Texas Nerve and Paralysis Institute, Houston, Texas 77030, USA.
J Reconstr Microsurg. 2010 May;26(4):235-42. doi: 10.1055/s-0030-1248231. Epub 2010 Feb 8.
Brachial plexus upper trunk injury is associated with winged scapula owing to the close anatomical course of the long thoracic nerve and upper trunk. Needle electromyography is a common diagnostic test for this injury; however, it does not detect injury in most patients with upper trunk damage. The pressure-specified sensory device may be an alternative to needle electromyography. Thirty patients with winged scapula and upper trunk injury were evaluated with needle electromyography (EMG) and pressure-specified sensory device (PSSD) tests. EMG testing of the biceps muscle was compared with PSSD testing of the dorsal hand skin (C6 damage), and EMG testing of the deltoid and spinati muscles was compared with PSSD testing of the deltoid skin (C5 damage). PSSD pressure values were significantly higher on the affected arm. On the basis of published and calculated threshold values the PSSD was found to be significantly more sensitive than EMG. The PSSD tests consistently identified injuries that were not detected by needle EMG tests. These findings provide strong evidence that the PSSD is more effective than needle EMG in the detection of brachial plexus upper trunk injury.
臂丛上干损伤与翼状肩有关，这是由于胸长神经和上干的解剖位置非常接近。针极肌电图是这种损伤的常用诊断测试；然而，它并不能在大多数上干损伤的患者中检测到损伤。压力特定感觉设备可能是针极肌电图的替代方法。对 30 例有翼状肩和上干损伤的患者进行了针极肌电图（EMG）和压力特定感觉设备（PSSD）测试评估。对肱二头肌进行 EMG 测试，并与 C6 损伤的手背皮肤的 PSSD 测试进行比较，对三角肌和斜方肌进行 EMG 测试，并与 C5 损伤的三角肌皮肤的 PSSD 测试进行比较。受影响手臂的 PSSD 压力值明显更高。根据已发表和计算的阈值，PSSD 的敏感性明显高于 EMG。PSSD 测试一致地识别出了针极肌电图测试未检测到的损伤。这些发现为 PSSD 在检测臂丛上干损伤方面比针极肌电图更有效提供了有力证据。
