Sensitivity and efficacy of intraoperative electromyography monitoring in combination with 3D imaging modality during complex lumbosacral procedures
10.3969/j.issn.1673-8225.2009.39.002
- VernacularTitle:与脊柱导航联合应用于椎弓根钉置入过程中的肌电图监测:敏感和有效吗?
- Author:
Feng XU
;
Xing YU
;
Lianyong BI
;
Fei GAO
;
Hai KE
;
Lin XU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2009;13(39):7613-7618
- CountryChina
- Language:Chinese
-
Abstract:
MAIN OUTCOME MEASURES: Free running EMG and stimulus triggered EMG, including time, frequency, amplitude, muscle group were observed and recorded simultaneously. Never root functional injury and restoration after surgery were detected.RESULTS: 378 pedicle screws in 74 patients were monitored intraoperatively, and only 3 pedicle screw malposition (2 of L_4, 1 of L_5) was detected and then replaced with the help of C-arm fluoroscopic examination. Myoelectricity appeared when the current intensity was less than 10 mA. The correct rate of implantation was 99.2%. Nerve root impingement was found in two cases during laminectomy for L_5 and S_1 decompression and never root solution, which alerted the surgical team of critical neural structures. Nerve symptoms of the lower limb were aggravated after surgery and restored following 2-4 weeks of conventional treatment. The error injury rate of nerve root was 2.7%. In all reported cases, no irreversible neurological deficit was observed 2-4 weeks after operation.CONCLUSION: Intraoperative EMG monitoring can find improperly placed screws and detect impending nerve root injury promptly. Combined EMG and 3-D imaging modality monitoring is a reliable and practicable method that can be used to protect neural structures during complex lumbosacral surgery.
