Macdonell R A, Cros D, Shahani B T
Spaulding Rehabilitation Hospital, Boston, Massachusetts.
Muscle Nerve. 1992 Aug;15(8):885-90. doi: 10.1002/mus.880150804.
Stimulation of lumbosacral nerve roots using a monopolar needle electrode was compared with magnetic stimulation using a 7-cm diameter surface coil. Compound muscle action potentials were recorded from the tibialis anterior (TA) and flexor hallucis brevis (FHB) muscles. Although the mean latency of CMAPs did not differ using the two techniques, amplitudes were considerably larger using a needle. Mean amplitudes were 66% (TA) and 64% (FHB) of the direct M response obtained by distal, supramaximal stimulation compared with mean values using maximal magnetic coil stimulation of 36% (TA) and 25% (FHB). Minimum F-wave latencies from FHB were used to estimate the site of nerve root stimulation using both techniques. Although there was a large amount of variability in the data from individual subjects, the results suggested that, on the average, both forms of stimulation act proximal to the intervertebral foramen. We conclude that a needle electrode is a more suitable technique for stimulating lumbosacral nerve roots.
使用单极针电极刺激腰骶神经根，并与使用直径7厘米的表面线圈进行磁刺激相比较。从胫前肌（TA）和拇短屈肌（FHB）记录复合肌肉动作电位。虽然使用这两种技术时复合肌肉动作电位的平均潜伏期没有差异，但使用针电极时的波幅要大得多。与使用最大磁线圈刺激时的平均值相比，通过远端超强刺激获得的直接M反应的平均波幅在TA中为66%，在FHB中为64%；而使用最大磁线圈刺激时，TA中的平均值为36%，FHB中的平均值为25%。使用这两种技术时，均采用FHB的最小F波潜伏期来估计神经根刺激部位。尽管个体受试者的数据存在很大差异，但结果表明，平均而言，两种刺激形式均作用于椎间孔近端。我们得出结论，针电极是刺激腰骶神经根更合适的技术。
