Intraoperative Neuromonitoring (IONM) Market - Growth, Trends, COVID-19 Impact, and Forecasts (2022 - 2027)

The Intraoperative Neuromonitoring Market is Segmented by Type (Outsource Monitoring, Insource Monitoring), Application (Spinal Surgery, Ent Surgery, Vascular Surgery, Orthopedic Surgery, Neurosurgery, Other Applications), End User (Hospitals, Ambulatory Surgical Centers), and Geography (North America, Europe, Asia-Pacific, Middle-East and Africa, and South America). The report offers the value (in USD million) for the above segments.

Market Snapshot

Intraoperative Neuromonitoring Market Size
Study Period: 2019-2027
Base Year: 2021
Fastest Growing Market: Asia Pacific
Largest Market: North America
CAGR: 5.1 %

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Market Overview

The intraoperative neuromonitoring (IONM) market is projected to expand at a CAGR of 6.5% over the forecast period, 2022-2027.

The COVID-19 pandemic is expected to have a significant impact on the growth of the brain implants market globally, due to the suspension and postponement of most of the elective surgeries and treatment during the pandemic to reserve the hospital infrastructure and staff for treating COVID-19-infected patients. According to a research article published in medRXiV, 2021, titled 'Covid-19 in Parkinson's Disease Treated by Drugs or Brain Stimulation', the prevalence of SARS-COV2 viral infection in patients with Parkinson's disease was found to be 11.28%. Thus, COVID-19 adversely affected the intraoperative neuromonitoring market. Further, COVID-19 prevalence in Parkinson's disease patients with deep brain stimulation was found to be 18.18%. Additionally, according to a research study published by the Frontiers in Neurology in 2020, titled ''Effects of COVID-19 Lockdown on Movement Disorders Patients With Deep Brain Stimulation: A Multicenter Survey", the motor, and psychiatric symptoms in Parkinson's disease patients and dystonic patients treated with deep brain stimulation were observed to have worsened during the lockdown restriction measures, leading to increased stress in the management of neurological disorders.

The growing prevalence of various lifestyles associated with chronic diseases such as neurological and cardiovascular conditions and increasing emphasis on patient safety during complicated surgeries are some of the factors expected to drive the overall market growth. According to the International Diabetes Federation Diabetes Atlas Tenth edition, updated in December 2021, around 537 million adults all over the world were found to have diabetes in 2021; with the numbers projected to grow to 643 million by 2030 and 783 million by 2045. Moreover, as per the Australian Bureau of Statistics released in March 2022, nearly half of Australians of all ages (46.6%) had one or more chronic conditions, and almost one in five (18.6%) had two or more chronic conditions. Almost half (49.0%) of all females had one or more chronic conditions, and one in five (20.7%) had two or more. Similarly, 43.9% of males had one or more chronic conditions and 16.4% had two or more. This will lead to the increased adoption of intraoperative neuromonitoring which has contributed to the growth of this market.

Intraoperative neuromonitoring (IONM) is a critical technique for monitoring neurosurgery as it offers an early warning concerning motor and sensory functions during surgery by reducing intervention time and risk. As per the Centers for Disease Control and Prevention (CDC) updates from March 2021, each year an estimated 1.5 million Americans sustain a traumatic brain injury (TBI). As a consequence of these injuries: 230,000 people are hospitalized and survive. Thus, with the increasing cases of TBI, the adoption of Intraoperative neuromonitoring is expected to increase over the forecast period.

Moreover, the development of advanced devices, such as neurosurgery devices, surgical microscopes, ophthalmic surgical devices, and surgical robots, has led to a reduction in direct human interference in surgical procedures, which is also expected to support the market growth in the near future. For instance, in October 2020, Medtronic plc received 510(k) clearance from the United States Food and Drug Administration for the NIM Vital nerve monitoring system, which allows physicians to detect, monitor, and confirm nerve function, to assist in reducing the risk of nerve damage during head & neck surgeries.

However, the lack of awareness of IONM in underdeveloped nations and the dearth of skilled personnel restrict the market.

Scope of the Report

Intraoperative neuromonitoring (IONM) is a technique that reduces the risk of neurological deficits during and after surgeries involving the nervous system. An IONM system uses recordings of potentials (such as EEG, EMG, and evoked potentials) from the nervous system during a surgical procedure. The use of neuromonitoring is important during surgeries as it helps in the detection of injuries before they become so severe that they cause postoperative complications in the patients. The Intraoperative Neuromonitoring Market is Segmented by Type (Outsource Monitoring, Insource Monitoring), Application (Spinal Surgery, Ent Surgery, Vascular Surgery, Orthopedic Surgery, Neurosurgery, Other Applications), End User (Hospitals, Ambulatory Surgical Centers), and Geography (North America, Europe, Asia-Pacific, Middle-East and Africa, and South America). The report also covers the estimated market sizes and trends for 17 countries across significant global regions. The report offers the value (in USD million) for the above segments.

Outsource Monitoring
Insource Monitoring
By Application
Spinal Surgery
Ent Surgery
Vascular Surgery
Orthopedic Surgery
Other Applications
By End User
Ambulatory Surgical Centers
By Geography
North America
United States
United Kingdom
Rest of Europe
South Korea
Rest of Asia-Pacific
Middle-East and Africa
South Africa
Rest of Middle-East and Africa
South America
Rest of South America

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Key Market Trends

The Insource IONM Segment is Expected to Dominate the Application Segment Over the Forecast Period

Based on source type, the market is segmented into insource IONM and outsourced IONM. the insource IONM monitors the vital stats during every surgical procedure.

The growth of the segment can be attributed due to the increasing emphasis on patient safety during difficult surgical procedures and the growing prevalence of chronic disorders, such as stroke, epilepsy, Alzheimer’s disease, and Parkinson’s disease.

For instance, according to the United States National Institute of Mental Health (NIMH) updates from 2020, it has been estimated that one in four American adults have a diagnosable mental disorder in any given year, and nearly 6% suffer from severe disabilities. The same source has also stated that the total cost of severe mental illness in the United States exceeds USD 317 billion per year. Thus, with the increasing cases of brain disorders the demand os insource IONM is expected to increase over the forecast period.

Moreover, with the increasing global population and an average lifespan, the prevalence of neurological disorders is on the rise worldwide. The National Institute of Environmental Health Sciences data updated in June 2022 stated that an estimated 6.2 million people may have Alzheimer’s disease in the United States and nearly a million Americans are living with Parkinson’s disease. Additionally, according to Pan American Health Organization data updated in 2021, neurological conditions accounted for 533,172 deaths in 2019, of which 213,129 (40%) in men and 320,043 (60%) in women. Such a burden of neurological disorders is expected to increase the demand for effective monitoring of the patients, thereby contributing to the growth of the insource IONM market.

Thus, owing to the aforementioned factors, the insource IONM segment is expected to witness significant growth in the coming years.


The North America Dominates the Market and is Expected to Continue the Same during the Forecast Period

North America is leading owing to the presence of major market players. A favorable and constantly improving reimbursement in North America has triggered the regional market. Many neurological centers in the United States strongly recommend the use of IONM and try to fulfill the manpower gap to meet the demand. In addition, well-defined guidelines help in implementing neuromonitoring during procedures resulting in better outcomes, thereby benefitting the patients and hospitals.

As per the Alzheimer’s Association 2021 Alzheimer's Disease Facts and Figures, an estimated 6.2 million Americans aged 65 and older were living with Alzheimer's dementia in 2021 the United States. By 2050, the number of people aged 65 and older with Alzheimer’s dementia is projected to increase to 12.7 million. This high burden of Alzheimer’s disease surges the demand for intraoperative neuromonitoring in the monitoring of the disease condition, thereby leading to the growth of the studied market in the country.

In addition, as per the Migraine Research Foundation statistics updated in 2021, in 2020, around, 35 million United States individuals suffer from migraine headaches. Moreover, nearly 43% of women and 18% of men are expected to experience migraines in the country. Thus, increasing cases of neurological disorders, such as TBI, migraine, and stroke, are likely to drive market growth in this country.

Moreover, in March 2021, Neurosign gained the United States Food and Drug Administration approval for the V4 4-channel and 8-channel nerve monitoring system and it is already being used on patients for nerve identification and preservation in the United States. Thus, the product launches in the region are further expected to boost the growth of the studied market in the years to come.

Therefore, owing to the aforesaid factors, the studied market is anticipated to grow over the forecast period in the North American region.

ionm geo

Competitive Landscape

The market for intraoperative neuromonitoring (IONM) is highly competitive and consists of the global and local players. Due to the technological advancements, small and mid-sized companies are focusing on market penetration to grab the market share. The market is witnessing dynamic merger and acquisition activities. Some of the companies which are currently present in the market are Computational Diagnostics Inc., inomed Medizintechnik GmbH, inomed Medizintechnik GmbH, Medtronic, Natus Medical Incorporated, Neuro Style, Nihon Kohden Corporation, Nuvasive Inc., Specialtycare, Technomed.

Recent Development

  • In June 2022, NuVasive, Inc. announced the grand opening of its Singapore Experience Center for the Asia-Pacific region, supporting the Company's growth strategy to globalize its business.
  • In March 2021, Neurosign gained the United States Food and Drug Administration approval for the V4 4-channel and 8-channel nerve monitoring system and it is already being used on patients for nerve identification and preservation in the United States.

Table of Contents


    1. 1.1 Study Assumptions and Market Definition

    2. 1.2 Scope of the Study




    1. 4.1 Market Overview

    2. 4.2 Market Drivers

      1. 4.2.1 The Rising Incidences of Chronic Diseases due to Lifestyle Changes

      2. 4.2.2 Risk Management through IONM During Complex Surgeries

    3. 4.3 Market Restraints

      1. 4.3.1 Low Awareness of IONM in Developing Nations

      2. 4.3.2 Dearth of Skilled professionals

    4. 4.4 Porter's Five Force Analysis

      1. 4.4.1 Threat of New Entrants

      2. 4.4.2 Bargaining Power of Buyers/Consumers

      3. 4.4.3 Bargaining Power of Suppliers

      4. 4.4.4 Threat of Substitute Products

      5. 4.4.5 Intensity of Competitive Rivalry

  5. 5. MARKET SEGMENTATION (Market Size by Value - USD million)

    1. 5.1 BY TYPE

      1. 5.1.1 Outsource Monitoring

      2. 5.1.2 Insource Monitoring

    2. 5.2 By Application

      1. 5.2.1 Spinal Surgery

      2. 5.2.2 Ent Surgery

      3. 5.2.3 Vascular Surgery

      4. 5.2.4 Orthopedic Surgery

      5. 5.2.5 Neurosurgery

      6. 5.2.6 Other Applications

    3. 5.3 By End User

      1. 5.3.1 Hospitals

      2. 5.3.2 Ambulatory Surgical Centers

    4. 5.4 By Geography

      1. 5.4.1 North America

        1. United States

        2. Canada

        3. Mexico

      2. 5.4.2 Europe

        1. Germany

        2. United Kingdom

        3. France

        4. Italy

        5. Spain

        6. Rest of Europe

      3. 5.4.3 Asia-Pacific

        1. China

        2. Japan

        3. India

        4. Australia

        5. South Korea

        6. Rest of Asia-Pacific

      4. 5.4.4 Middle-East and Africa

        1. GCC

        2. South Africa

        3. Rest of Middle-East and Africa

      5. 5.4.5 South America

        1. Brazil

        2. Argentina

        3. Rest of South America


    1. 6.1 Company Profiles

      1. 6.1.1 Computational Diagnostics Inc.

      2. 6.1.2 Inomed Medizintechnik GmbH

      3. 6.1.3 Neuro Alert

      4. 6.1.4 Medtronic PLC

      5. 6.1.5 Natus Medical Incorporated

      6. 6.1.6 Neuro Style.

      7. 6.1.7 Nihon Kohden Corporation

      8. 6.1.8 Nuvasive Inc.

      9. 6.1.9 Specialty Care Inc.

      10. 6.1.10 Technomed

      11. 6.1.11 Accurate Monitoring

      12. 6.1.12 NeuroMonitoring Technologies

    2. *List Not Exhaustive

**Subject to Availability
**Competitive Landscape covers- Business Overview, Financials, Products and Strategies and Recent Developments

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Frequently Asked Questions

The Global Intraoperative Neuromonitoring (IONM) Market market is studied from 2019 - 2027.

The Global Intraoperative Neuromonitoring (IONM) Market is growing at a CAGR of 5.1% over the next 5 years.

Asia Pacific is growing at the highest CAGR over 2021- 2026.

North America holds highest share in 2021.

Accurate Monitoring , Medtronic , NATUS MEDICAL INCORPORATED , Nihon Kohden Corporation , Technomed are the major companies operating in Global Intraoperative Neuromonitoring (IONM) Market.

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