Abstract
Background: Stimulus evoked electromyography (EMG) is commonly
used to identify clinically relevant misplaced pedicle screws in the
lumbosacral spine. This monitoring modality is more meaningful in
minimally invasive surgery. In minimally invasive surgery, the pedicle
screws are usually not tested, only the pedicle access needle and the
tapscrew are tested by using the same stimulation threshold. No studies
have compared the electrical resistance of cannulated pedicle screws and
tapscrews. This study is designed to measure and to compare the
resistance of cannulated tapscrews and noncoated pedicle screws of
similar electroconductive characteristics and of different diameters to
determine whether the same stimulation threshold can be applied for
tapscrews and pedicles screws in minimally invasive lumbosacral
fixation.
Materials and Methods: Resistance measurements were obtained
three times across the shank from a random sampling of nine commonly
used cannulated titanium noncoated pedicle screws and nine cannulated
tapscrews (three composed of titanium and six of stainless steel), one
of each diameter.
Results: Resistance of all tested pedicle screws ranged from
0.1ohms to 0.3ohms and tapscrews ranged from 0.1ohms to 0.3ohms. No
significant differences in resistance values were observed between the
cannulated noncoated titanium pedicle screws and, titanium and stainless
steel tapscrews of different diameters (P > 0.05).
Conclusion: Using non-metallic dilators, the authors propose
the same stimulation threshold can be used for the testing of the
cannulated tapscrew and noncoated pedicle screw of similar
electroconductive characteristics to optimize the accuracy of the
stimulus-evoked EMG.
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