Sihvonen T, Partanen J
Department of Clinical Neurophysiology, University Central Hospital of Kuopio, Finland.
Electromyogr Clin Neurophysiol. 1990 Apr-May;30(3):175-80.
Low back pain patients (N = 18) having segmental hypermobility in one lumbar segment and healthy controls (N = 13) were chosen for this study. Patients had no other structural spinal pathology except displacement of one vertebra to another in lateral X-ray bending pictures. Kinetic intramuscular EMG-activity from paraspinal muscles was studied off-line during back flexion and reextension. Routine needle EMG study of paraspinal muscles was also performed in addition to measurements of the tibial nerve H-reflexes and peroneal F-responses. Results showed that the number of MUAPs in erector spinae muscle on voluntary efforts was rarefied at hypermobile levels, and spontaneous activity, positive sharp waves and high frequency discharges were found in more than half of the patients in paraspinal muscles, usually at hypermobile levels only. No signs of proximal nerve root compression were found. This indicates neuropathy of dorsal rami at the instable level.
本研究选取了18例在一个腰椎节段存在节段性活动过度的下腰痛患者和13例健康对照者。除了在X线侧位弯曲片上有一个椎体向另一个椎体移位外，患者没有其他脊柱结构病变。在背屈和再伸展过程中离线研究了椎旁肌的动态肌内肌电图活动。除了测量胫神经H反射和腓总神经F反应外，还对椎旁肌进行了常规针电极肌电图研究。结果显示，在活动过度节段，竖脊肌在自主用力时运动单位动作电位（MUAPs）数量稀少，并且在超过半数的患者中，椎旁肌出现了自发电活动、正锐波和高频放电，通常仅在活动过度节段出现。未发现近端神经根受压的迹象。这表明在不稳定节段存在背侧支神经病变。
