Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint. (4th December 2014)

• Record Type: Journal Article
• Authors: Woods, Michael; Birkholz, Denise; MacBarb, Regina; Capobianco, Robyn; Woods, Adam
• Other Names: Carl Allen L. Academic Editor.
• Is Part Of: Advances in orthopedics. Volume 2014(2014)
• Publication Date: 2014-12-04
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedic Procedures; Orthopedics; Electronic journals; Periodicals; Periodicals; 616.7
• DOI: 10.1155/2014/154041
• Languages: English
• ISSNs: 2090-3464

Abstract

Abstract : Study Design . Retrospective case series. Objective . To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data . Intraoperative neuromonitoring is a well-accepted adjunct to minimally invasive pedicle screw placement. The utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion using a series of triangular, titanium porous plasma coated implants has not been evaluated. Methods . A medical chart review of consecutive patients treated with minimally invasive surgical sacroiliac joint fusion was undertaken at a single center. Baseline patient demographics and medical history, intraoperative electromyography thresholds, and perioperative adverse events were collected after obtaining IRB approval. Results . 111 implants were placed in 37 patients. Sensitivity of EMG was 80% and specificity was 97%. Intraoperative neuromonitoring potentially avoided neurologic sequelae as a result of improper positioning in 7% of implants. Conclusions . The results of this study suggest that intraoperative neuromonitoring may be a useful adjunct to minimally invasive surgical sacroiliac joint fusion in avoiding nerve injury during implant placement.