Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model

Abstract Background A warning system to avoid potential nerve root thermal injury caused by automatic spine robot is essential. However, there is a lack of basic research to support the development of such warning system. The aims of this study are to confirm the feasibility of continuous intraopera...

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Main Authors: Chengxia Wang, Zhuofu Li, Woquan Zhong, Shuai Jiang, Weishi Li
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12891-024-08177-4
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author Chengxia Wang
Zhuofu Li
Woquan Zhong
Shuai Jiang
Weishi Li
author_facet Chengxia Wang
Zhuofu Li
Woquan Zhong
Shuai Jiang
Weishi Li
author_sort Chengxia Wang
collection DOAJ
description Abstract Background A warning system to avoid potential nerve root thermal injury caused by automatic spine robot is essential. However, there is a lack of basic research to support the development of such warning system. The aims of this study are to confirm the feasibility of continuous intraoperative neuromonitoring (CIONM) in spinal nerve root monitoring and study the exposure time of spinal nerve root thermal injury at different temperature in a porcine model. Methods The experiment was carried out on 32 nerve roots of 4 pigs (bilateral L4-S1 nerve roots). Sham group (CIONM only), control group (Room temperature stimulation with CIONM), and 40 °C, 45 °C, 50 °C, 55 °C, 60 °C, 65 °C temperature stimulation groups were conducted at random in each pig. The change of EMG was recorded continuously. The exposure time of nerve root injury at different temperatures was recorded. Histological analysis of the nerve roots was performed to confirm the injury. Results The EMG of the sham, control, 40 °C and 45 °C groups were stable during the experiment, and no significant nerve root injury was observed on histological analysis. The time of 50% EMG amplitude decrease in 50℃, 55℃, 60℃ and 65℃ groups were 277.5 ± 18.2, 59.5 ± 6.2, 20.8 ± 1.0 and 16.5 ± 1.3 s, respectively. And the nerve specimens of these groups showed varying degrees of damage. Conclusions CIONM can be used for continuous monitoring of spinal nerve roots. For 5 min, 40℃ and 45℃ did not cause significant nerve root injury. However, when the temperature reached 50℃ and above, nerve roots appeared injury.
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spelling doaj-art-6597150da67c43e690ddca033196b2a52025-08-20T01:59:47ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-012511810.1186/s12891-024-08177-4Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine modelChengxia Wang0Zhuofu Li1Woquan Zhong2Shuai Jiang3Weishi Li4Department of Orthopaedics, Peking University Third HospitalDepartment of Orthopaedics, Peking University Third HospitalDepartment of Orthopaedics, Peking University Third HospitalDepartment of Orthopaedics, Peking University Third HospitalDepartment of Orthopaedics, Peking University Third HospitalAbstract Background A warning system to avoid potential nerve root thermal injury caused by automatic spine robot is essential. However, there is a lack of basic research to support the development of such warning system. The aims of this study are to confirm the feasibility of continuous intraoperative neuromonitoring (CIONM) in spinal nerve root monitoring and study the exposure time of spinal nerve root thermal injury at different temperature in a porcine model. Methods The experiment was carried out on 32 nerve roots of 4 pigs (bilateral L4-S1 nerve roots). Sham group (CIONM only), control group (Room temperature stimulation with CIONM), and 40 °C, 45 °C, 50 °C, 55 °C, 60 °C, 65 °C temperature stimulation groups were conducted at random in each pig. The change of EMG was recorded continuously. The exposure time of nerve root injury at different temperatures was recorded. Histological analysis of the nerve roots was performed to confirm the injury. Results The EMG of the sham, control, 40 °C and 45 °C groups were stable during the experiment, and no significant nerve root injury was observed on histological analysis. The time of 50% EMG amplitude decrease in 50℃, 55℃, 60℃ and 65℃ groups were 277.5 ± 18.2, 59.5 ± 6.2, 20.8 ± 1.0 and 16.5 ± 1.3 s, respectively. And the nerve specimens of these groups showed varying degrees of damage. Conclusions CIONM can be used for continuous monitoring of spinal nerve roots. For 5 min, 40℃ and 45℃ did not cause significant nerve root injury. However, when the temperature reached 50℃ and above, nerve roots appeared injury.https://doi.org/10.1186/s12891-024-08177-4Thermal injuryNerve injuryLumbosacral plexusContinuous intraoperative neuromonitoringEMG
spellingShingle Chengxia Wang
Zhuofu Li
Woquan Zhong
Shuai Jiang
Weishi Li
Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
BMC Musculoskeletal Disorders
Thermal injury
Nerve injury
Lumbosacral plexus
Continuous intraoperative neuromonitoring
EMG
title Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
title_full Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
title_fullStr Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
title_full_unstemmed Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
title_short Application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
title_sort application of continuous intraoperative neuromonitoring in the study of spinal nerve root thermal injury in a porcine model
topic Thermal injury
Nerve injury
Lumbosacral plexus
Continuous intraoperative neuromonitoring
EMG
url https://doi.org/10.1186/s12891-024-08177-4
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