Intraop Neuromonitoring (Woods - Adv Orthop 2014)

Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

Woods M, Birkholz D, MacBarb R, Capobianco R, Woods A.
Adv Orthop. 2014;2014:154041. Epub 2014 Dec 4.
DOI: 10.1155/2014/154041. PMCID: PMC4273583

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.

Author information

Woods M – Missoula Bone and Joint, 2360 Mullan Road, Suite C, Missoula, MT 59808, USA.

Birkholz D, Wood A – Pronerve, 7600 East Orchard Road, Suite 200, Greenwood Village, CO 80111, USA.

MacBarb R, Capobianco R – SI-BONE, Inc., 3055 Olin Avenue, Suite 2200, San Jose, CA 95128, USA.

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