Lateral mass screw stimulation thresholds in posterior cervical instrumentation surgery: a predictor of medial deviation.

OBJECTIVE Normative data exists for stimulus-evoked pedicle screw electromyography (EMG) current thresholds in the lumbar spine, and is routinely referenced during spine surgeries to detect a screw breach, prevent injury of neural elements, and ensure the most biomechanically sound instrumentation construct. To date, similar normative data for cervical lateral mass screws is limited, thus the utility of lateral mass screw testing remains unclear. To address this disparity, in this study the authors describe cumulative lateral mass screw stimulation threshold data in patients undergoing posterior cervical instrumentation with lateral mass screws.

Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery.

Background: Minimally invasive surgery decreases postoperative pain and disability. However, limited views of the surgical field require extensive use of intraoperative fluoroscopy that may expose the surgical team to higher levels of ionizing radiation.

Purpose: To assess the feasibility and safety of navigation-assisted fluoroscopy during minimally invasive spine surgery.