ArticleNorth American Spine Society journal2025
Prospective evaluation of mechanomyography versus triggered electromyography for intraoperative assessment of cortical breaches during instrumented lumbar surgery.
Article in North American Spine Society journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Pedicle screws are essential in spinal arthrodesis surgeries but pose potential risks due to their proximity to neural and vascular structures. Traditionally, tEMG has been used to assess screw placement, though its invasiveness, low specificity, and cost limit its applicability. MMG may offer a promising alternative for routine clinical use. Our study compares the relative accuracy of triggered electromyography (tEMG) versus mechanomyography (MMG) in detecting intraoperative cortical bony breaches. Methods: Using an equivalence trial design, consecutive patients undergoing posterior lumbosacral spinal arthrodesis were prospectively enrolled at a single institution. Pedicle screw trajectories were queried in real-time using combined tEMG and MMG-based evaluations at pretap, tap, post-tap and postscrew placement stages. Intraoperative computed tomography (CT) scans were performed to evaluate pedicle screw trajectories according to the Gertzbein-Robbins (GR) classification. Receiver operating characteristic curve analysis were performed to evaluate the relative accuracy of tEMG and MMG threshold potentials to detect cortical breaches. Pain and quality-of-life outcomes were evaluated up to 3 months postoperatively. Results: A total of 303 consecutive lumbar pedicle screw trajectories were included (61 participants; mean age: 61.3 ± 9.7 years; male-to-female ratio: 32:29). 7 grade C-E GR cortical breaches were identified in a total of 5 subjects, with 5 (71.4%) classified as Grade C and 2 (28.6%) as Grade E. Baseline demographics were comparable between the breach and nonbreach groups. The tEMG and MMG AUC values determining predictive ability for breach detection were comparable for the pretap (AUC 0.82 vs. 0.80, p = .442) and post-tap stages (AUC 0.71 vs. 0.79, p = .380). Follow-up pain and functional assessments revealed significant improvements at last follow-up. Conclusion: tEMG and MMG demonstrate high and equivalent accuracy to detect cortical breaches intraoperatively. Adequate utilization of either technique may enhance pedicle screw placement accuracy, reducing intraoperative complications and improving surgical outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.