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*Corresponding author:Yunfen Wu, Department of Intraoperative Neurophysiology, University of Cantabria, Spain
Received: August 20, 2018; Published: September 04, 2018
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Background: Stimulus-evoked EMG improves the safety during the pedicle screw placement in the lumbosacral spine. The reported reliability of stimulus-evoked EMG in the detection of pedicle breaches in minimally invasive lumbosacral fixation has been variable. Besides the influence from different physiopathological conditions, current shunting may also contribute in this variable reliability due to the small incision during minimally invasive surgery. Using a traditional suction system, continues suction is not viable during tapping and pedicle screw placement in minimally invasive surgery.
Objective: The authors propose a new design of non-metallic dilators adapted to continuous suction during tapping and pedicle screw placement in minimally invasive surgery with the aim of minimizing the possible current shunting and optimizing the stimulation
Materials and Methods: The proposed nonmetallic dilators have 2 canals. The larger canal would be used for the passage of the tap and the pedicle screw attached to the screwdriver. The lumen of the smaller canal would be connected to the connecting tubing attached to a reservoir with vacuum pressure. After a small skin incision made, each dilator was placed into a piece of porcine meat. The main canal of both dilators was partially sealed to simulate the passage of the instrumentation. Porcine blood was continuously injected into the created cavity to simulate the concurrent bleeding.
Results/Observations: By applying a suction pressure set to 15cmHg, the aspirated porcine blood was seen through the clear tubing.
Conclusion: In this experimental set-up, the proposed dilators showed an excellent operation while realizing that further electrophysiological experiment is necessary to confirm clinical relevance.
Keywords: EMG; Dilator; Lumbar Fixation; Pedicle Screw; Percutaneous; Suction
Abstract | Introduction | Method and Materials | Results | Discussion | Conclusion | References |