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Implementation and Feasibility of Mechanomyography in Minimally Invasive Spine Surgery
Fabian Sommer1, Ibrahim Hussain1, Noah Willett1
1Department of Neurological Surgery, Och Spine at New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY 10065, USA.
Journal of Personalized Medicine
|February 25, 2025
Summary
Mechanomyography (MMG) shows promise for assessing nerve root decompression during spine surgery. It was effective in cervical foraminotomies and far lateral discectomies, but less so in minimally invasive transforaminal interbody fusions.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Spinal Surgery
Background:
- Mechanomyography (MMG) is a neurodiagnostic tool for evaluating nerve root compression.
- Its application in degenerative spine surgery remains unexplored.
Purpose of the Study:
- To evaluate the utility of intraoperative MMG in three spinal procedures: cervical posterior foraminotomy, MIS-TLIF, and tubular lumbar far lateral discectomy.
Main Methods:
- A prospective feasibility study involved 22 patients undergoing MMG during surgery.
- Adhesive accelerometers were placed on muscle groups, recording stimulus thresholds before and after nerve root decompression.
Main Results:
- Cervical foraminotomies showed a mean 3.4 mA reduction in threshold post-decompression.
- Far lateral discectomies demonstrated a mean 4.3 mA reduction.
- Minimally invasive transforaminal interbody fusions (MIS-TLIFs) exhibited a limited mean 1.7 mA reduction.
Conclusions:
- MMG may offer intraoperative feedback on nerve root decompression adequacy.
- Promising results were observed in cervical foraminotomies and far lateral discectomies.
- Limited reduction in MIS-TLIFs may stem from nerve identification timing relative to decompression.
