The usefulness of electrical stimulation for assessing pedicle screw placements

• Published in: Journal of spinal disorders Vol. 13; no. 4; pp. 283 - 289
• Main Authors: TOLEIKIS, J. R, SKELLY, J. P, CARLVIN, A. O, TOLEIKIS, S. C, BERNARD, T. N, BURKUS, J. K, BURR, M. E, DORCHAK, J. D, GOLDMAN, M. S, WALSH, T. R
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams and Wilkins 01-08-2000
• Subjects: Biological and medical sciences; Bone Screws; Differential Threshold; Diseases of the osteoarticular system; Electric Stimulation - methods; False Negative Reactions; Humans; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Monitoring, Intraoperative - methods; Peripheral Nervous System Diseases - prevention & control; Postoperative Complications - prevention & control; Spinal Nerve Roots; Spine - surgery; Performance evaluation; Human; Spine; Diseases of the osteoarticular system; Electric; Exploration; Osteosynthesis; Intraoperative; Stimulation; Spine disease; Screw; Surgery; Instability; Pedicle of the lumbar vertebral arch
• ISSN: 0895-0385; 1531-2305
• DOI: 10.1097/00002517-200008000-00003

The purpose of this study was to further establish the efficacy of pedicle screw stimulation as a monitoring technique to avoid nerve root injury during screw placement. The study population consisted of 662 patients in whom 3,409 pedicle screws were placed and tested by electrical stimulation. If stimulation resulted in a myogenic response at a stimulation intensity of 10 mA or less, the placement of the screw was inspected. Inspection was necessary for 3.9% of the screw placements in 15.4% of the study population. None of the patients in the study experienced any new postoperative neurologic deficits. These findings provide guidelines for the interpretation of stimulation data and support the use of this technique as an easy, inexpensive, and quick method to reliably assess screw placements and protecting neurological function.