The global intraoperative neuromonitoring market size was valued at USD 3.17 billion in 2022 and is anticipated to grow at a compound annual growth rate (CAGR) of 4.9% from 2023 to 2030. The growth of the market can be attributed 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. According to the World Health Organization, annually, 15 million people worldwide suffer from a cerebral stroke. The increasing demand for intraoperative neuromonitoring solutions for the treatment of cerebral strokes is estimated to fuel the growth of the market over the forecast period.
The COVID-19 pandemic had a significant impact on the intraoperative neuromonitoring (IONM) market. Hospitals in the U.S. and around the world postponed and delayed elective surgeries to allocate and direct medical supplies and capacity to COVID-19 response. Manufacturers found it difficult to serve their surgeon customers since several hospitals restricted access to their facilities or changed access regulations. As a result, they saw a decrease in procedural volume in 2020, thus impeding market growth.
According to a Frontiers Media S.A. report in November 2020, a higher incidence of neurological complications was observed in critically ill patients affected with COVID-19 and undergoing invasive mechanical ventilation, which in turn correlated with extended stays in the intensive care unit (ICU). Throughout the pandemic, the utilization of multimodal noninvasive neuromonitoring devices proved valuable in promptly detecting abnormalities in cerebrovascular parameters.
Moreover, during this period, there was a growing emphasis on patient education, comprehensive evaluation in recovery rooms for non-ICU hospitalizations, earlier mobilization, effective post-discharge communication, increased adoption of minimally invasive procedures, and prompt post-imaging assessments. These factors are projected to create substantial market growth opportunities in the coming years by enhancing patient care and optimizing post-operative management strategies.
An increase in the prevalence of neurovascular disorders is expected to boost the demand for minimally invasive/noninvasive procedures and advanced intraoperative neuromonitoring devices, thus driving market growth. Additionally, the need for intraoperative neuromonitoring in various healthcare settings is likely to increase with the growing aging population, a demographic that is more susceptible to chronic illnesses.
According to the Centers for Disease Control and Prevention, adults aged 65 years and above are more likely to suffer from heart disease, COPD, diabetes, cancer, neurological problems, and other chronic illnesses. According to a Nature Reviews Neurology article published in September 2019, Alzheimer’s disease affects one out of every 10 people over the age of 65, and its prevalence rises with age. Patients suffering from such illnesses require both emergency and non-emergency hospital treatments, which is projected to drive market growth in the near future.
Monitoring the nervous system's health during spinal surgeries has been a major component of manufacturers' product differentiation strategy. With the evolution of IONM technology and techniques, the demand for neuromonitoring from surgeons and hospitals has increased over time. This is because of the availability of proprietary software from manufacturers and ease of operation. Intraoperative neuromonitoring devices enable surgeons to make key decisions in real-time, making surgeries safer, faster, and more repeatable, resulting in better patient outcomes, and driving industry growth.
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 market growth in the near future. For instance, in October 2020, Medtronic received 510(k) clearance from the U.S. FDA 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. The NIM Vital system employs patented technology to deliver precise intraoperative nerve status data that influences surgical strategies, improves operative efficiency & precision, and helps patients maintain their quality of life. Such developments are expected to impel growth in the near future.
Increasing government initiatives and growing awareness about products and services are further expected to boost industry growth. For instance, Accurate Neuromonitoring provided IONM in Africa during the 2019 Weill Cornell Tanzania Neurosurgery Mission. The mission trip raised awareness about the need for IONM in difficult brain & spine procedures and demonstrated the need for it. Similar advances in the market are expected to boost the demand for intraoperative neuromonitoring in the projection period.
The insourced segment dominated the market with the largest revenue share of 54.4% in 2022. This can be attributed to a rise in procedural frequency and the necessity of monitoring vital statistics throughout each procedure. Hospitals are adopting IONM and training technologists who oversee procedures by neurologists & physiologists. There are no established criteria for the use of neuromodulation devices, but the practice is expected to become more common as demand and usage increase.
The outsourced segment is expected to witness the fastest growth rate of 6.7% over the forecast period, owing to features such as cost-effectiveness and availability of dedicated service providers. IONM devices are being constantly advanced and modified. Outsourcing relieves hospitals of the financial burden of purchasing and maintaining this equipment. Moreover, it is expensive and time-consuming to train neurophysiologists. In addition, they constantly have to keep up-to-date with new technologies. All these factors contribute to the shift in preference for the outsourcing of IONM procedures.
Moreover, industry players are acquiring smaller companies to expand their product offerings. This is anticipated to propel segment growth in the intraoperative neuromonitoring market in the coming years. For instance, in August 2018, Precedent Health, an IONM provider, was acquired by SpecialtyCare. SpecialtyCare is the most comprehensive provider of patient-centered outsourced IONM services to surgery centers, surgeons, hospitals, and health systems.
North America dominated the market with the largest revenue share of 49.3% in 2022. The favorable reimbursement scenarios in the region and increasing cases of neurological disorders are key contributors to this dominance. According to the National Institute of Health, in the U.S., around 795,000 people have a stroke annually, causing 137,000 deaths.
In addition, according to the Migraine Research Foundation, in 2020, around 35 million U.S. individuals suffered from migraine headaches. Moreover, nearly 43% of women and 18% of men are expected to experience migraines in the country. Thus, the increasing occurrence of cases of neurological disorders, such as TBI, migraine, and stroke, is likely to drive market growth in this country.
The increasing prevalence of chronic diseases and the growing geriatric population are the factors driving industry growth in the U.S. According to the CDC in 2021, at least one chronic condition, such as stroke, heart disease, cancer, or diabetes, affects six out of 10 Americans. Chronic diseases such as these are the main causes of death and disability in the U.S., while also being the major drivers of healthcare expenses. In addition, the market is impelled by continued medical infrastructure development as well as growing government and private sector investments to promote the usage of safer & cost-effective healthcare solutions.
IONM is not covered under national insurance but under local one. Many neurological facilities in the U.S. encourage the use of IONM and are working to address the staffing shortage and fulfill unmet demands. There is a shortage of physicians in the medical space, but the shortage is significantly higher in neurology. The introduction of IONM alleviates pressure on neurologists and reduces the number of cases. There are around 700,000 IONM cases annually in the U.S. This can be turned into an opportunity by outsourced IONM providers, technologists, and neurologists trained in IONM interpretation.
The Asia Pacific region is expected to grow at the fastest rate of 5.4% over the forecast period from 2023 to 2030. Emerging economies, such as China, Japan, South Korea, and India, are expected to witness considerable growth over the forecast period. The presence of several notable players such as Medtronic, Natus Medical Incorporated,NuVasive, Inc., and Accurate Monitoring in China and Japan can potentially boost market growth.
Moreover, the growing geriatric population, along with the increasing incidence of traumatic brain injuries, is expected to drive the regional market over the coming years. For instance, according to the 2020 Chinese Census estimates, there are about 264 million (18.7%) people in China aged 60 years or more. The elderly population in the country is expected to further increase to 300 million by 2025 and cross 400 million by 2033.
The intensifying competition is leading to rapid technological advancements and companies are constantly working towards the improvement of their products with a strong focus on research and development. Factors such as investments in R&D, compliance with regulatory policies, and technological advancements are constantly driving the introduction of novel techniques. In addition, market players are adopting strategies such as mergers & acquisitions, partnerships, product launches, and innovations to strengthen their foothold in the market.
For instance, in January 2023, Natus Medical Incorporated, a provider of medical device solutions for sensory system and central nervous system disorders, announced the acquisition of Micromed Holding SAS, a global provider of neurophysiology solutions. This strategic acquisition is estimated to enhance the product portfolio of Natus Medical Incorporated, further expanding its offerings in the field of neurophysiology diagnostics and treatments. Some of the prominent players in the global intraoperative neuromonitoring market include:
Natus Medical Incorporated
Market size value in 2023
USD 3.32 billion
Revenue forecast 2030
USD 4.65 billion
CAGR of 4.9% from 2023 to 2030
Base year for estimation
2018 - 2021
2023 - 2030
Revenue in USD million and CAGR from 2023 to 2030
Revenue forecast, company ranking, competitive landscape, growth factors, and trends
North America; Europe; Asia Pacific; Latin America; MEA
U.S.; Canada; UK; Germany; France; Italy; Spain; Denmark; Sweden; Norway; Japan; China; India; Australia; South Korea; Thailand; Brazil; Mexico; Argentina; Saudi Arabia; South Africa; UAE; Kuwait
Key companies profiled
Natus Medical Incorporated; Accurate Monitoring; Neuromonitoring Technologies; Medtronic; NuVasive, Inc.; SpecialtyCare
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This report forecasts revenue growth at the global, regional, and country levels and provides an analysis of the latest industry trends in each of the sub-segments from 2018 to 2030. For the purpose of this study, Grand View Research has segmented the global intraoperative neuromonitoring market report based on type and region:
Type Outlook (Revenue, USD Million, 2018 - 2030)
Regional Outlook (Revenue, USD Million, 2018 - 2030)
Middle East & Africa
b. The global intraoperative neuromonitoring market size was estimated at USD 3.17 billion in 2022 and is expected to reach USD 3.3 billion in 2023.
b. The global intraoperative neuromonitoring market is expected to grow at a compound annual growth rate of 4.9% from 2023 to 2030 to reach USD 4.65 billion by 2030.
b. North America dominated the intraoperative neuromonitoring market with a share of 49.3% in 2022. This is attributable to favorable and constantly improving reimbursement scenarios and well-defined guidelines.
b. Some of the key players operating in the intraoperative neuromonitoring market include Natus Medical Incorporated, Accurate Monitoring, NeuroMonitoring Technologies, Biotronic NeuroNetwork, LLC, Medtronic, NuVasive Inc, SpecialtyCare, and Sentient Medical Systems.
b. Key factors that are driving the intraoperative neuromonitoring market growth include increasing awareness and benefits of intraoperative neuromonitoring and the application of intraoperative neuromonitoring to broader types of surgeries.
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