caa a22 4500 44583160X CHVBK 20180317145316.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s00586-010-1653-x doi (NATIONALLICENCE)springer-10.1007/s00586-010-1653-x Triggered electromyography for placement of thoracic pedicle screws: is it reliable? [Elektronische Daten] [Amer Samdani, Mark Tantorski, Patrick Cahill, Ashish Ranade, Stephen Koch, David Clements, Randal Betz, Jahangir Asghar] Reliable electromyography (EMG) thresholds for detecting medial breaches in the thoracic spine are lacking, and there is a paucity of reports evaluating this modality in patients with adolescent idiopathic scoliosis (AIS). This retrospective analysis evaluates the ability of triggered EMG to detect medial breaches with thoracic pedicle screws in patients with AIS. We reviewed 50 patients (937 pedicle screws) undergoing posterior spinal fusion (PSF) with intraoperative EMG testing. Postoperative CT scans were used for breach identification, and EMG values were analyzed. There were 47 medial breaches noted with a mean threshold stimulus of 10.2mA (milliamperes). Only 8/47 breaches stimulated at 2-6mA. Thirteen of the forty-seven screws tested at an EMG value ≤6mA and/or a decrease of ≥65% compared with intraosseously placed screws. The sensitivity and positive predictive value for EMG was 0.28 and 0.21. A subanalysis of T10-T12 screws identified six of seven medial breaches. Using guidelines from the current literature, EMG does not appear to be reliable in detecting medial breaches from T2 to T9 but may have some utility from T10 to T12. Springer-Verlag, 2010 Triggered electromyography nationallicence Pedicle screws nationallicence Thoracic nationallicence Adolescent idiopathic scoliosis nationallicence Posterior spinal fusion nationallicence Samdani Amer Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut Tantorski Mark Philadelphia College of Osteopathic Medicine, 4170 City Avenue, 19130, Philadelphia, PA, USA aut Cahill Patrick Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut Ranade Ashish Department of Orthopaedic Surgery, Smt. Kashibai Navale Medical College & Hospital, Narhe, 411051, Pune, India aut Koch Stephen Temple University School of Medicine, 3500 North Broad Street, 19140, Philadelphia, PA, USA aut Clements David Cooper Bone and Joint Institute, 3 Cooper Plaza, Suite 411, 08103, Camden, NJ, USA aut Betz Randal Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut Asghar Jahangir Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut European Spine Journal Springer-Verlag 20/6(2011-06-01), 869-874 0940-6719 20:6<869 2011 20 586 https://doi.org/10.1007/s00586-010-1653-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1653-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Samdani Amer Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Tantorski Mark Philadelphia College of Osteopathic Medicine, 4170 City Avenue, 19130, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Cahill Patrick Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Ranade Ashish Department of Orthopaedic Surgery, Smt. Kashibai Navale Medical College & Hospital, Narhe, 411051, Pune, India aut NATIONALLICENCE 700 1- Koch Stephen Temple University School of Medicine, 3500 North Broad Street, 19140, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Clements David Cooper Bone and Joint Institute, 3 Cooper Plaza, Suite 411, 08103, Camden, NJ, USA aut NATIONALLICENCE 700 1- Betz Randal Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Asghar Jahangir Shriners Hospitals for Children, 3551N Broad Street, 19140, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/6(2011-06-01), 869-874 0940-6719 20:6<869 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer