Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Ann Palliat Med. 2021 Jun;10(6):7069-7072. doi: 10.21037/apm-20-1699. Epub 2021 Feb 2.
The obturator nerve lies deep within the pelvis, and it can be damaged by direct injury during surgery. In this study, nerve conduction was used to confirm an obturator nerve injury in a patient who presented with hip adductor weakness following gynecological surgery for endometrial cancer. A 56-year-old woman complained of weakness in the right adductor muscles after a laparoscopic hysterectomy due to endometrial cancer. Seven days after surgery, the degree of weakness of the right hip adductor was Medical Research Council (MRC) Scale 1; thus, a nerve conduction velocity test was conducted. To obtain the compound muscle action potentials of the obturator nerve, stimulation was performed (1.5 cm inferior and 1.5 cm lateral to the pubic tubercle) with a surface electrical simulator and recording (midpoint of the right medial thigh) of the adductor muscles. The compound muscle action potentials of the right obturator nerve showed lower amplitude (left side: 2.7 mV vs. right side: 0.3 mV) and delayed onset latency (left side: 3.2 ms vs. right side: 2.2 ms). These results indicate a partial right obturator neuropathy. Therefore, nerve conduction could be useful to diagnose an early-stage obturator nerve injury and provide information on the degree of damage.
闭孔神经位于骨盆深处，手术过程中可因直接损伤而受损。在这项研究中，神经传导用于确认一名因子宫内膜癌行妇科手术的患者出现闭孔神经损伤，该患者术后出现髋关节内收肌无力。一名 56 岁女性因子宫内膜癌行腹腔镜子宫切除术，术后 7 天出现右侧内收肌无力。右侧髋关节内收肌无力程度为医学研究委员会（MRC）量表 1 级，因此进行了神经传导速度测试。为了获得闭孔神经的复合肌肉动作电位，使用表面电模拟器对耻骨结节下 1.5 厘米和外侧 1.5 厘米处进行刺激，并记录（右侧大腿内侧中点）内收肌的复合肌肉动作电位。右侧闭孔神经的复合肌肉动作电位幅度较低（左侧：2.7 mV，右侧：0.3 mV），起始潜伏期延迟（左侧：3.2 ms，右侧：2.2 ms）。这些结果表明右侧闭孔神经部分病变。因此，神经传导对于诊断早期闭孔神经损伤和提供损伤程度的信息可能是有用的。
