Macnicol M F, Nadeem R D
Murrayfield Hospital, Edinburgh, Scotland.
J Bone Joint Surg Br. 2000 Jul;82(5):731-5. doi: 10.1302/0301-620x.82b5.9988.
Somatosensory evoked potentials (SSEPs) measure the conduction pathways from the periphery to the brain and can demonstrate the site of neurological impairment in a variety of locomotor conditions. SSEPs were studied in 44 children (64 feet) with surgically corrected club feet. Four children had unreproducible responses, 18 showed abnormal recordings and 22 showed normal responses. In a further 31 feet (21 children) subjected to motor electrophysiological tests, 16 (52%) were abnormal. Overall, 44 of 95 feet (46%) showed abnormal SSEPs or motor electrophysiological tests. Neurological abnormality was related both to the severity of the deformity and the surgical outcome. It was seen in 38% of feet with grade-2 and in 53% of feet with grade-3 deformity. A fair surgical result was obtained in 36% of feet with a conduction deficit and in only 6% with no abnormality. These results suggest an association between neurological abnormality as demonstrated by SSEPs or motor electrophysiological studies and the severity of deformity in club foot and its response to surgical treatment.
体感诱发电位（SSEPs）可测量从外周到大脑的传导通路，并能在多种运动情况下显示神经损伤的部位。对44名接受过手术矫正马蹄内翻足的儿童（64只脚）进行了体感诱发电位研究。4名儿童的反应无法重复，18名儿童的记录异常，22名儿童的反应正常。在另外31只脚（21名儿童）接受运动电生理测试中，16只脚（52%）异常。总体而言，95只脚中有44只脚（46%）的体感诱发电位或运动电生理测试异常。神经异常与畸形的严重程度和手术结果均有关。在2级畸形的脚中，38%出现神经异常；在3级畸形的脚中，53%出现神经异常。在有传导缺陷的脚中，36%获得了较好的手术结果；在无异常的脚中，只有6%获得了较好的手术结果。这些结果表明，体感诱发电位或运动电生理研究显示的神经异常与马蹄内翻足畸形的严重程度及其对手术治疗的反应之间存在关联。
