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应用多模态脊髓诱发电位和神经学发现评估 C4-C5 压迫性颈脊髓病中的脊髓相对脆弱性。

Assessment of spinal cord relative vulnerability in C4-C5 compressive cervical myelopathy using multi-modal spinal cord evoked potentials and neurological findings.

机构信息

Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.

出版信息

J Spinal Cord Med. 2021 Jul;44(4):541-548. doi: 10.1080/10790268.2019.1617920. Epub 2019 Jun 10.


DOI:10.1080/10790268.2019.1617920
PMID:31180810
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8288130/
Abstract

The correlation between the progression of spinal cord lesions using spinal cord evoked potentials (SCEPs) and neurological findings are unclear. The purpose is to electrophysiologically evaluate relative vulnerability of spinal cord in patients with compressive cervical myelopathy (CCM) at C4-C5 intervertebral level using SCEPs and correlate the progression of spinal cord lesions with neurological findings. Retrospective study. Yamaguchi University Hospital. 36 patients. SCEPs following median nerve stimulation (MN-SCEPs), ulnar nerve stimulation (UN-SCEPs), transcranial electric stimulation (TCE-SCEPs), and spinal cord stimulation (SC-SCEPs) were intraoperatively recorded. MN-SCEPs are mediated by posterior horns (4, 5 layers), UN-SCEPs by the Burdach tract, TCE-SCEPs by the lateral corticospinal tract, and SC-SCEPs by the Goll tract. We evaluated the neurological findings (numbness, tactile sense and pain sense in the C6 area, tactile sense in the lower extremities, and triceps tendon reflex [TTR]). The incidence of electrophysiological and clinical abnormalities decreased in the order of UN-SCEPs (100%), TCE-SCEPs (94.4%), MN-SCEPs (77.8%), and SC-SCEPs (69.4%), and in the order of numbness (100%), pain sense (97.2%), TTR (91.7%), tactile sense in the C6 area (83.3%), and tactile sense in the lower extremities (70.0%), respectively. The relative vulnerability of spinal cord occurred in the order of the Burdach tract, the lateral corticospinal tract, posterior horns (4, 5 layers), and the Goll tract in most patients with CCM at the C4-C5 intervertebral level.

摘要

脊髓诱发电位(SCEPs)检测到的脊髓病变进展与神经学发现之间的相关性尚不清楚。本研究旨在通过 SCEPs 对 C4-C5 颈椎水平的压迫性颈髓病(CCM)患者的脊髓相对易损性进行电生理评估,并将脊髓病变的进展与神经学发现相关联。回顾性研究。日本山口大学医院。36 例患者。正中神经刺激(MN-SCEPs)、尺神经刺激(UN-SCEPs)、经颅电刺激(TCE-SCEPs)和脊髓刺激(SC-SCEPs)术中记录 SCEPs。MN-SCEPs 由后角(4、5 层)介导,UN-SCEPs 由 Burdach 束介导,TCE-SCEPs 由外侧皮质脊髓束介导,SC-SCEPs 由 Goll 束介导。我们评估了神经学发现(C6 区麻木、触觉和痛觉、下肢触觉和三头肌腱反射[TTR])。电生理和临床异常的发生率依次为 UN-SCEPs(100%)、TCE-SCEPs(94.4%)、MN-SCEPs(77.8%)和 SC-SCEPs(69.4%),麻木(100%)、痛觉(97.2%)、TTR(91.7%)、C6 区触觉(83.3%)和下肢触觉(70.0%)。在 C4-C5 颈椎水平的 CCM 患者中,脊髓的相对易损性依次为 Burdach 束、外侧皮质脊髓束、后角(4、5 层)和 Goll 束。

相似文献

[1]
Assessment of spinal cord relative vulnerability in C4-C5 compressive cervical myelopathy using multi-modal spinal cord evoked potentials and neurological findings.

J Spinal Cord Med. 2021-7

[2]
Relative vulnerability of various spinal tracts in C3-4 cervical spondylotic myelopathy: multi-modal spinal cord evoked potentials.

Spinal Cord. 2011-7-5

[3]
Use of Central Motor Conduction Time and Spinal Cord Evoked Potentials in the Electrophysiological Assessment of Compressive Cervical Myelopathy.

Spine (Phila Pa 1976). 2017-6-15

[4]
Correlation Between Spinal Cord Function Assessed by Intraoperative SCEPs and Morphology of the Compressed Spinal Cord on MRI.

Clin Spine Surg. 2016-12

[5]
Cortical activity after stimulation of the corticospinal tract in the spinal cord.

Clin Neurophysiol. 2016-2

[6]
The radiological characteristics associated with the development of myelopathy due to ossification of the posterior longitudinal ligaments at each responsible level based on spinal cord evoked potentials.

Clin Neurol Neurosurg. 2020-7

[7]
Corticospinal tract conduction block results in the prolongation of central motor conduction time in compressive cervical myelopathy.

Clin Neurophysiol. 2006-3

[8]
Selective laminoplasty after the preoperative diagnosis of the responsible level using spinal cord evoked potentials in elderly patients with cervical spondylotic myelopathy: a preliminary report.

J Spinal Disord Tech. 2009-12

[9]
Significant correlation between corticospinal tract conduction block and prolongation of central motor conduction time in compressive cervical myelopathy.

J Neurol Sci. 2007-5-15

[10]
A correlation between magnetic resonance imaging and electrophysiological findings in cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2001-7-1

引用本文的文献

[1]
Volume conductor models for magnetospinography.

Sci Rep. 2025-7-19

[2]
Resting-state functional magnetic resonance imaging indices are related to electrophysiological dysfunction in degenerative cervical myelopathy.

Sci Rep. 2024-1-29

[3]
Isolating Neurologic Deficits in Cervical Spondylotic Myelopathy: A Case-Controlled Study, Using the NIH Toolbox Motor Battery.

Neurol Clin Pract. 2023-4

本文引用的文献

[1]
Degenerative Cervical Myelopathy: Epidemiology, Genetics, and Pathogenesis.

Spine (Phila Pa 1976). 2015-6-15

[2]
C8 and T1 innervation of forearm muscles.

Clin Neurophysiol. 2015-4

[3]
Global maps of non-traumatic spinal cord injury epidemiology: towards a living data repository.

Spinal Cord. 2013-1-15

[4]
Biomechanical analysis of cervical spondylotic myelopathy: the influence of dynamic factors and morphometry of the spinal cord.

J Spinal Cord Med. 2012-7

[5]
Relative vulnerability of various spinal tracts in C3-4 cervical spondylotic myelopathy: multi-modal spinal cord evoked potentials.

Spinal Cord. 2011-7-5

[6]
Biomechanical study of the effect of degree of static compression of the spinal cord in ossification of the posterior longitudinal ligament.

J Neurosurg Spine. 2010-3

[7]
A decade of functional brain imaging applied to bladder control.

Neurourol Urodyn. 2010

[8]
Spinal cord mechanisms of pain.

Br J Anaesth. 2008-7

[9]
Neurologic level diagnosis of cervical stenotic myelopathy.

Spine (Phila Pa 1976). 2006-5-20

[10]
Usefulness of neurological examination for diagnosis of the affected level in patients with cervical compressive myelopathy: prospective comparative study with radiological evaluation.

J Neurosurg Spine. 2005-5

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