Development of Neuromonitoring Pedicle Screw - Results of Electrical Resistance and Neurophysiologic Test in Pig Model

Neurospine. 2021 Mar;18(1):117-125. doi: 10.14245/ns.2040424.212. Epub 2020 Nov 18.

Abstract

Objective: To analyze the electrical resistance of a newly developed neuromonitoring pedicle screw (Neuro-PS) and to verify the electrophysiologic properties of the Neuro-PS in a pig model.

Methods: We developed 2 types of the Neuro-PS in which a gold lead was located internally (type I) and externally (type II). We measured the electrical resistance of the Neuro-PS and the conventional screw and analyzed the electrical thresholds of triggered EMG (t-EMG) of each screw by intentionally penetrating the medial pedicle wall and contacting the exiting nerve root in a pig model.

Results: The electrical resistances of the Neuro-PS were remarkably lower than that of the conventional screw. In electrophysiologic testing, only the type II Neuro-PS under the leadnerve contact condition showed a significantly lower stimulation threshold as compared to the conventional screw.

Conclusion: The Neuro-PS demonstrated lower electrical resistances than the conventional screw. The type II Neuro-PS under the lead-nerve contact condition showed a significantly lower stimulation threshold compared to that of the other screws in the t-EMG test.

Keywords: Electrical resistance; Electromyography; Gold lead; Neuromonitoring; Pedicle screw; Titanium alloy.