Neurosurgery is one of the most complex medical procedures and requires an extremely high level of precision. Every step involves nerve tissues that play vital roles in body functions, including movement, sensation, and speech. Therefore, neurosurgeons must work with maximum accuracy and minimize even the smallest errors to prevent nerve damage that could have serious consequences for patients. In such conditions, advanced technological support becomes crucial.
Mandaya Royal Puri Hospital has now introduced Intraoperative Neuromonitoring (IONM), also known as Intraoperative Monitoring (IOM), to help make neurosurgical procedures safer, more accurate, and better controlled—ensuring optimal patient safety throughout surgery.
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Understanding IONM Technology at Mandaya Puri for Safer Neurosurgery
IONM is a technology used during neurosurgery to monitor a patient’s nerve function directly and in real time. During neurosurgical procedures, surgeons often work very close to sensitive nerve tissues and their supporting blood vessels. These areas are critical because they regulate essential body functions such as movement, speech, and motor skills, and they are at risk of disruption if not handled with extreme care.
Through IONM, the neurosurgical team receives immediate information regarding the patient’s nerve responses and functions throughout the procedure.
This technology acts as an “early warning system” for surgeons if changes in nerve function are detected. As a result, surgeons can promptly adjust their surgical approach to prevent or minimize nerve injury and reduce the likelihood of postoperative functional impairment.
Benefits of IONM Technology at Mandaya Puri
Below are several advantages of Intraoperative Neuromonitoring (IONM) in neurosurgery at Mandaya Puri Hospital:
1. Real-Time Nerve Monitoring
During surgery, the patient’s nerve function is continuously monitored. If any changes or warning signs occur, the surgeon can immediately take corrective action to prevent damage.
2. Reduced Risk of Permanent Nerve Damage
With early detection, the risk of complications such as paralysis, limb weakness, or loss of sensation can be minimized, as potential injury is identified before becoming permanent.
3. Enhanced Surgical Precision
IONM helps surgeons differentiate between healthy, critical nerve tissue and problematic areas, enabling more accurate surgical intervention.
4. Early Warning System
If nerves experience pressure, stretching, or blood flow disturbances during surgery, the system immediately alerts the medical team for prompt correction.
5. Increased Safety in Complex Neurosurgery
In high-risk and complicated procedures, IONM helps ensure that nerve function remains protected throughout the operation.
6. Support During Anesthesia
The technology also assists in ensuring the stability of the nervous system while the patient is under anesthesia.
When Is IONM Used?
IONM can be applied in various neurosurgical procedures, particularly when surgery is performed near critical nerve structures. Examples include:
1. Cervical Pinched Nerve Surgery (e.g., ACDF or Disc Replacement)
Used to monitor nerve and spinal cord function during the procedure, minimizing the risk of movement or sensory disturbances after surgery.
2. Brain Tumor Removal
Helps surgeons protect brain areas responsible for essential functions such as movement, speech, and sensory processing while removing tumors.
3. Awake Brain Surgery
IONM is used alongside direct patient evaluation to more accurately monitor brain function, especially when tumors are located near speech or motor centers.
4. Spinal Tumor Surgery
Assists in protecting surrounding nerve function during tumor removal from the spine.
5. Surgery for Nerve and Spinal Cord Disorders
Used in procedures that carry the risk of affecting major nerve pathways responsible for body movement and sensation.
In general, IONM is applied in high-risk neurosurgical procedures to ensure greater safety and better surgical control.
Neurosurgeons at Mandaya Royal Puri Hospital
If you wish to consult regarding neurosurgical conditions, such as brain tumor removal or cervical pinched nerve surgery, here are the neurosurgeons available at Mandaya Royal Puri Hospital:
1. dr. Christian Permana, Sp.BS, FTB, FINSS, FICS

dr. Christian Permana is an experienced neurosurgeon specializing in minimally invasive techniques for treating pinched nerves. He performs various modern procedures designed to reduce pain, minimize surgical incisions, and accelerate patient recovery.
In addition to PLDD (Percutaneous Laser Disc Decompression), he is skilled in performing PELD (Percutaneous Endoscopic Lumbar Discectomy), PSLD, ACDF, and microdiscectomy. Each procedure is selected and tailored according to the patient’s specific medical condition and needs.
He also has expertise in treating spinal tumors and spinal infections, including bone tuberculosis (spinal TB) and spondylodiscitis, using a comprehensive approach supported by advanced medical technology.
Practice Schedule at Mandaya Royal Puri Hospital:
- Tuesday: 1:00 PM – 5:00 PM
- Thursday: 1:00 PM – 5:00 PM
- Friday: 1:00 PM – 5:00 PM
- Saturday: 1:00 PM – 5:00 PM
2. dr. Christian Ariono, Sp.BS, FICS

dr. Christian Ariono is a neurosurgeon with special expertise in treating pinched nerves. He is well known for performing minimally invasive arthrospine procedures through small incisions of approximately 1.5 cm, minimizing damage to surrounding tissues.
This approach offers multiple benefits for patients, including reduced postoperative pain, shorter recovery time, and a faster return to daily activities compared to conventional surgical techniques.
Practice Schedule at Mandaya Royal Puri Hospital:
- Monday: 8:00 AM – 4:00 PM
- Tuesday: 8:00 AM – 12:00 PM
- Wednesday: 8:00 AM – 4:00 PM
- Thursday: 8:00 AM – 4:00 PM
- Friday: 8:00 AM – 4:00 PM
- Saturday: 8:00 AM – 4:00 PM
To make your visit more convenient, you can use the Chat via WhatsApp feature, Book Appointment service, or the Care Dokter application available on Google Play and the App Store to schedule visits, check queue numbers, and access additional information.



