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Submitted: 03 September 2009
HERDIN Record #: PCHRD090209060952

Malpositioned pedicle screw detection using triggered EMG monitoring during transpedicular spine instrumentation: Results from 357 pedicle screws .

Emmanuel J. Eduardo,
Mario R. Ver,
Hans Ludwig Damian,
Joselito L. Lasaga

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Three hundred fifty seven pedicle screws in 45 patients were tested intraoperatively after radiographic examination revealed acceptable positions. A threshold value equal and below 11 milliAmps was used to identify (Triggered EMG) positive screws. Inspection for evidence of screw to nerve root contact was done.

Results showed eighteen out of 357(5 percent) in 14 out of 45 (31.1 percent) patients were detected by TrEMG. All 18 screws were inspected and exhibited evidence of medial or caudal wall perforation and contact with the adjacent nerve roots.

TrEMG is a real-time intraoperative neurodiagnostic tool that provides an objective basis for reassessment of screw position when there is a discrepancy with radiographic imaging. We believe this technique may afford the surgeon the ability to improve final screw position and thus prevent complications.

Publication Type
Journal
Publication Sub Type
Others
Title
Philippine Journal of Orthopaedics
Frequency
Annual
Publication Date
November 2008
Volume
27
Issue
1
Page(s)
32-37
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)