The effect of neuromuscular blockade on pedicle screw stimulation thresholds.
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.
Minahan
R E
RE
Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Riley
L H
LH
Lukaczyk
T
T
Cohen
D B
DB
Kostuik
J P
JP
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*