Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, R-House, Floor 7, SE-431 80 Mölndal, Gothenburg, Sweden.
The Carl Todd Clinic, 5 Pickwick Park, Park Lane, Corsham, SN13 0HN, UK.
J Orthop Surg Res. 2020 Apr 17;15(1):155. doi: 10.1186/s13018-020-01652-3.
Simultaneous measurement of electromyography (EMG) and local muscle oxygenation is proposed in an isometric loading model adjusted for patients that have undergone spinal surgery.
Twelve patients with degenerative lumbar spinal stenosis (DLSS) were included. They were subjected to a test protocol before and after surgery. The protocol consisted of two parts, a dynamic and an isometric Ito loading with a time frame of 60 s and accompanying rest of 120 s. The Ito test was repeated three times. EMG was measured bilaterally at the L4 level and L2 and was recorded using surface electrodes and collected (Biopac Systems Inc.). EMG signal was expressed as RMS and median frequency (MF). Muscle tissue oxygen saturation (MrSO) was monitored using a near-infrared spectroscopy (NIRS) device (INVOS® 5100C Oxymeter). Two NIRS sensors were positioned bilaterally at the L4 level. The intensity of the leg and back pain and perceived exertion before, during, and after the test was evaluated with a visual analogue scale (VAS) and Borg RPE-scale, respectively.
All patients were able to perform and complete the test protocol pre- and postoperatively. A consistency of lower median and range values was noted in the sensors of EMG1 (15.3 μV, range 4.5-30.7 μV) and EMG2 (13.6 μV, range 4.0-46.5 μV) that were positioned lateral to NIRS sensors at L4 compared with EMG3 (18.9 μV, range 6.5-50.0 μV) and EMG4 (20.4 μV, range 7.5-49.0 μV) at L2. Right and left side of the erector spinae exhibited a similar electrical activity behaviour over time during Ito test (60 s). Regional MrSO decreased over time during loading and returned to the baseline level during recovery on both left and right side. Both low back and leg pain was significantly reduced postoperatively.
Simultaneous measurement of surface EMG and NIRS seems to be a promising tool for objective assessment of paraspinal muscle function in terms of muscular activity and local muscle oxygenation changes in response to isometric trunk extension in patients that have undergone laminectomy for spinal stenosis.
在为接受过脊柱手术的患者调整的等长加载模型中，提出了同时测量肌电图（EMG）和局部肌肉氧合的方法。
纳入 12 例退行性腰椎管狭窄症（DLSS）患者。他们在术前和术后接受了测试方案。该方案包括两部分，即 60s 的动态和等长 Ito 加载，以及 120s 的伴随休息。Ito 测试重复了三次。在 L4 水平双侧使用表面电极测量 EMG，并使用 Biopac Systems Inc. 进行记录。EMG 信号表示为均方根值（RMS）和中值频率（MF）。使用近红外光谱（NIRS）设备（INVOS®5100C 血氧计）监测肌肉组织氧饱和度（MrSO）。两个 NIRS 传感器在 L4 水平双侧定位。使用视觉模拟量表（VAS）和 Borg RPE 量表分别评估腿部和背部疼痛以及测试前后的感知用力强度。
所有患者均能够进行并完成术前和术后的测试方案。在 L4 水平，与 EMG3（18.9μV，范围 6.5-50.0μV）和 EMG4（20.4μV，范围 7.5-49.0μV）相比，位于 NIRS 传感器外侧的 EMG1（15.3μV，范围 4.5-30.7μV）和 EMG2（13.6μV，范围 4.0-46.5μV）的传感器显示出较低的中位值和范围值。在 Ito 测试（60s）期间，右侧和左侧竖脊肌随时间表现出相似的电活动行为。在加载过程中，MrSO 随时间逐渐下降，在左侧和右侧的恢复期间均恢复到基线水平。术后腰痛和腿痛均显著减轻。
表面 EMG 和 NIRS 的同时测量似乎是一种有前途的工具，可用于评估接受椎管狭窄症减压术后患者脊柱伸展等长运动时脊柱旁肌肉功能，包括肌肉活动和局部肌肉氧合变化。
