Intraoperative Neuromonitoring Market , IONM Marke
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Intraoperative neuromonitoring (IONM) encompasses the application of a wide variety of electrophysiological methods to monitor the functional integrity of the nervous system during surgical interventions.

The global Intraoperative neuromonitoring market is expected to cross $4 billion, growing at a CAGR of close to 7.8% during the period 2016–2022. High burden of healthcare expenditures, patients and healthcare providers’ preferences for choice of treatment with negligible/no risk post-surgical complications options have fuelled the demand for Intraoperative neuromonitoring services globally. The number of establishments providing outsourced IONM has also increased considerably in recent years in the US. Thus, opportunities witnessed by the Intraoperative neuromonitoring market in US are highly lucrative.

Global Intraoperative Neuromonitoring (IONM) Market at a Glance

Intraoperative Neuro Monitoring Market IONM Market


The report provides a holistic view of the global IONM market, the companies involved in the market, and the factors driving its growth. It also provides information on some of the latest trends that have started to surface and are likely to become strong market driving forces over the next five years. This report also provides the Porter’s Five Forces analysis along with a description of each force and its impact on the market. Further, the report also provides complete value chain analysis of the global market.

IONM Market: Key Vendor Analysis

Vendors majorly focus on merger & acquisition to strengthen their presence

The global market can be termed as attractive one because of the growth prospects it holds. Mergers and acquisition are the major strategies used by vendors in the market. The report includes the news and details of the key mergers and acquisition of major vendors in the industry.  Major vendors in the global market SpecialtyCare, Natus, NuVasive, Medtronic, inomed Medizintechnik GmbH.

Other emerging vendors are Accurate Monitoring, Cadwell Industries, Computational Diagnostics, Bromedicon Neuromonitoring, Clinical Neurodiagnostics, CNS Neuromonitoring, Dr. Langer Medical GmbH, IntraNerve, Medsurant Health, Neuro Alert, Neurophysiology Services Asia, and Nihon Kohden Corp.

 IONM Market Dynamics

Advent of portable and multi-modality IONM devices to boost the market

Increase in volume of surgical procedures, growing utility of intraoperative neuromonitoring in varied surgeries, technological innovations and increase in use of out-sourced Intraoperative neuromonitoring by small and rural healthcare centers are the major factors that are enhancing the growth of the market. Increasing demand for tele-neuromonitoring, advent of portable and multi-modality IONM devices, increase in strategic consolidations and integration of MI surgeries with intraoperative neuromonitoring are the latest trends that will boost the market and will pave the way for growth opportunities.

IONM Market: Segmental Overview

Neurosurgery segment is going to dominate the market during the forecast period

Outsourced intraoperative neuromonitoring is growing at a rapid pace due to its benefits over in-sourced monitoring. Hospitals prefer outsourced monitoring as it eliminates the need for purchase of premium priced Intraoperative neuromonitoring capital equipment and avoid the requirement to appoint full-time IONM professionals.

In terms of modality, the EP segment dominated the market with a major share of 68.25% of the global IONM market due to its broad range of surgical applications and the high utilization rate. This segment is anticipated to be driven at a slightly growth rate during 2016−2022 and will retain to be major segment of the global Intraoperative neuromonitoring market by modality type during the forecast period. In terms of the growth rate, orthopedic surgeries are likely to grow at a higher CAGR than other surgical types. However, neurosurgery will remain the major revenue contributor during the forecast period in the application segment.

IONM Market: Geographical Analysis

IONM market in North America to be the largest market

The primary factor for the high share of North America in the global IONM market is the existence of the favorable and constantly improving reimbursement scenario in the region. The penetration of Intraoperative neuromonitoring devices is significantly higher in the US than other developed or developing countries worldwide. Their demand in this region is also rapidly growing increased in rate of utilization of IONM for varied surgeries and due to increase in demand for out-sourced  services. Europe is the second largest market, followed by APAC, Latin America, and MEA.

SpecialtyCare, Natus, NuVasive, Medtronic, and inomed Medizintechnik GmbH are the leading players in the global intraoperative neuromonitoring (IONM) market. The global IONM market is expected to cross $4 billion, growing at a CAGR close to 7.8% during 2016–2022. The market for IONM is relatively entrenched in developed countries, especially in the US and Europe. North America will lead the market and the US will have the maximum share (90%) of the total market share in the region. The orthopedic surgery segment is likely to post the highest growth CAGR in the application segment, whereas the neurosurgery segment will remain the largest market. The EP segment will dominate the market during the forecast period.

Global IONM Market Segmentation


Report Timeline

  • Base Year:                  2016  
  • Forecast Year:            2017–2022  

Major vendors profiled in the report are as following:

  • SpecialtyCare
  •  Natus
  • NuVasive
  • Medtronic
  • inomed Medizintechnik GmbH

Other emerging vendors are   Accurate Monitoring, Cadwell Industries, Computational Diagnostics, Bromedicon Neuromonitoring, Clinical Neurodiagnostics, CNS Neuromonitoring, Dr. Langer Medical GmbH, IntraNerve, Medsurant Health, Neuro Alert, Neurophysiology Services Asia, Nihon Kohden Corporation.

Scope of the Report

The study considers the present scenario of the global IONM Market and its market dynamics for the period 2016−2022. It covers a detailed overview of various market growth enablers, restraints, and trends. The study covers both the demand and supply sides of the market. The report also profiles and analyzes the leading five companies and 15 other prominent companies operating in the market.

The sale of major IONM market companies was aggregated to arrive at the market size. The same approach is used to calculate the market size in terms of revenue. An estimated 85−90% of vendors’ capacity are mapped and considered in the calculations.

The report provides the analysis of the key segments of the market by end-users, geography, and vendors. It provides a detailed analysis of revenue from various segments:

Source Types

  • In-sourced
  • Outsourced

Methodology Types

  • Evoked Potential (EP)
  • Electromyography (EMG)
  • Electroencephalography (EEG)

Application Types

  • Neurosurgery
  • Orthopedic surgery
  • ENT surgery
  • Cardiovascular surgery

Major Geographies

  • APAC
  • Europe
  • Latin America
  • MEA
  • North America

1              Research Methodology

2              Research Objectives

3              Research Process

4              Report Coverage

4.1          Market Definition

4.2          Base Year

4.3          Scope of Study

4.3.1       Market Segmentation by Source Type

4.3.2       Market Segmentation by Methodology

4.3.3       Market Segmentation by Application

4.3.4       Market Segmentation by Geography


5              Report Assumptions & Caveats

5.1          Currency Conversion rate

5.2          Market Derivation


6              Market at a Glance


7              Introduction

7.1          Overview Of Nervous System and Neurophysiology

7.2          Introduction to IONM

7.3          Evolution of IONM

7.4          Standard STAGES in IONM

7.4.1       Pre-operative Preparation

7.4.2       Baseline IONM Recording

7.4.3       Perioperative IONM Recording

7.4.4       IONM Documentation

7.4.5       Interpretive Report Preparation

7.5          Key Advantages of IONM


8              Reimbursement Scenario

8.1          Background

8.2          Reimbursement Scenario in North America

8.2.1       Reimbursement Scenario in US

8.2.2       Overview of IONM Reimbursement

8.2.3       Outline of Coding Considerations-

8.3          Reimbursement Scenario in Europe

8.3.1       Reimbursement Scenario in UK

8.3.2       Reimbursement Scenario in France

8.3.3       Reimbursement Scenario in Germany

8.3.4       Reimbursement Scenario in Italy

8.3.5       Reimbursement Scenario in Spain

8.4          Reimbursement Scenario in Latin America

8.4.1       Reimbursement Scenario in Mexico

8.5          Reimbursement Scenario in APAC

8.5.1       Reimbursement Scenario in Japan

8.5.2       Reimbursement Scenario in Australia


9              Market Dynamics

9.1          Market Growth Enablers

9.1.1       Increase in Volume of Surgical Procedures

9.1.2       Increased Utility of IONM in Varied Surgeries

9.1.3       Technological Advancements

9.1.4       Increased Use of Out-sourced IONM by Small and Rural Healthcare Centers

9.1.5       YOY Impact of Market Enablers

9.2          Market Growth Restraint

9.2.1       Low Awareness and Adoption of IONM in Emerging Countries

9.2.2       Limited Skilled Healthcare Professionals

9.2.3       High Cost of IONM Utilized Surgeries

9.2.4       Associated Complications of IONM

9.2.5       YOY Impact of Market Restraints

9.3          Market Opportunities & Trends

9.3.1       High Demand for Tele-Neuromonitoring

9.3.2       Advent of Portable and Multi-modality IONM Devices

9.3.3       Increase in Strategic Consolidation

9.3.4       Integration of MI Surgeries with IONM

9.3.5       YOY Impact of Trends and Opportunities


10           Global IONM Market

10.1        market Overview

10.2        Market Size & Forecast

10.3        Porter’s Five Forces Analysis

10.3.1     Threat of New Entrants

10.3.2     Bargaining Power of Suppliers

10.3.3     Bargaining Power of Buyers

10.3.4     Threat of Substitutes

10.3.5     Competitive Rivalry


11           IONM Market- By Source Type

11.1        Market Overview

11.2        In-Sourced IONM Market

11.3        Outsourced IONM Market


12           IONM Market- By Modality

12.1        Segment Overview

12.2        Evoked Potential (EP) Market

12.2.1     Market Size & Forecast

12.3        Detailed Description of EP Types

12.3.1     Somatosensory evoked potentials (SSEP)

12.3.2     Motor Evoked Potentials (MEP)

12.3.3     Visual Evoked Potential (VEP)

12.3.4     Brainstem Auditory Evoked Potential (BAEP)

12.4        Electromyography (EMG)

12.4.1     Market Size & Forecast

12.4.2     Free-running EMG

12.4.3     Stimulated EMG

12.5        Electroencephalogram (EEG) Market


13           Global IONM Market – By Application

13.1        Segment Overview

13.2        NEURAL Surgeries

13.2.1     Market Size & Forecast

13.3        Orthopedic Surgeries

13.3.1     Market Size & Forecast

13.4        ENT Surgeries

13.4.1     Market Size & Forecast

13.5        Cardiovasular Surgeries

13.5.1     Market Size & Forecast


14           IONM Market - By Geography

14.1        Market Overview


15           North America: IONM Market

15.1        Market Overview

15.2        Market Size & Forecast

15.3        Leading Trends, Enablers, and Restraints

15.4        Key Countries

15.4.1     US: Market Size & Forecast

15.4.2     Canada: Market Size & Forecast


16           Europe: IONM Market

16.1        Market Overview

16.2        Market Size & Forecast

16.3        Leading Trends, Enablers, and Restraints

16.4        Key Countries

16.4.1     Germany: Market Size & Forecast

16.4.2     UK: Market Size & Forecast

16.4.3     France, Italy, and Spain: Market Size and Forecast


17           APAC: IONM Market

17.1        Market Overview

17.2        Market Size & Forecast

17.3        Leading Trends, Enablers, and Restraints

17.4        Key Countries

17.4.1     Japan: Market Size & Forecast

17.4.2     Australia: Market Size & Forecast

17.4.3     China and India: Market Size & Forecast


18           Latin America: IONM Market

18.1        Market Overview

18.2        Market Size & Forecast

18.3        Major Trends, Enablers, and Restraints

18.4        Key Countries

18.4.1     Mexico: Market Size & Forecast

18.4.2     Brazil: Market Size & Forecast


19           Middle East & Africa: IONM Market

19.1        Market Overview

19.2        Market Size & Forecast

19.3        Major Trends, Enablers, and Restraints


20           Competitive Landscape

20.1        Competition overview


21           Key Company Profiles

21.1        SpecialtyCare

21.1.1     Key Highlights

21.1.2     Strength Assessment

21.1.3     Strategy Assessment

21.1.4     Opportunity Assessment

21.2        Natus Medical Incorporated

21.2.1     Key Highlights

21.2.2     Strength Assessment

21.2.3     Strategy Assessment

21.2.4     Opportunity Assessment

21.3        NuVasive Inc

21.3.1     Key Highlights

21.3.2     Strength Assessment

21.3.3     Strategy Assessment

21.3.4     Opportunity Assessment

21.4        Medtronic plc

21.4.1     Key Highlights

21.4.2     Strength Assessment

21.4.3     Strategy Assessment

21.4.4     Opportunity Assessment

21.5        inomed Medizintechnik GmbH

21.5.1     Key Highlights

21.5.2     Strength Assessment

21.5.3     Opportunity Assessment

21.5.4     Strategy Assessment


22           Other Prominent Companies

22.1        Accurate Monitoring

22.1.1     Strength Assessment

22.1.2     Strategy Assessment

22.1.3     Opportunity Assessment

22.2        Cadwell Industries INC.

22.2.1     Strength Assessment

22.2.2     Strategy Assessment

22.2.3     Opportunity Assessment

22.3        Computational Diagnostics INC.

22.3.1     Strength Assessment

22.3.2     Strategy Assessment

22.3.3     Opportunity Assessment

22.4        Bromedicon Neuromonitoring LLC

22.4.1     Strength Assessment

22.4.2     Strategy Assessment

22.4.3     Opportunity Assessment

22.5        Clinical Neurodiagnostics LLC

22.5.1     Strength Assessment

22.5.2     Strategy Assessment

22.5.3     Opportunity Assessment

22.6        CNS Neuromonitoring

22.6.1     Strength Assessment

22.6.2     Strategy Assessment

22.6.3     Opportunity Assessment

22.7        Dr. Langer Medical

22.7.1     Strength Assessment

22.7.2     Strategy Assessment

22.7.3     Opportunity Assessment

22.8        IntraNerve LLC

22.8.1     Strength Assessment

22.8.2     Strategy Assessment

22.8.3     Opportunity Assessment

22.9        Medsurant Health LLC

22.9.1     Strength Assessment

22.9.2     Strategy Assessment

22.9.3     Opportunity Assessment

22.1        Neuro Alert

22.10.1  Strength Assessment

22.10.2  Strategy Assessment

22.10.3  Opportunity Assessment

22.11      Neurophysiology Services Asia

22.11.1  Strength Assessment

22.11.2  Strategy Assessment

22.11.3  Opportunity Assessment

22.12      Nihon Kohden CORP.

22.12.1  Strength Assessment

22.12.2  Strategy Assessment

22.12.3  Opportunity Assessment


23           Report Summary

23.1        Key Takeaways

23.2        Qualitative Summary of Global IONM Market

23.3        Quantitative Summary of Global IONM Market


24           Appendix

24.1        List of Abbreviations







List of Exhibits        

Exhibit 1         Segmentation of Global IONM Market

Exhibit 2         Market Size Calculation Approach 2016

Exhibit 3         Schematic Representation of Neurotransmission

Exhibit 4         Mechanism of IONM

Exhibit 5         Common IONM Modalities

Exhibit 6         Evolution of IONM

Exhibit 7         Standard Steps Followed in IONM

Exhibit 8         Key Advantages of IONM

Exhibit 9         Increase in Volume of Select Surgical Procedures in US (in thousands)

Exhibit 10       Increase in Number of Hospitals Utilizing IONM in US 2008 and 2012

Exhibit 11       Common Specialist Areas Utilizing IONM Techniques

Exhibit 12       Snapshot of Out-sourced IONM’s Benefits Over In-sourced IONM

Exhibit 13       Global Outsourced IONM Market ($million)

Exhibit 14       Additional Costs of IONM Utilized MIS-TLIF Surgery

Exhibit 15       Demand for Remote IONM in US

Exhibit 16       List of Key Portable and Multi-Modal IONM Devices

Exhibit 17       Overview of Global Disease Burden and Need For IONM

Exhibit 18       Global IONM Market 2016–2022 ($ million)

Exhibit 19       Five Forces Analysis 2016

Exhibit 20       Global IONM Market by Source Type

Exhibit 21       Percentage Share of In-sourced and Out-sourced IONM 2016 and 2022

Exhibit 22       Global IONM Market by Source Type ($ million)

Exhibit 23       Comparison of Growth Rates for Out-sourced and In-sourced IONM Segments

Exhibit 24       Key Beneficial Aspects and Drawbacks of In-sourced IONM

Exhibit 25       Global In-sourced IONM Market Size and Forecast ($ million)

Exhibit 26       End-users of Out-Sourced IONM Service Providers

Exhibit 27       Key Benefits of Outsourced IONM Services

Exhibit 28       Global Out-sourced IONM Market Size and Forecast ($ million)

Exhibit 29       Global IONM Market by Modality

Exhibit 30       Percentage Share of EP, EMG, and EEG

Exhibit 31       Global IONM Market Lucrativeness by Modality

Exhibit 32       Global IONM Market by Modality ($ million)

Exhibit 33       Comparison of Growth Rates for EP, EMG, and EEG

Exhibit 34       Types of Evoked Potentials Used as IONM Modalities

Exhibit 35       Global EP Market Size and Forecast ($ million)

Exhibit 36       Common MEP Indicated Surgeries

Exhibit 37       Common VEP Indicated Surgeries

Exhibit 38       Common BAEP Indicated Surgeries

Exhibit 39       Snapshot of Basic EMG Techniques

Exhibit 40       Key EMG Indicated Surgeries

Exhibit 41       Global Electromyography Market Size and Forecast ($ million)

Exhibit 42       Key EEG Indicated Surgeries

Exhibit 43       Global EEG Market Size and Forecast ($ million)

Exhibit 44       Global IONM Market by Application

Exhibit 45       Percentage Share of Surgical Specialties 2016 and 2022

Exhibit 46       Global IONM Market Lucrativeness by Application 2022

Exhibit 47       Incidence of Brain and Nervous System Tumors (in ‘000)

Exhibit 48       Increase in IONM Utilization Rate for Simple Fusions and Laminectomies in US

Exhibit 49       Global IONM Market Size for Neural Surgeries ($ million)

Exhibit 50       Hip replacements Surgical Volume in Select OECD Countries (in ‘000)

Exhibit 51       Global IONM Market Size for Orthopedic Surgeries ($ million)

Exhibit 52       Incidence of Thyroid Cancer (in ‘000)

Exhibit 53       Global IONM Market Size for ENT Surgeries ($ million)

Exhibit 54       Decrease in CABG Surgical Volume in Select OECD countries

Exhibit 55       Global IONM Market Size for Cardiovascular Surgeries ($ million)

Exhibit 56       Global IONM Market by Geography

Exhibit 57       IONM Market by Geography ($ million)

Exhibit 58       Market Revenue Growth Rates Comparison by Geography

Exhibit 59       Global IONM Market Lucrativeness by Geography 2022

Exhibit 60       IONM Market in North America by Country 2016

Exhibit 61       IONM Market in North America 2016–2022 ($ million)

Exhibit 62       Key IONM Market Dynamics in North America

Exhibit 63       Increase in Select Surgical Procedures in US (in '000's)

Exhibit 64       IONM Market in the US 2016–2022 ($ million)

Exhibit 65       Increase in Volume of Select Surgeries in Canada 2006–2015

Exhibit 66       IONM Market in Canada 2016–2022 ($ million)

Exhibit 67       IONM Market in Europe by Country 2016

Exhibit 68       IONM Market in Europe ($ million)

Exhibit 69       Key IONM Market Dynamics in Europe

Exhibit 70       Increase in Volume of Select Surgeries in Germany 2006–2015

Exhibit 71       IONM Market in Germany 2016–2022 ($ million)

Exhibit 72       Increase in Volume of Select Surgeries in UK

Exhibit 73       IONM Market in UK ($ million)

Exhibit 74       Increase in Volume of Total Knee Replacement in France, Italy, and Spain 2006–2015

Exhibit 75       IONM Market in France ($ million)

Exhibit 76       IONM Market in Italy ($ million)

Exhibit 77       IONM Market in Spain ($ million)

Exhibit 78       IONM Market in APAC ($ million)

Exhibit 79       Key IONM Market Dynamics in APAC

Exhibit 80       IONM Market in Japan 2016–2022 ($ million)

Exhibit 81       IONM Market in Australia ($ million)

Exhibit 82       IONM Market in China ($ million)

Exhibit 83       IONM Market in India ($ million)

Exhibit 84       IONM Market in Latin America ($ million)

Exhibit 85       Key IONM Market Dynamics in Latin America

Exhibit 86       Increase in Common Surgical Procedures in Mexico

Exhibit 87       IONM Market in Mexico ($ million)

Exhibit 88       IONM Market in Brazil ($ million)

Exhibit 89       IONM Market in MEA 2016–2022 ($ million)

Exhibit 90       Key IONM Market Dynamics in Latin America

Exhibit 91       Snapshot of IONM Competitive Scenario



List of Tables

Table 1            Key Geographies Definition

Table 2            Key Caveats

Table 3            Currency Conversion 2013−2016

Table 4            Federally Funded Key Health Insurance Programs in US

Table 5            IONM Related Primary CPT Codes (2017)

Table 6            IONM Add-on Reimbursement Codes Description, 2017

Table 7            IONM Add-on Reimbursement Codes, Key Considerations

Table 8            Description of Advanced Features of Select IONM Equipment

Table 9            YOY Impact of Market Enablers 2016–2022

Table 10         Limitations of Select IONM Modalities

Table 11         YOY Impact of Market Restraints 2016–2022

Table 12         Key Mergers and Acquisitions in Global IONM Market

Table 13         YOY Impact of Trends and Opportunities 2016–2022

Table 14         Global IONM Market by Source-Type, 2016 – 2022 ($ million)

Table 15         Global IONM Market by Modality, 2016 – 2022 ($ million)

Table 16         Key Surgeries Monitored through SSEP

Table 17         Global IONM Market by Application, 2016 – 2022 ($ million)

Table 18         Common IONM Procedures Recommended for Specific Neural Procedures

Table 19         Common IONM Procedures Recommended for Specific Orthopedic Procedures

Table 20         Common IONM Procedures Recommended for Specific ENT Procedures

Table 21         Global IONM Market by Geography, 2016 – 2022 ($ million)

Table 22         Natus Medical:  IONM Product Portfolio 2017

Table 23         Medtronic IONM Product Portfolio

Table 24         inomed's IONM Product Portfolio 2017

Table 25         Qualitative Summary of Global IONM Market

Table 26         Quantitative Summary of Global IONM Market by Geography ($ million)

Table 27         Quantitative Summary of Global IONM Market by Geography (Revenue %)

Table 28         Quantitative Summary of Global IONM Market by Source Type ($ million)

Table 29         Quantitative Summary of Global IONM Market by Modality ($ million)

Table 30         Quantitative Summary of Global IONM Market by Application ($ million)

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