Intraoperative Monitoring with Stimulus-Evoked Electromyography during Placement of Iliosacral Screws. An Initial Clinical Study*

Treatment of posterior pelvic ring injuries with minimally invasive percutaneous plate osteosynthesis

“…Therefore, some researchers have performed the operation under the guidance of somatosensory evoked potential (SEP), electromyelography or electroneurography to reduce the incidence of nerve injury [6]. Nevertheless, nerve injury due to the guide pin, drill bit and screws can not be effectively prevented [16], and doctors are constantly exposed to radiation during the operation. What's more, extensive anatomical knowledge and surgical skills are needed for this operation.…”

Fluoroscopic Views for a More Accurate Placement of Iliosacral Screws

“…Some authors have reported that the incidence of malpositioned IS screw could be reduced with modern technology such as navigationassisted techniques, intraoperative 3D imaging, and intraoperative monitoring of stimulus evoked electromyography. [24][25][26][27][28][29] However, these are not available in all hospitals and the evaluation of intraoperative fluoroscopy is essential.…”

Fixation of posterior pelvic disruption by trans-iliac bar using ISOLA rods and hooks

“…11 Complications of this procedure include: malreduction, breakage of bars due to limited biomechanical strength, LLD, instability, compressive neuropathy of sacral roots or cauda equina, injury to vascular or intestinal structures, lower back pain and infection. 13,1,5,11,10 In order to reduce the hazard to sacral roots, some surgeons attain intra-operative monitoring with stimulus-evoked EMG, especially when introducing ilio-sacral screws, 6,16 or the wake-up test of Stanjara in the case of trans-iliac bars. 11 Our conclusion is that ISOLA rods and hooks are suitable for fixation of sacral fractures.…”