U.S. Intraoperative Neuromonitoring Market Size & Share Analysis - Emerging Trends, Growth Opportunities, Competitive Landscape, and Forecasts (2025 - 2032)

U.S. Intraoperative Neuromonitoring Market Emerging Trends & Growth Drivers

Increase in Remote and Outsourced Monitoring Services Is a Key Trend

The flexibility of healthcare providers is boosted through outsourcing because they receive neuromonitoring service as required, rather than being burdened by hiring permanent staff for the task. Transparent contracting with outsourcing allows hospitals to expand or decrease IONM support according to their current patient volumes and surgery complexity levels.

In addition, medical teams obtain flexible options to select neurophysiologic monitoring for individual operations, without requiring ongoing investments in inhouse staff. Moreover, surgical centers use the IONM technology only during high-risk and difficult procedures, which is why investing in staff and equipment to perform it for standard operations raises unnecessary expenses.

Furthermore, through outsourcing peripheral functions, such as IONM, hospitals and surgical centers can direct their funds toward core activities, including clinical operations and procedural knowledge enhancement.

Rising Preference for Minimally Invasive Surgeries Is Key Growth Driver

The biggest driver for the market is the increasing popularity of minimally invasive surgical procedures in the country. As per estimates, more than 25 million MISs were performed in the U.S. in 2023.

The smaller incisions required in MIS procedures minimize tissue trauma, thus quickening up recoveries and reducing both surgical pain and patient discomfort. Laparoscopic, endoscopic, as well as robotic-assisted surgical procedures represent three common examples.

However, restricted visibility and positional difficulties represent a fundamental obstacle in minimally invasive surgeries. Doctors performing traditional surgeries benefit from direct touch and visual feedback of the tissues, while minimally invasive techniques depend primarily on camera systems for endoscopic views and robotic operations.

This decreased visibility makes it difficult for surgeons to see or distinguish important structures, particularly nerves, and assess if they have been impacted. Hence, MIS requires continuous neural pathway monitoring to identify immediate nerve function changes. The immediate detection of nerve function deviations through continuous monitoring decreases the risk of disabling neurological injuries, thus propelling the demand for IONM.

High Costs of Equipment and Services Are Major Challenge

The implementation of IONM systems is limited by their high initial purchase expenses, which are compounded by the continuous upkeep costs. This becomes an expensive burden for smaller facilities, such as primary-care hospitals and ambulatory surgical centers. Availing of IONM services from outside providers through third-party agreements helps facilities access specialized expertise and saves on direct staffing expenses. However, these services still prove expensive for smaller outpatient facilities and surgical centers. Hospitals need to match these expenditures with their financing capabilities and treatment volume details, which continues to hamper the growth of the market.

U.S. Intraoperative Neuromonitoring Market Segmentation Analysis

Offering Analysis

• The systems category held the largest market share, of 65%, in 2024.
• This is because hospitals and ambulatory surgery centers are increasingly purchasing these expensive systems so surgeons can monitor electrophysiological signals from patients during procedures.
• The services category will grow at the highest CAGR, of 6.7%, during the forecast period.
• The compounding need for healthcare cost reduction via decreased system maintenance expenses and the expanding outsourcing vendor base nationwide drive the demand for outsourced monitoring services.

The offerings analyzed here are:

• Systems (Largest Category)
• Accessories
• Services (Fastest-Growing Category)
  • Insourced
  • Outsourced

Modality Analysis

• The motor evoked potentials category held the largest market share, of 45%, in 2024.
• This is because monitoring procedure risks with MEPs guarantees continuous tracking of nervous system motor pathways, especially during spinal, brain, and orthopedic approaches.
• The brainstem auditory evoked potentials category will grow at the highest CAGR, of 6.9%, during the forecast period.
• This is because surgeons extensively use BAEPs to monitor auditory brainstem pathway responses, specifically during surgical procedures on the brainstem, cranial nerves, and the ear.
• BAEP testing is experiencing increasing demand as minimally invasive surgeries are on the rise.

The modalities analyzed here are:

• Motor Evoked Potentials (MEPs) (Largest Category)
• Somatosensory Evoked Potentials (SSEPs)
• Electroencephalography (EEG)
• Electromyography (EMG)
• Brainstem Auditory Evoked Potentials (BAEPs) (Fastest-Growing Category)
• Visual Evoked Potentials (VEPs)
• Others

End User Analysis

• The hospitals category held the larger market share, in 2024.
• This is because most high-risk surgical operations are performed at hospitals, where healthcare providers depend on established safety procedures and outcome efficiency standards.
• Hospitals across the U.S. have widely implemented IONM because this technology helps detect neural injuries during surgical procedures.
• The ambulatory surgery centers category will grow at the higher CAGR, during the forecast period.
• This is because patients receive quicker and more-affordable medical care across various specialties at ASCs, including neurosurgery, cardiac surgery, ENT procedures, gastroenterology and general surgery, gynecologic procedures, and complex orthopedic operations.
• This category is also driven by the increasing demand for MISs, which ASCs are rapidly adopting to reduce the cost, pain, and mental burden on patients.

The end users analyzed here are:

• Hospitals (Larger Category)
• Ambulatory Surgery Centers (ASCs) (Faster-Growing Category)

Applications Analysis

• The spine category held the largest market share in 2024, and it will grow at the highest CAGR, during the forecast period.
• This is because higher surgical safety and precision result from IONM during spinal operative procedures.
• IONM proves highly beneficial for spinal surgery procedures as they need special caution because of the involvement of essential neural tissues.
• As per the Christopher & Dana Reeve Foundation, 54 in 1 million people in the U.S. suffer from a spinal cord injury each year.

The applications analyzed here are:

• Spine (Largest and Fastest-Growing Category)
• ENT
• Craniotomy
• Vascular/CT
• Others

U.S. Intraoperative Neuromonitoring Regional Market Performance

• The Northeastern region of the U.S. held the largest market share, of 40%, in 2024.
• This is because cities such as New York, Boston, and Philadelphia lead national medical facility counts, boast both advanced healthcare systems, and cater to extensive patient needs.
• Medical centers in this region perform specialized neurosurgical and spine surgical treatments and orthopedic procedures, which propels IONM requirements.
• The Southern region of the U.S. will grow at the highest CAGR, of 7.0%, during the forecast period.
• This is because healthcare infrastructure in the South has grown quickly through new hospital construction.
• IONM adoption by an increasing number of hospitals performing complex surgery drives the market in the region.
• The patient safety advantages of IONM have ignited a surge in demand for it during surgical procedures.
• The South also has the highest population and heaviest disease burden in the country, thus propelling the demand for complex surgeries.

The regions analyzed in this report are:

• Northeast (Largest Category)
• Midwest
• West
• South (Fastest-Growing Category)

U.S. Intraoperative Neuromonitoring Market Share Analysis

The U.S. intraoperative neuromonitoring market is consolidated in nature because a handful of established healthcare technology vendors hold a combined major share. The high regulatory standards for equipment and monitoring devices for intraoperative neuromonitoring create substantial barriers to market entry for new companies. It takes deep experience in this field and substantial technological capability for organizations to successfully understand and develop these advanced technologies, which continuously evolve.

U.S. Intraoperative Neuromonitoring Market Developments

• In August 2024, Natus Medical Incorporated launched autoSCORE as the initial AI model that provides precise clinical EEG interpretations automatically.
• In December 2023, Nihon Kohden Corporation introduced One View its Neuromaster G1 IONM system. This technology integrates anesthesia machine data with patient vitals, including heart rate, SpO₂, and temperature, along with additional physiological indicators.