Pulse-train versus single-pulse t-EMG stimulation for intraoperative neurophysiologic monitoring of thoracic pedicle screws in adolescent idiopathic scoliosis.

Objective: To assess the PTS method in neuromonitoring of thoracic pedicle screws in a young cohort of AIS patients. The accuracy of both PTS (Pulse-train stimulation) and SPS (Single-pulse stimulation) techniques in the detection of misplaced thoracic screws was compared with special reference to the screws placed at the concavity and the convexity of the curve.

Patients And Methods: A single-center prospective clinical cohort study.

Neurophysiological monitoring during acute and progressive experimentally induced compression injury of the spinal cord in pigs.

Purpose: To evaluate the degree of acute or progressive lateral compression needed to cause neurologic injury to the spinal cord assessed by electrophysiological monitoring.

Methods: In five domestic pigs, the spinal cord was exposed and compressed between T8-T9 roots using a precise compression device. Two sticks placed on both sides of the spinal cord were sequentially brought together (0.

Influence of hypotension and nerve root section on the ability to mobilize the spinal cord during spine surgery. An experimental study in a pig model.

Background Context: The correction of severe spinal deformities by an isolated posterior approach often involves cord manipulation together with hypotensive anesthesia. To date, the efficiency of methods to increase the tolerance of the cord to displacement and the influence of hypotension on this tolerance is yet to be assessed.

Purpose: The objective of this study was to determine the limits of cord displacement before the disappearance of neurophysiologic signals.

Safe pedicle screw placement in thoracic scoliotic curves using t-EMG: stimulation threshold variability at concavity and convexity in apex segments.

Study Design: A cross-sectional study of nonconsecutive cases (level III evidence).

Objective: In a series of young patients with thoracic scoliosis who were treated with pedicle screw constructs, data obtained from triggered electromyography (t-EMG) screw stimulation and postoperative computed tomographic scans were matched to find different threshold limits for the safe placement of pedicle screws at the concavity (CC) and convexity (CV) of the scoliotic curves. The influence of the distance from the medial pedicle cortex to the spinal cord on t-EMG threshold intensity was also investigated at the apex segment.

Electromyographic thresholds after thoracic screw stimulation depend on the distance of the screw from the spinal cord and not on pedicle cortex integrity.

Background Context: Present studies concerning the safety and reliability of neurophysiological monitoring during thoracic pedicle screw placement remain inconclusive, and therefore, universally validated threshold levels that confirm osseous breakage of the instrumented pedicles have not been properly established.

Purpose: The objective of this work was to analyze whether electromyographic (EMG) thresholds, after stimulation of the thoracic pedicle screw, depend on the distance between the neural structures and the screws. The modifier effect of different interposed tissues between a breached pedicle and neural structures was also investigated.

Recording triggered EMG thresholds from axillary chest wall electrodes: a new refined technique for accurate upper thoracic (T2-T6) pedicle screw placement.

This study was aimed at evaluating the sensitivity and safety of a new technique to record triggered EMG thresholds from axillary chest wall electrodes when inserting pedicle screws in the upper thoracic spine (T2-T6). A total of 248 (36.6%) of a total of 677 thoracic screws were placed at the T2-T6 levels in 92 patients with adolescent idiopathic scoliosis.