上腰椎狭窄的电诊断特征：神经水平与结构水平的差异。
Electrodiagnostic characteristics of upper lumbar stenosis: Discrepancy between neurological and structural levels.
机构信息
Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea.
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
出版信息
Muscle Nerve. 2020 May;61(5):580-586. doi: 10.1002/mus.26844. Epub 2020 Mar 7.
BACKGROUND
Radiculopathies caused by spinal stenosis in the upper lumbar spinal canal (L1/2, L2/3, L3/4) have not been comprehensively investigated.
METHODS
This retrospective study reviewed 14 patients from a tertiary hospital outpatient clinic. The inclusion criteria were upper lumbar stenosis seen on MRI and radiculopathies with active denervation confirmed on electromyography. Patients with any other conditions that could explain the clinical or electrophysiological manifestations were excluded.
RESULTS
Neurogenic findings were predominantly observed in L5 or S1 myotomes on electromyography. Abnormal spontaneous activity was observed in distal muscles in all patients and in proximal muscles in eight patients. Axonal involvement was bilateral in 10 patients and unilaterally in 4 patients. MRI showed redundant nerve roots in 13 patients with chronic reinnervation on electromyography.
CONCLUSIONS
Upper lumbar spinal stenosis usually causes L5 or S1 radiculopathies with diverse patterns. This discrepancy may cause diagnostic confusion.
背景
上腰椎椎管（L1/2、L2/3、L3/4）的狭窄引起的根性病变尚未得到全面研究。
方法
本回顾性研究纳入了来自一家三级医院门诊的 14 名患者。纳入标准为 MRI 显示上腰椎狭窄，肌电图证实存在活动性失神经支配的根性病变。排除任何其他可能解释临床或电生理表现的疾病。
结果
肌电图显示 L5 或 S1 肌节主要存在神经源性表现。所有患者的远端肌肉均存在异常自发性活动，8 名患者的近端肌肉也存在异常。10 名患者的轴索受累为双侧，4 名患者为单侧。MRI 显示 13 名患者的神经根冗余，肌电图显示慢性再支配。
结论
上腰椎狭窄通常引起 L5 或 S1 的根性病变，表现多样。这种差异可能导致诊断混淆。
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