Commentary: Electromyographic thresholds for stimulated thoracic pedicle screws are influenced by multiple factors.

摘要

The use of pedicle screws in thoracic spine constructs is commonplace, with accuracy rates improving [1-3] even in the setting of severe deformity [4]. Detecting safe placement of pedicle screws is critically important to the practicing surgeon, given the disastrous clinical consequences of a maldirected screw. Several methods are available to confirm placement; however, their accuracy is often debated. Recently, probing pedicle screw tracts, one of the most regularly used clinical practices to detect pedicle wall breach, was found to have a sensitivity of only 81% [5]. Recognition of the limitations to clinically or radiographically detect correct screw placement led way to the introduction of electromyography (EMG)-monitored action potentials through pedicle screw stimulation.