Department of Physical Medicine and Rehabilitation, Shahid Beheshti University, MC, Shohada Hospital, Tajrish Square, Tehran, Iran.
J Clin Neurophysiol. 2009 Dec;26(6):458-60. doi: 10.1097/WNP.0b013e3181c2bb00.
The sixth and seventh roots are among the most common roots involved in cervical radiculopathy. The aim of this study was to evaluate the diagnostic value of flexor carpi radialis H-reflex in patients with suspected C6 or C7 root lesion.
This study was performed on 42 controls and 38 patients with suspected C6 or C7 radiculopathy. All patients were evaluated by physical examination, electromyogram, nerve conduction study and flexor carpi radialis H-reflex (superficial technique), and cervical magnetic resonance imaging. Side-to-side difference >1 millisecond or ipsilateral absent H-responses is considered as an abnormal response. Results were analyzed with SPSS.
Specificity and sensitivity of H-reflex are 86% and 50% in C6 radiculopathy and 86% and 75% in C7, respectively. In six (54.5%) patients without electromyogram finding, flexor carpi radialis H-response was ipsilaterally abnormal. The mean of H-latency in control group was 15.7 (+/-1) milliseconds, and mean of side-to-side H-latency difference in this group was 0.43 (+/-0.39) milliseconds.
Flexor carpi radialis H-reflex can be a helpful additional technique to routine needle electromyogram in the diagnosis of root lesions. The probability of abnormal flexor carpi radialis H-reflex in C7 root lesion is higher than that of C6 root lesion; however, it was not statistically significant.
第六和第七神经根是颈椎神经根病中最常见的神经根之一。本研究旨在评估屈肌腕桡侧 H 反射在疑似 C6 或 C7 神经根病变患者中的诊断价值。
本研究纳入了 42 名对照者和 38 名疑似 C6 或 C7 神经根病变患者。所有患者均通过体格检查、肌电图、神经传导研究和屈肌腕桡侧 H 反射(浅表技术)以及颈椎磁共振成像进行评估。侧间差异>1 毫秒或同侧 H 反应缺失被认为是异常反应。结果采用 SPSS 进行分析。
H 反射在 C6 神经根病变中的特异性和敏感性分别为 86%和 50%,在 C7 神经根病变中的特异性和敏感性分别为 86%和 75%。在 6 名(54.5%)无肌电图发现的患者中,屈肌腕桡侧 H 反应同侧异常。对照组 H 潜伏期的平均值为 15.7(+/-1)毫秒,组间 H 潜伏期差异的平均值为 0.43(+/-0.39)毫秒。
屈肌腕桡侧 H 反射可以作为常规针肌电图在神经根病变诊断中的辅助技术。C7 神经根病变中异常屈肌腕桡侧 H 反射的概率高于 C6 神经根病变,但无统计学意义。