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腰骶神经根病的常规电诊断及多参数技术

Routine electrodiagnosis and a multiparameter technique in lumbosacral radiculopathies.

作者信息

Fisher M A, Bajwa R, Somashekar K N

机构信息

Hines VAH, Hines, IL 60141, USA.

出版信息

Acta Neurol Scand. 2008 Aug;118(2):99-105. doi: 10.1111/j.1600-0404.2007.00987.x. Epub 2008 Mar 18.

Abstract

OBJECTIVE

This study compares Routine nerve conductions studies (NCS)/needle electromyography (nEMG) with a multiparameter recording method (NC-stat; NeuroMetrix Inc., Waltham, MA, USA) in patients with lumbosacral radiculopathies (LSR).

METHODS

Charts from 34 consecutive patients with a clinical history and/or examination consistent with an LSR were retrospectively reviewed. All underwent both Routine NCS/nEMG studies and NC-stat EDX. NC-stat testing included peroneal and posterior tibial nerve distal motor latencies and amplitudes and F-wave analysis. Twenty-eight patients had magnetic resonance imaging of the lumbosacral spine, and two had post-myelogram computerized tomography scan.

RESULTS

In the 24 patients with abnormal routine NCS/nEMG, NC-stat EDX was abnormal in 22. Raw agreement values between specific abnormal Routine and NC-stat EDX parameters ranged from 065 to 0.76. NC-stat amplitude and F-wave data provide reasonable electrodiagnostic 'rule in, rule out' information for LSR. Routine and NC-stat EDX had comparable positive and negative likelihood ratios with radiographic findings based on blinded neuroradiological evaluation. This included good 'stand alone' values for NC-stat F-wave and compound muscle action potential (CMAP) amplitude abnormalities in patients with spinal stenosis.

CONCLUSIONS

This report supports the value of multiparameter clinical neurophysiological evaluations in patients with LSR including CMAPs and F-waves.

摘要

目的

本研究比较常规神经传导研究(NCS)/针极肌电图(nEMG)与多参数记录方法(NC-stat;美国马萨诸塞州沃尔瑟姆市NeuroMetrix公司)在腰骶神经根病(LSR)患者中的应用。

方法

回顾性分析34例有与LSR相符的临床病史和/或检查结果的连续患者的病历。所有患者均接受了常规NCS/nEMG研究和NC-stat电诊断检查。NC-stat测试包括腓总神经和胫后神经的远端运动潜伏期、波幅以及F波分析。28例患者进行了腰骶部脊柱磁共振成像检查,2例进行了脊髓造影后计算机断层扫描。

结果

在24例常规NCS/nEMG异常的患者中,22例NC-stat电诊断检查异常。常规和NC-stat电诊断检查特定异常参数之间的原始一致性值范围为0.65至0.76。NC-stat波幅和F波数据为LSR提供了合理的电诊断“纳入、排除”信息。基于盲法神经放射学评估,常规和NC-stat电诊断检查与影像学结果具有相当的阳性和阴性似然比。这包括脊髓狭窄患者中NC-stat F波和复合肌肉动作电位(CMAP)波幅异常的良好“独立”值。

结论

本报告支持多参数临床神经生理学评估在LSR患者中的价值,包括CMAP和F波。

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