Abstract
Posterior cervical instrumentation is used to treat a variety of cervical pathologies,
including cervical spondylotic myelopathy, severe canal stenosis, and degenerative
diseases. A 55-year-old man with severe cervical canal stenosis underwent a C3–C6
laminectomy and lateral mass screw fixation under general anesthesia. After lateral
mass screw fixation and rod placement on the right side, raw electromyography (EMG)
revealed irritative discharges in the right biceps brachii muscle. Following a suspicion
of irritation/mechanical stretching of the C5–C6 nerve root, a posterior foraminotomy
was performed on the right side as a rescue measure. The amplitude of raw EMG irritative
discharges in the right biceps brachii muscle decreased significantly after posterior
foraminotomy. Following rod reapplication with decreased rod lordosis, the irritative
EMG discharges were eliminated. Before implementing further measures, posterior foraminotomy
can be a crucial initial intervention for minimizing nerve root irritation due to
mechanical factors after cervical lateral mass screw fixation.
Keywords
raw electromyography - foraminotomy - posterior cervical instrumentation - lateral
mass screw fixation
