title: The effect of neuromuscular blockade on pedicle screw stimulation thresholds.
abstract: METHODS
  Nerve root stimulation thresholds were studied relative to the level of neuromuscular blockade in patients undergoing lumbar decompression surgery.
  
  
  OBJECTIVE
  To determine what levels of intraoperative neuromuscular blockade can be used during pedicle screw stimulation.
  
  
  BACKGROUND
  Previous studies of intraoperative pedicle screw stimulation thresholds have failed to determine the effect of neuromuscular blockade on the stimulation threshold.
  
  
  METHODS
  Twenty-one roots in 10 patients undergoing lumbar decompression surgery were studied at different levels of neuromuscular blockade. Ninety-five nerve root thresholds were determined relative to level of blockade.
  
  
  RESULTS
  Neuromuscular blockade below 80% provides nerve root thresholds similar to thresholds without blockade.
  
  
  CONCLUSIONS
  Neuromuscular blockade should be less than 80% when using pedicle screw electrical stimulation testing.
authors.affiliation: Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Minahan
authors.forename: L H
authors.initials: LH
authors.lastname: Riley
authors.forename: T
authors.initials: T
authors.lastname: Lukaczyk
authors.forename: D B
authors.initials: DB
authors.lastname: Cohen
authors.forename: J P
authors.initials: JP
authors.lastname: Kostuik
mesh_terms: D001863:Bone Screws; D019299:Decompression, Surgical; D004558:Electric Stimulation / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D016343:Monitoring, Intraoperative; D009408:Nerve Compression Syndromes / Q000503:physiopathology / Q000601:surgery*; D019148:Neuromuscular Blockade; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D011843:Radiculopathy / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D012684:Sensory Thresholds / Q000502:physiology; D013126:Spinal Nerve Roots / Q000503:physiopathology*