ArticleBMC musculoskeletal disorders2023
Intraoperative triggered electromyographic monitoring of pedicle screw efficiently reduces the lumbar pedicle breach and re-operative rate-a retrospective analysis based on postoperative computed tomography scan.
Article in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Performance and safety of the PYTHEAS Your Guided TrajectoryJournal of orthopaedic surgery and research · 2026Trial
- Article
- Perspective: Can intraoperative neurophysiological monitoring (IONM) limit errors associated with lumbar pedicle screw fusions/transforaminal lumbar interbody fusions (TLIF)?Surgical neurology international · 2023Review
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4 authors.
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Abstract
backgroundTo investigate whether intraoperative triggered electromyographic (T-EMG) monitoring could effectively reduce the breach rate of pedicle screws and the revision rate.
methodsPatients with posterior pedicle screw fixation from L1-S1 were enrolled between June 2015 and May 2021. The patients in whom T-EMG was utilized were placed in the T-EMG group, and the remaining patients were considered in the non-T-EMG group. Three spine surgeons evaluated the images. The two groups were divided into subgroups based on screw position (lateral/superior and medial/inferior) and breach degree (minor and major). Patient demographics, screw positions, and revision procedures were reviewed.
resultsA total of 713 patients (3403 screws) who underwent postoperative computed tomography (CT) scans were included. Intraobserver and interobserver reliabilities were perfect. The T-EMG and non-T-EMG groups had 374(1723 screws) and 339 (1680 screws) cases, respectively. T-EMG monitoring efficiently reduced the overall screw breach (T-EMG 7.78% vs. non-T-EMG 11.25%, p = 0.001). in the subgroup analysis, the medial/inferior breach rate was higher in the T-EMG group than in the non-T-EMG group (T-EMG 6.27% vs. non-T-EMG 8.93%, p = 0.002); however, no difference was observed between the lateral and superior breaches (p = 0.064). A significant difference was observed between the minor (T-EMG 6.21% vs. non-T-EMG 8.33%, p = 0.001) and major (T-EMG 0.06% vs. non-T-EMG 0.6%, p = 0.001) medial or inferior screw breach rates. Six screws (all in the non-T-EMG group) underwent revision, with a significant difference between the groups (T-EMG 0.0% vs. non-T-EMG 3.17%, p = 0.044).
conclusionsT-EMG is a valuable tool in improving the accuracy of screw placement and reducing the screw revision rate. The screw-nerve root distance is vital in causing symptomatic screw breach.
trial registrationThe study is retrospective registered in China National Medical Research Registration and Archival information system in Nov 17th 2022.
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