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梨状肌综合征患者坐骨神经运动神经传导速度的测量:一项磁刺激研究。

Measurement of motor nerve conduction velocity of the sciatic nerve in patients with piriformis syndrome: a magnetic stimulation study.

作者信息

Chang Chein-Wei, Shieh Shie-Fu, Li Chih-Ming, Wu Wei-Ting, Chang Kai-Fong

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan.

出版信息

Arch Phys Med Rehabil. 2006 Oct;87(10):1371-5. doi: 10.1016/j.apmr.2006.07.258.

Abstract

OBJECTIVE

To assess the motor nerve conduction of the sciatic nerve by a magnetic stimulation method in patients with piriformis syndrome.

DESIGN

Prospective study.

SETTING

An electrodiagnostic laboratory in a university hospital.

PARTICIPANTS

Twenty-three patients with piriformis syndrome and 15 healthy persons for control.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Motor nerve conduction velocity (MNCV) of the sciatic nerve was measured at the gluteal segment by magnetic stimulation proximally at L5 and S1 roots and distally at sciatic nerve at gluteal fold and recording at the corresponding muscles. Diagnostic sensitivities were measured in the magnetic stimulation method and the conventional nerve conduction, long latency reflex, and needle electromyography studies.

RESULTS

The mean MNCV of the sciatic nerve +/- standard deviation at the gluteal segment in L5 component was 55.4+/-7.8 m/s in patients with piriformis syndrome, which was slower than the mean value of 68.1+/-10.3 m/s obtained in healthy controls (P=.014). The MNCV of the sciatic nerve in S1 component showed no significant difference between the patients and controls (P=.062). A negative relation was found between the disease duration and the MNCV values of sciatic nerves in patients with piriformis syndrome (r=-.68, P<.01). The diagnostic sensitivity by magnetic stimulation is .467.

CONCLUSIONS

Magnetic nerve stimulation provides a painless, noninvasive, and objective method for evaluation of sciatic nerve function in patients with piriformis syndrome.

摘要

目的

采用磁刺激法评估梨状肌综合征患者坐骨神经的运动神经传导情况。

设计

前瞻性研究。

地点

大学医院的电诊断实验室。

参与者

23例梨状肌综合征患者及15名健康对照者。

干预措施

不适用。

主要观察指标

通过在L5和S1神经根近端进行磁刺激、在臀褶处坐骨神经远端进行磁刺激并在相应肌肉记录,测量坐骨神经在臀段的运动神经传导速度(MNCV)。在磁刺激法以及传统神经传导、长潜伏期反射和针极肌电图检查中测量诊断敏感性。

结果

梨状肌综合征患者L5成分坐骨神经在臀段的平均MNCV±标准差为55.4±7.8 m/s,慢于健康对照者的平均值68.1±10.3 m/s(P = 0.014)。S1成分坐骨神经的MNCV在患者和对照者之间无显著差异(P = 0.062)。梨状肌综合征患者的病程与坐骨神经MNCV值呈负相关(r = -0.68,P < 0.01)。磁刺激的诊断敏感性为0.467。

结论

磁神经刺激为评估梨状肌综合征患者的坐骨神经功能提供了一种无痛、无创且客观的方法。

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