PT - JOURNAL ARTICLE AU - Woodall, Michael Neil AU - Shakir, Basheer AU - Smitherman, Adam AU - Choudhri, Haroon TI - Technical note: Resolution of spontaneous electromyographic discharge following disk-space distraction during lateral transpsoas interbody fusion AID - 10.1016/j.ijsp.2013.02.002 DP - 2013 Jan 01 TA - International Journal of Spine Surgery PG - e39--e41 VI - 7 4099 - https://www.ijssurgery.com/content/7/e39.short 4100 - https://www.ijssurgery.com/content/7/e39.full SO - Int J Spine Surg2013 Jan 01; 7 AB - Purpose The lateral transpsoas interbody fusion (LTIF) is an increasingly popular minimally invasive technique for lumbar interbody fusion. Although a posterior approach to the lumbar spine has traditionally been favored for the treatment of canal stenosis and neural foraminal stenosis, a growing body of evidence suggests that indirect decompression of the spinal canal and neural foramen can be achieved using a lateral transpsoas approach to the lumbar spine. We present 2 cases that may suggest a role for spontaneous electromyography (s-EMG) monitoring in assessing the adequacy of decompression during LTIF.Methods The 2 cases presented in this technical note illustrate resolution of s-EMG firing during LTIF, following distraction across the disk space. Removal of the distracting device produced the return of s-EMG firing. Both of these cases were operated at the L2-3 level.Results In the first case, s-EMG firing was noted in the bilateral tibialis anterior leads. Resolution of EMG firing may suggest indirect decompression of the canal via ligamentotaxis as the L5 root traverses the L2-3 disk space. In the second case, s-EMG firing was noted in the left abductor hallucis and resolved with distraction of the L2-3 disk space. Again, this may be explained by canal decompression via ligamentotaxis as the S1 root traverses the L2-3 disk space.Conclusion In both cases, distraction across the disk space resulted in resolution of s-EMG discharges—this correlated with an improvement in symptoms. These findings may suggest a role for s-EMG as a marker for adequacy of decompression in a select subset of patients undergoing LTIF. Further study is needed to determine if resolution of s-EMG is a useful measure of indirect decompression during LTIF.