surgery Isn’t Just Smart Medicine - It’s Smart Economics

This week, we’re highlighting a groundbreaking study that bridges neurophysiology and health economics, modeling the lifetime value of using intraoperative neuromonitoring (IONM) to detect large vessel occlusion (LVO) during cardiac surgery.

Featured Article:
“Cost-Benefit Analysis of Intraoperative Neuromonitoring for Cardiac Surgery”
Lead Author: Bhav Jain, BS | Stanford School of Medicine / MIT

Stroke during cardiac surgery can be catastrophic—with mortality rates as high as 20%. This research used decision-analysis trees and Markov models to determine when the use of IONM (EEG + SSEP) becomes cost-saving over a patient’s lifetime.

Key Findings:

At a baseline LVO risk of 0.31%, IONM adds ~$1,047 in lifetime cost.

When LVO risk reaches ~3.67%, IONM becomes cost-neutral.

At higher risk levels, IONM is cost-saving—even dramatically so.

Sensitivity analysis showed that stroke risk is the most impactful factor on cost outcomes. Cost of IONM and thrombectomy had relatively minimal influence.

Why It Matters:
This study provides quantitative validation for implementing IONM in high-risk cardiac surgical patients, offering a new layer of protection for the brain and the bottom line.

IONM isn’t just a clinical safety net - it’s a strategic investment in better outcomes.

Get the article: email danielle.stewart@axisneuro.com

07/10/2025

Neuromuscular Blockade in IONM
Coming next week! Are you ready to decode the most misunderstood variable in the OR?

Whether you're battling suppressed signals or navigating tricky anesthesia plans—this webinar gives you the tools to handle NMB like a pro.

July 16th | 7-830PM EST | Free & Virtual

Save your spot: www.asnm.org/webinars

07/09/2025

ASNM 2025 Outstanding Publication Nominee Spotlight
Precision Inside the Orbit: Advancing Cranial Nerve Monitoring

This week’s featured nominee showcases a targeted approach to monitoring cranial nerves III, IV, and VI—responsible for controlling eye movement—using intraorbital EMG recordings during complex skull base surgeries.

Featured Article:
“Extraocular Muscle Electromyographic Recordings for Intraoperative Monitoring of Cranial Nerves III, IV, and VI: A Single-Center Experience with Intraorbital Electrodes”
Lead Author: [Insert Name, if available] | [Insert Institution, if known]

What’s New?
This study details the use of intraorbital needle electrodes to monitor the extraocular muscles—offering direct, high-fidelity insight into motor cranial nerve integrity during high-risk surgeries near the orbit and cavernous sinus.

Key Advantages:

Enhanced detection of subtle changes in oculomotor, trochlear, and abducens nerve function

Real-time feedback to help preserve ocular motor control

A more anatomically precise monitoring method than traditional surface EMG

Study Highlights:

Single-center experience over multiple procedures involving skull base, orbital, and parasellar lesions

Demonstrates safety, feasibility, and clinical utility of intraorbital monitoring in improving outcomes

Why It Matters:
Loss of eye movement function can drastically impact a patient’s quality of life. This innovative technique arms the surgical team with sharper tools to protect what patients often take for granted: the ability to move their eyes safely and symmetrically.

Get the article: email danielle.stewart@axisneuro.com

07/08/2025

Congratulations to Alexandra Gallaty!
We are proud to recognize Alexandra (Ali) Gallaty as one of this year’s recipients of the ASNM Mary Stecker Travel Scholarship!
This scholarship, founded by past ASNM President Dr. Mark Stecker in honor of his mother, supports promising IONM professionals early in their careers—fostering growth through education and networking at the ASNM Annual Meeting.
Ali joined Seastnan Medical in 2024 and earned her CNIM certification the same year. In just one year, she has gone from CNIM trainee to confidently managing complex craniotomy and mapping cases. Her dedication to patient care, eagerness to learn, and drive to reduce false positives in MEPs highlight her as a rising star in the field.
With a BS in Equine Science and an MS in Biomedicine (specializing in Anatomical & Physiological Sciences) from Colorado State University, Ali blends strong academic grounding with compassionate clinical practice.
Congratulations, Ali! Your passion and perseverance are an inspiration to us all.

07/03/2025

ASNM 2025 Outstanding Publication Nominee Spotlight
Unmasking False Alarms: How to Identify and Resolve Neuromonitoring Changes from Brain Sag

This week’s featured nominee offers a vital strategy for distinguishing true neural injury from artifactual signal loss—a challenge faced during complex brain tumor resections.

Featured Article:
“Interpretation and Strategy to Resolve Neuromonitoring Changes Associated with Brain Sag”
Lead Author: Mitali Bose, CNIM | SpecialtyCare
Co-authored by neurosurgical teams from Brigham and Women's Hospital and the University of Pennsylvania

The Challenge:
During resection of large or deep-seated tumors, brain sag—a shift in brain tissue due to CSF loss or tumor mass removal—can mimic true loss of function by altering electrode proximity and cortical alignment.

This can result in:

Sudden decreases in SSEPs and TcMEPs

False-positive IONM alerts that may halt or delay surgery unnecessarily

The Solution:
The authors introduce a saline infusion technique to restore cortical topography in real-time—resolving artifactual changes and allowing safe surgical progression.

Backed by 6 illustrative cases, this study outlines:

Electrophysiological patterns typical of brain sag

Predictable signal changes based on lesion location and patient positioning

Effective signal recovery through intraoperative strategy

Why It Matters:
This work elevates the diagnostic accuracy of IONM and reduces unnecessary surgical interruptions -keeping patient safety front and center without compromising progress in the OR.

Get the article: email danielle.stewart@axisneuro.com

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