Tsao Bryan E, Levin Kerry H, Bodner Russ A
Department of Neurology, S-90, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Muscle Nerve. 2003 Jan;27(1):60-4. doi: 10.1002/mus.10291.
To identify the segmental innervation of L-2-S-1 muscles, we compared the preoperative electrodiagnostic examinations of 45 patients with single-level lumbosacral radiculopathies confirmed radiologically and surgically. The electrodiagnostic findings were classified as abnormal only by the needle examination and only if muscles demonstrated active denervation or a marked neurogenic motor unit potential firing pattern. In comparison to other surgical, intraoperative root stimulation, and clinical studies, we found several differences. Overall, there was little overlap among L-2-4, L-5, and S-1 radiculopathies. The tibialis anterior was predominantly L-5 innervated, the gastrocnemius (medial and lateral head) predominantly S-1 innervated, and the biceps femoris (short and long head) exclusively S-1 innervated. The two heads of biceps femoris were not affected in any patients with L-5 radiculopathy in whom they were examined. These findings help guide both the clinician and surgeon in the diagnosis and treatment of lumbosacral radiculopathies.
为确定L2 - S1节段肌肉的神经支配情况,我们比较了45例经放射学和手术确诊为单节段腰骶神经根病患者的术前电诊断检查结果。电诊断结果仅在针极检查时被判定为异常,且仅当肌肉表现出主动失神经支配或显著的神经源性运动单位电位发放模式时才被判定为异常。与其他手术、术中神经根刺激及临床研究相比,我们发现了一些差异。总体而言,L2 - 4、L5和S1神经根病之间几乎没有重叠。胫骨前肌主要由L5神经支配,腓肠肌(内侧头和外侧头)主要由S1神经支配,股二头肌(短头和长头)仅由S1神经支配。在接受检查的L5神经根病患者中,股二头肌的两个头均未受影响。这些发现有助于指导临床医生和外科医生对腰骶神经根病的诊断和治疗。