Chang C W, Lien I N
Department of Physical Medicine and Rehabilitation, National Taiwan University, College of Medicine, Taipei, Republic of China.
Am J Phys Med Rehabil. 1990 Dec;69(6):318-22. doi: 10.1097/00002060-199012000-00008.
Direct spinal nerve stimulation was compared with needle electromyography (EMG) in 40 patients who were suspected of having an L5 or S1 radiculopathy. For spinal nerve stimulation, we adapted a monopolar needle electrode inserted deep into the paraspinal muscle. The minimal latency, amplitude, and negative phase area of compound muscle action potential from myotomal muscles were recorded with computer assistance. Abnormality was considered to be significant when the value fell outside of 2 SD of control mean values. Among 17 patients with clinical evidence of radiculopathy, needle EMG was abnormal in 10 patients (58.8%), whereas in the nerve stimulation test the abnormalities were shown in 16 patients (94.1%); in amplitude difference and the abnormal area, differences were shown in 12 patients (70.6%). Among 23 patients with only subjective symptoms of radiculopathy, needle EMG was abnormal in nine patients (39.1%), whereas the abnormal amplitude differences were shown in 18 patients (78.3%) and 15 patients (65.2%) with abnormal area difference by spinal nerve stimulation, respectively. Direct spinal nerve stimulation is recognized as an objective and sensitive test in the diagnosis of lumbosacral radiculopathy.
在40例疑似L5或S1神经根病的患者中，对直接脊髓神经刺激与针极肌电图（EMG）进行了比较。对于脊髓神经刺激，我们采用了一根插入椎旁肌深处的单极针电极。在计算机辅助下记录来自肌节肌肉的复合肌肉动作电位的最小潜伏期、波幅和负相面积。当数值落在对照平均值的2个标准差范围之外时，异常被认为具有显著性。在17例有神经根病临床证据的患者中，针极肌电图有异常的有10例（58.8%），而在神经刺激试验中，16例（94.1%）显示异常；在波幅差异和异常面积方面，12例（70.6%）显示有差异。在23例仅有神经根病主观症状的患者中，针极肌电图有异常的有9例（39.1%），而脊髓神经刺激显示波幅差异异常者有18例（78.3%），异常面积差异者有15例（65.2%）。直接脊髓神经刺激被认为是诊断腰骶神经根病的一种客观且敏感的检查方法。
