Liaqat Mahmood Awan, Mukhtar Ahmed, Azam Niaz, Anjum Habib Vohra.
Diathermy Stimulation to Avoid Nerve Injuries during Trans-pedicular Screw Placement in Dorso-lumbar Spine.
Pak J Neuro Surg Jan ;16(2):107-12.

Objective: To demonstrate the utility of diathermy in avoiding nerve injuries due to misplacement of trans-pedicular screws (TPSs) during Dorso-lumbar spinal fusion.Study Design: Retrospective studyPlace and Duration of the Study: Department of Neurosurgery, Lahore General Hospital, Lahore, from Oct. – 2007 to Oct. 2012.Materials and Methods: In this retrospective study, diathermy was used to assess whether a screw deviated from the pedicle by observing synchronous leg movements caused by intermittently touching a diathermy to the pedi-cular instrument. Diathermy was performed in 159 cases in which 561 pedicle screws had been placed.Results: Leg movements were observed in 36 cases and the sensitivity of diathermy was 82.7%, the specificity of 98.6%. No neurological complications associated with the placement of pedicular screws were observed after adding diathermy stimulation to the conventional methods.Conclusion: Diathermy may be helpful to avoid nerve injuries during transpedicular screw placement.

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