Thoracic pedicle screws placement remains being a challenge despite modern technologies available. To assess neural integrity during these surgeries, intraoperative neurophysiological monitoring (IOM) is indicated. Motor-evoked potentials (MEP) and somatosensory-evoked potentials (SSEP) give valuable information regarding spinal cord function, and pedicle screws stimulation could evaluate medial malpositioning. However, the accuracy of thoracic pedicle screws stimulation is still controversial, using single-pulse stimulation, recording from intercostal and abdominal muscles, and with high false-positive rate.
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