Related Experiment Videos
Persistently electrified pedicle stimulation instruments in spinal instrumentation. Technique and protocol
R D Rose1, W C Welch, J R Balzer
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
Spine
|February 1, 1997
Summary
A new technique using persistently electrified pedicle stimulation instruments accurately detects pedicle integrity during spinal fusion surgery. This method helps confirm screw placement and prevent potential neurologic injury in patients.
Area of Science:
- Spine surgery
- Neurophysiology
- Surgical instrumentation
Background:
- Pedicle instrumentation in fusion techniques carries a risk of nerve root injury.
- Existing methods for improving outcomes include imaging and neurophysiologic approaches.
- This novel technique offers a significant advancement over previously reported methods.
Purpose of the Study:
- To detail the technique of persistently electrified pedicle stimulation instruments for broader clinical adoption.
- To demonstrate the application, typical outcomes, interpretation, and protocol of this neurophysiologic monitoring method.
- To provide a standardized and adaptable protocol for clinical neurophysiologists and spine surgeons.
Main Methods:
- A prospective review of a new intraoperative technique for detecting and preventing neurologic compromise during pedicle screw insertion.
- Conversion of standard pedicle instrumentation tools into monopolar stimulators.
- Identification of pedicle breaches using evoked-electromyograms (EMG) from relevant muscle groups.
Main Results:
- The persistently electrified pedicle stimulation instrument technique yielded accurate intraoperative neurophysiologic data on pedicle integrity.
- The developed protocol is standardized, easily adaptable, inexpensive, and quick for most clinical settings.
- Evoked-EMG successfully identified breaches of pedicle bone.
Conclusions:
- The described technique is valuable for monitoring instrumented lumbar fusion procedures.
- This protocol aids in confirming intraosseous pedicle screw placement.
- The technique effectively helps prevent neurologic injury during spinal surgery.