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The use of mechanically elicited electromyograms to protect nerve roots during surgery for spinal degeneration
J H Owen1, J P Kostuik, M Gornet
1Department of Neurology, Johns Hopkins University and Hospital, Baltimore, Maryland.
Study Design:
This study investigated the use of mechanically elicited electromyograms during the placement of pedicle screws in 89 patients undergoing surgery for spinal stenosis.
Summary Of Background Data:
Several methods for monitoring nerve roots are available. However, mechanically elicited electromyograms may be more sensitive to mechanical irritation of nerve roots by pedicle screws than by other methods.
Methods:
Mechanically elicited electromyograms were recorded in muscle groups innervated by cervical or lumbar nerve roots. Confirmation of surgical activity with the level of the electromyogram was correlated.
Results:
Results indicated that mechanically elicited electromyograms are extremely sensitive to nerve root irritation. Compared to other methods, electromyograms are a viable alternative.
Conclusions:
Results from this study indicated that mechanically elicited electromyograms are sensitive and specific to nerve root firings and should be considered for use during the dynamic phases of surgery.