Adhesive surface electrodes versus needle-based neuromonitoring in lumbar spinal surgery

Area of Science:

• Neurosurgery
• Medical Devices
• Patient Safety

Background:

• Traditional needle-based neuromonitoring (NBM) is effective but can be time-consuming and costly.
• Adhesive surface electrode-based neuromonitoring (ABM) presents a potentially safer and more versatile alternative.

Purpose of the Study:

• To compare the efficacy, safety, and cost-effectiveness of ABM versus NBM in transforaminal lumbar interbody fusion (TLIF) procedures.
• To evaluate the impact of ABM on surgical duration and resource utilization.

Main Methods:

• Retrospective cohort review of one- and two-level TLIF procedures (2019-2023).
• Comparison of operative times (OR entry to incision, OR entry to closure, incision to closure) between ABM (31 patients) and NBM (51 patients) groups.
• Univariate and bivariate analyses were used to assess outcome differences.

Main Results:

• No significant differences in surgical times were observed between ABM and NBM groups.
• Both methods demonstrated comparable safety, with no reoperations for malpositioned instrumentation or new postoperative neurological deficits.
• ABM led to a reduction in neurophysiologist workforce and overall neuromonitoring costs.

Conclusions:

• ABM is a viable alternative to NBM for TLIF, offering similar clinical outcomes and safety.
• While ABM does not reduce surgical time, it significantly lowers invasiveness, workforce requirements, and costs associated with neuromonitoring.