Heffernan L P
Arch Phys Med Rehabil. 1979 Apr;60(4):170-4.
Differentiation between peroneal palsy and L5 radiculopathy poses a diagnostic challenge. However, clinical weakness of the tibialis posterior muscle indicates that the involvement must lie outside the peroneal territory, potentially at a radicular level. Electromyographically this muscle should provide similar information but it has been relatively ignored, possibly for reasons of presumed inaccessibility. A retrospective study was undertaken to delineate the potential electrical discriminatory value of this muscle. Patients selected were those with clinical evidence of lower extremity neurogenic dysfunction in whom needle electrode examination had been performed on the tibialis posterior as well as other posterior and anterior compartment musculature. The parameters measured were the presence of abnormal spontaneous activity suggestive of denervation plus neurogenic motor unit alterations. Abnormalities were detected in the tibialis posterior which were reflected equally in the anterior but not posterior compartment muscles, indicating a shared L5 radicular innervation. Thus this muscle represents a useful source of electrical information assisting in the differentiation between peroneal and radicular dysfunction.
腓总神经麻痹与L5神经根病的鉴别诊断颇具挑战。然而，胫后肌的临床无力表明病变肯定不在腓总神经支配区域内，可能处于神经根水平。从肌电图角度看，该肌肉应能提供类似信息，但相对被忽视了，可能是因为推测难以检测到。开展了一项回顾性研究以明确该肌肉潜在的电鉴别价值。入选患者为有下肢神经源性功能障碍临床证据且已对胫后肌以及其他后室和前室肌肉进行针电极检查的患者。所测量的参数包括提示失神经的异常自发电活动以及神经源性运动单位改变的存在情况。在胫后肌检测到异常，在前室肌肉中同样有反映，但后室肌肉中未出现，表明存在共同的L5神经根支配。因此，该肌肉是有助于鉴别腓总神经和神经根功能障碍的有用电信息来源。
