Utility of Evoked EMG Monitoring to Improve Bone Screw Placements in the Cervical Spine

• DOI: 10.1097/bsd.0b013e31828871a1
• Publication Date: 2013-02-20T10:10:43Z
• Authors: Robert N. Holdefer; Daniel S. Heffez; Bernard A. Cohen
• Keywords: Blinded study; Lateral mass

EMG threshold testing as a guide to accurate screw placement was examined during posterior cervical spine instrumentation. The accuracy of placements compared with the surgeon blinded and unblinded thresholds.To determine utility in improving lateral mass pedicles cervical/upper thoracic spine.EMG lumbar is generally thought improve pedicle placements. These results may not generalize spine, where smaller pedicles, bicortical pilot holes, orientation screws away from midline result different alert thresholds.Triggered thresholds were obtained holes 244 113 32 patients. Thresholds determined postoperative computed tomography scans. percentage inaccurate potentially dangerous (IAPD) determined.EMG more predicting IAPD trajectories (likelihood ratio 5.1) 2.9). In number decreased 4.5% controls 0% group. mass, there no control group, whereas 2% group IAPD.EMG (C3, T1) moderately diagnostic test predictive (C7, (C3-C6). decrease but have less case because reproducible stimulating probe.