Michigan Head and Spine Institute and Providence Hospital, 29275 Northwestern Highway, Southfield, MI 48034, USA.
Am J Phys Med Rehabil. 2011 Mar;90(3):233-8; quiz 239-42. doi: 10.1097/PHM.0b013e31820b163b.
The aim of this study was to determine the specificity of needle electromyography for lumbar radiculopathy in subjects with low back pain and sciatica without stenosis.
Subjects 55 yrs or older with diagnoses of low back pain and sciatica underwent a standardized monopolar needle evaluation by blinded electromyographers as part of a spinal stenosis study. The presence or absence of radiculopathy was determined using different electrodiagnostic criteria.
Seventy-two subjects with a mean age of 64.6 years (SD, 7.0 yrs) were studied. When only positive sharp waves or fibrillations were considered abnormal, most of the diagnostic criteria--two limb muscles + associated lumbar paraspinal muscle abnormal, two limb muscles abnormal, or one limb muscle + associated lumbar paraspinal muscle abnormal--had 97%, 96%, and 92% specificity, respectively. When 30% or greater polyphasia in the limb muscles was also considered abnormal, the respective specificities were 90%, 81%, and 85%. When 20% or greater polyphasia in the limb muscles was also considered abnormal, the respective specificities were 90%, 74%, and 71% [corrected].
There is good specificity for lumbosacral radiculopathy when appropriate diagnostic criteria are used.
本研究旨在确定在无狭窄的腰痛和坐骨神经痛患者中,针极肌电图对腰椎神经根病的特异性。
本研究纳入了年龄在 55 岁及以上、被诊断为腰痛和坐骨神经痛的患者,他们接受了由经过盲法培训的肌电图医生进行的标准单极针评估,这是一项椎管狭窄研究的一部分。使用不同的电诊断标准来确定是否存在神经根病。
共纳入了 72 名平均年龄为 64.6 岁(标准差,7.0 岁)的患者。当仅考虑阳性的锐波或纤颤时,大多数诊断标准——两条肢体肌肉+相关的腰椎旁肌异常、两条肢体肌肉异常或一条肢体肌肉+相关的腰椎旁肌异常——的特异性分别为 97%、96%和 92%。当也考虑到肢体肌肉中 30%或更多的多相波时,相应的特异性分别为 90%、81%和 85%。当也考虑到肢体肌肉中 20%或更多的多相波时,相应的特异性分别为 90%、74%和 71%[纠正]。
当使用适当的诊断标准时,针极肌电图对腰骶神经根病具有良好的特异性。