Department of Physical Medicine and Rehabilitation, University of Washington, Seattle, Washington.
Department of Plastic and Reconstructive Surgery, University of Washington, Seattle, Washington.
Muscle Nerve. 2019 Nov;60(5):595-597. doi: 10.1002/mus.26684. Epub 2019 Sep 4.
In this study we aimed to determine whether needle electromyographic assessment of voluntary motor unit recruitment in traumatic brachial plexus injuries could predict spontaneous motor recovery.
A retrospective study was performed on patients with brachial plexus injury affecting deltoid, supraspinatus/infraspinatus, and biceps brachii. The outcome measure was strength on manual muscle testing at least 1 year after injury. Good outcome was considered strength >3/5 on the Medical Research Council (MRC) scale.
No muscles with no recruitment (n = 27) at 1-9 months improved to MRC 4/5 strength at a mean of 2.0 years postinjury. Twenty-five percent of muscles with discrete or severely reduced recruitment (n = 8) regained strength to >3/5 at a mean of 1.4 years postinjury (P = .047).
Absent voluntary motor unit potential recruitment at 1-9 months predicted poor prognosis for spontaneous recovery. A high percentage of patients with discrete recruitment did not improve to >3/5 strength. These patients should be considered for early nerve transfer surgery.
本研究旨在确定创伤性臂丛神经损伤中针极肌电图评估随意运动单位募集情况是否可以预测自发性运动功能恢复。
对影响三角肌、冈上肌/冈下肌和肱二头肌的臂丛神经损伤患者进行回顾性研究。主要观察指标为损伤后至少 1 年时徒手肌力测试的力量。根据医学研究委员会（MRC）量表，肌力＞3/5 被认为是良好的预后。
1-9 个月时无募集（n = 27）的肌肉在损伤后平均 2.0 年时没有恢复到 MRC 4/5 力量。25%（n = 8）离散或严重减少募集的肌肉在损伤后平均 1.4 年时恢复到＞3/5力量（P =.047）。
1-9 个月时无随意运动单位电位募集预示着自发性恢复的预后不良。有离散募集的患者中很大一部分没有恢复到＞3/5 力量。这些患者应考虑早期神经转移手术。
