{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:33:30Z","timestamp":1762018410235,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81874017","81960403","82060405"],"award-info":[{"award-number":["81874017","81960403","82060405"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the rationale and application of triggered EMG (T\u2010EMG) in intraoperative neurophysiological monitoring, and to explore the efficacy and safety of posterior percutaneous endoscopic cervical discectomy (PPECD) in the treatment of cervical spondylotic radiculopathy (CSR) under multimodal intraoperative neurophysiological monitoring (IOM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a retrospective cohort control study. The clinical data of 74 patients with single\u2010segment CSR from June 2015 to August 2018 were analyzed retrospectively, of whom 35 underwent IOM\u2010assisted PPECD with triggered EMG (T\u2010EMG group), while 39 were subjected to IOM\u2010assisted PPECD alone (IOM group). Operation time, hospital stay, and complications were recorded for both groups. The curative effect was evaluated according to the Visual Analog Scale (VAS) of neck and arm pain, Japanese Orthopaedic Association (JOA) score, and modified MacNab scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Operations were successful and all patients were followed up for at least 24 (average 31.77 \u00b1\u20099.51) months with no patient lost to follow\u2010up. No significant difference was found in preoperative baseline data between the T\u2010EMG and the IOM group (<jats:italic>P<\/jats:italic> &gt;\u20090.05). Also, no significant difference was found in the operation time between the T\u2010EMG (108.29 \u00b1\u200911.44\u2009min) and the IOM (110.13 \u00b1\u200912.70\u2009min) (<jats:italic>P<\/jats:italic> &gt;\u20090.05) group, but the difference in hospital stay (T\u2010EMG: 5.66 \u00b1\u20090.99\u2009days; IOM: 7.10 \u00b1\u20091.43\u2009days) was statistically significant (<jats:italic>P<\/jats:italic> &lt;\u20090.05). The VAS for the neck and upper limbs in the two groups at 1\u2009month post\u2010operation (T\u2010EMG: 2.09 \u00b1\u20091.07, 2.26 \u00b1\u20090.92; IOM:2.18 \u00b1\u20091.05, 2.31 \u00b1\u20090.77) and the last follow\u2010up (T\u2010EMG: 0.83 \u00b1\u20090.62, 0.86 \u00b1\u20090.55; IOM: 0.90 \u00b1\u20090.50, 0.87 \u00b1\u20090.61) were significantly different from the preoperative scores (T\u2010EMG: 6.14 \u00b1\u20091.09, 7.17 \u00b1\u20091.04; IOM: 6.18 \u00b1\u20091.28, 7.15 \u00b1\u20091.23) (<jats:italic>P<\/jats:italic> &lt;\u20090.05). However, no significant difference was found between the two groups (<jats:italic>P<\/jats:italic> &gt;\u20090.05). The 1\u2010month postoperative JOA scores for the two groups (12.69 \u00b1\u20090.76; 12.59 \u00b1\u20090.82) and those at the last follow\u2010up (14.60 \u00b1\u20090.77; 14.36 \u00b1\u20090.78) were significantly different from the preoperative scores (11.09 \u00b1\u20090.98; 11.05 \u00b1\u20090.89) (<jats:italic>P<\/jats:italic> &lt;\u20090.05), but the difference between the two groups was not significant (<jats:italic>P<\/jats:italic> &gt;\u20090.05). One patient in the T\u2010EMG group developed a transient aggravation of symptoms on the first day after surgery. In the IOM group, three patients had intraoperative cerebrospinal fluid leakage, and symptoms of C5 nerve root paralysis were presented in four patients following surgery. Compared with the IOM group, the T\u2010EMG group had fewer complications (1\/35; 7\/39, <jats:italic>P<\/jats:italic> &lt;\u20090.05). At the last follow\u2010up, the modified MacNab criteria were 91.43% (32\/35) and 89.7% (35\/39) for the T\u2010EMG group and IOM group, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Triggered EMG prevents the occurrence of neurological complications, which not only aids PPECD for CSR treatment in achieving satisfactory results, but also reduces average hospital stay and complication rates.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13092","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T11:54:13Z","timestamp":1634817253000},"page":"2236-2245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Application of Triggered <scp>EMG<\/scp> in the Intraoperative Neurophysiological Monitoring of Posterior Percutaneous Endoscopic Cervical Discectomy"],"prefix":"10.1111","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7004-5237","authenticated-orcid":false,"given":"Yao\u2010bin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Lanzhou University Second Hospital  Lanzhou China"},{"name":"Gansu Provincial Orthopaedic Clinical Medicine Research Center  Lanzhou China"},{"name":"Key Laboratory of Bone and Joint Disease Research of Gansu Province  Lanzhou China"},{"name":"Department of Spinal and Spinal Cord surgery Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010bing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Lanzhou University Second Hospital  Lanzhou China"},{"name":"Gansu Provincial Orthopaedic Clinical Medicine Research Center  Lanzhou China"},{"name":"Key Laboratory of Bone and Joint Disease Research of Gansu Province  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Lanzhou University Second Hospital  Lanzhou China"},{"name":"Gansu Provincial Orthopaedic Clinical Medicine Research Center  Lanzhou China"},{"name":"Key Laboratory of Bone and Joint Disease Research of Gansu Province  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao\u2010yun","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Lanzhou University Second Hospital  Lanzhou China"},{"name":"Gansu Provincial Orthopaedic Clinical Medicine Research Center  Lanzhou China"},{"name":"Key Laboratory of Bone and Joint Disease Research of Gansu Province  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Spinal and Spinal Cord surgery Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Spinal and Spinal Cord surgery Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2576-5539","authenticated-orcid":false,"given":"Ya\u2010yi","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Lanzhou University Second Hospital  Lanzhou China"},{"name":"Gansu Provincial Orthopaedic Clinical Medicine Research Center  Lanzhou China"},{"name":"Key Laboratory of Bone and Joint Disease Research of Gansu Province  Lanzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu\u2010lian","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Spinal and Spinal Cord surgery Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"E215","article-title":"Minimally invasive full\u2010endoscopic posterior cervical foraminotomy assisted by O\u2010arm\u2010based navigation","volume":"21","author":"Zhang C","year":"2018","journal-title":"Pain 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