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- W38387737 abstract "edicle screw–based constructs provide a stronger basis for spinal instrumentation and fusion than hooks. Placement of the screws within the pedicles is a technically challenging procedure. The orientation of the pedicles with respect to surface landmarks changes along the length of the spine and may be abnormal in the scoliotic spine. In fact, some pedicles may not even have a cancellous core. The medial wall of the pedicle forms one side of the spinal canal, and intrusion of the screw into the canal can lead to major neurologic damage. Breaches in the other pedicle walls can also cause neurologic deficits by irritating or damaging spinal nerve roots. It is possible to assess the screw hole within the pedicle electrophysiologically. 1 Pedicle screw stimulation involves the passing of an increasing current between a probe in the hole or the screw itself and a return electrode, usually a needle placed in a contralateral paraspinal muscle. The neuromonitorist observes the electromyograph and reports the threshold (lowest current) at which a muscle twitch occurs. If a muscle response is observed below 11 mA of stimulation current, this is taken to indicate a possible breach in the wall of the pedicle, which warrants further surgical exploration. 1,2 There are published guidelines for the stimulation thresholds to be used in assessing the lumbosacral vertebrae. 1–3" @default.
- W38387737 created "2016-06-24" @default.
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- W38387737 date "2009-06-01" @default.
- W38387737 modified "2023-09-23" @default.
- W38387737 title "Monitoring placement of high thoracic pedicle screws by triggered electromyography of the intercostal muscles." @default.
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