Lumbar nerve root mapping by the spinal cord monitoring in adult spinal deformity surgery

Objective When we perform surgical correction for spinal deformity with degenerative changes, nerve root impingement, traction, or nerve root injury could be occurred. Electromyographic (EMG) monitoring provides a real-time measure of impending spinal nerve root injury during instrumented posterior lumbar fusion. However, the utility of intraoperative EMG monitoring is still questionable because of large variance in muscle domination, morphological abnormality and the abnormal EMG signal from a nearby muscle. The aim of this study was identified clinical mapping of lumbar nerve root motor domination under EMG monitoring in the patients who had normal root morphology.