The purpose of this study was to further establish the efficacy of pedicle
screw stimulation as a monitoring technique to avoid nerve root injury duri
ng screw placement. The study population consisted of 662 patients in whom
3,409 pedicle screws were placed and tested by electrical stimulation. If s
timulation resulted in a myogenic response at a stimulation intensity of 10
mA or less, the placement of the screw was inspected. Inspection was neces
sary for 3.9% of the screw placements in 15.4% of the study population. Non
e of the patients in the study experienced any new postoperative neurologic
deficits. These findings provide guidelines for the interpretation of stim
ulation data and support the use of this technique as an easy, inexpensive,
and quick method to reliably assess screw placements and protecting neurol
ogical function.