Document Detail


Electromyography monitoring for percutaneous placement of iliosacral screws.
MedLine Citation:
PMID:  10898196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report our experience with the use of continuous electromyography (EMG) for placement of iliosacral screws. DATA SOURCES: Concurrently acquired data as well as patient charts, intraoperative EMG records, x-rays, and pelvic computed tomography (CT) scans. DESIGN: The monitored group of twenty-nine patients was studied prospectively. The control group consisted of twenty-two patients studied retrospectively. SETTING: Level One trauma center. METHODS: Continuous electromyograms were recorded for twenty-nine patients and compared with those from a group of twenty-two antecedent patients who were not monitored. The primary parameter of interest of this study was the presence or absence of neurologic change after iliosacral screw placement. This information was obtained prospectively in the study group and by retrospective review in the historical control. RESULTS: Four patients in the control group had postoperative and/or sensory motor changes prompting a postoperative CT scan; in each of these patients, a misdirected screw was identified and subsequently removed in a second procedure. There were no neurologic changes subsequent to placement in the twenty-nine patients who were monitored (7.5 percent versus 0 percent; p = 0.029, Fisher's exact test). All monitored patients had postoperative CT scans and showed the screw in a safe position with no significant violations of the S1 tunnel. CONCLUSION: Continuous EMG monitoring during iliosacral screw placement may be a useful neuroprotective tool.
Authors:
L X Webb; W de Araujo; P Donofrio; C Santos; F O Walker; M A Olympio; T Haygood
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  14     ISSN:  0890-5339     ISO Abbreviation:  J Orthop Trauma     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-11-20     Completed Date:  2000-11-20     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  245-54     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1070, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Screws*
Electromyography*
Female
Fractures, Bone / therapy*
Humans
Injury Severity Score
Male
Middle Aged
Monitoring, Physiologic
Pelvic Bones / injuries*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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