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成人创伤性下肢及腰骶部周围神经损伤:电诊断研究与患者症状

Traumatic lower extremity and lumbosacral peripheral nerve injuries in adults: Electrodiagnostic studies and patients symptoms.

作者信息

Babaei-Ghazani Arash, Eftekharsadat Bina, Samadirad Bahram, Mamaghany Vida, Abdollahian Saeed

机构信息

Neuromusculoskeletal Research Center, Department of Physical Medicine and Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.

Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

J Forensic Leg Med. 2017 Nov;52:89-92. doi: 10.1016/j.jflm.2017.08.010. Epub 2017 Aug 24.

Abstract

BACKGROUND

Peripheral nerve injuries (PNI) are relatively common pathologies in clinical practice. PNIs are rare in the lower extremity but have worse prognosis than those in the upper extremity. Electrodiagnostic studies could help better understanding PNIs. In this study, we aimed to evaluate the distribution of lower extremity PNI in traumatic patients in northwest of Iran.

METHODS

In this prospective study, 74 patients (62 male and 12 female with mean age of 38.39 ± 14.42 years) with possible lower or lumbosacral peripheral nerve injury were studied. Patients' demographic information and physical examination findings were recorded. Electrodiagnostic investigations including electromyography and Nerve Conduction Study were performed for all subjects.

RESULTS

Common chief complaints were pain and weakness. Impairment in the sensory function was present in 59.5% and muscle force reduction in 47.3%. PNIs were present in 23.0% and mostly were severe. Injuries in sciatic nerve were the most common PNIs (16.2%). Electrodiagnostic studies showed radiculopathy in 48.7% and plexopathy in 8.10% of cases. In 52 patients (70.3%), the physical examination findings were compatible with Electrodiagnostic studies.

CONCLUSION

Not all patients presenting with traumatic injuries have lower extremity PNIs. Due to the nature of the trauma and the anatomical course of the nerves, sciatic nerve is more susceptible to traumatic injuries.

摘要

背景

周围神经损伤(PNI)在临床实践中是相对常见的病症。下肢PNI较为罕见,但预后比上肢PNI更差。电诊断研究有助于更好地了解PNI。在本研究中,我们旨在评估伊朗西北部创伤患者下肢PNI的分布情况。

方法

在这项前瞻性研究中,对74例可能存在下肢或腰骶部周围神经损伤的患者(62例男性和12例女性,平均年龄38.39±14.42岁)进行了研究。记录患者的人口统计学信息和体格检查结果。对所有受试者进行了包括肌电图和神经传导研究在内的电诊断检查。

结果

常见的主要症状是疼痛和无力。59.5%的患者存在感觉功能障碍,47.3%的患者存在肌力下降。23.0%的患者存在PNI,且大多为重度。坐骨神经损伤是最常见的PNI(16.2%)。电诊断研究显示,48.7%的病例存在神经根病,8.10%的病例存在神经丛病。在52例患者(70.3%)中,体格检查结果与电诊断研究结果相符。

结论

并非所有创伤患者都存在下肢PNI。由于创伤的性质和神经的解剖走行,坐骨神经更容易受到创伤性损伤。

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