Texas Back Institute, 2817 South Mayhill Rd, Suite 100, Denton, TX 76208, USA.
PM R. 2010 Nov;2(11):1016-20. doi: 10.1016/j.pmrj.2010.07.002.
To determine if improvements in pain after epidural steroid injections (ESIs) were related to electromyographic (EMG) findings in patients with radicular symptoms and clinical findings consistent with radiculopathy.
Retrospective chart review.
Multisite spine clinic.
Data were analyzed from 89 patients who had needle EMG within 6 months of ESI between 2005 and 2008.
Clinical and demographic data and results of EMG testing from qualified patients were recorded from patient charts at least 10 days after ESI. Evidence of radiculopathy on EMG reports was classified as positive, normal, or equivocal. In all 3 EMG groups, the percentage of patients who had 50% improvement in leg pain after ESI was noted. As a secondary analysis, improvement in pre-ESI to post-ESI leg and back pain scores in the EMG groups were compared.
The clinical outcome measurements were visual analog scale (VAS) scores assessing leg and back pain. ESI relief was defined as at least 50% improvement in the VAS score assessing leg pain after the injection.
EMG findings were normal in 47.2%, positive in 31.5%, and equivocal in 21.3% of patients. No significant differences were found in the percentages of patients experiencing a positive response to the ESI with respect to EMG findings. Forty-three percent of patients with normal EMG findings (18/42), 25.0% of patients with positive EMG findings (7/28), and 31.6% patients with equivocal EMG findings (6/19) had relief after ESI. In all 3 EMG groups, a statistically significant improvement in mean VAS scores was found after ESI.
Mean leg and back pain scores improved significantly after ESI in all 3 EMG groups: those with positive, normal, and equivocal findings. Results of this study do not suggest that ESI is contraindicated in patients with normal EMG findings.
确定硬膜外类固醇注射（ESI）后疼痛改善是否与神经根症状患者的肌电图（EMG）发现以及与神经根病相一致的临床发现有关。
回顾性图表审查。
多地点脊柱诊所。
对 2005 年至 2008 年间进行 ESI 治疗后 6 个月内进行过针 EMG 的 89 名患者的数据进行了分析。
从患者图表中记录合格患者的临床和人口统计学数据以及 EMG 测试结果，至少在 ESI 后 10 天。在 EMG 报告中，神经根病的证据被归类为阳性、正常或不确定。在所有 3 个 EMG 组中，记录 ESI 后腿部疼痛改善 50%的患者比例。作为二次分析，比较 EMG 组中 ESI 前后腿部和背部疼痛评分的改善。
临床结局测量是评估腿部和背部疼痛的视觉模拟量表（VAS）评分。ESI 缓解定义为注射后评估腿部疼痛的 VAS 评分至少改善 50%。
EMG 结果正常占 47.2%，阳性占 31.5%，不确定占 21.3%。在 ESI 对 EMG 结果的反应中，没有发现患者经历阳性反应的百分比存在显著差异。43%的 EMG 正常发现患者（42/18）、25.0%的 EMG 阳性发现患者（28/7）和 31.6%的 EMG 不确定发现患者（19/6）在 ESI 后有缓解。在所有 3 个 EMG 组中，ESI 后 VAS 评分的均值均有统计学显著改善。
在所有 3 个 EMG 组中，ESI 后腿部和背部疼痛评分均显著改善：阳性、正常和不确定发现的患者。本研究结果并未表明 ESI 在 EMG 正常的患者中是禁忌的。
