Ertekin C, Nejat R S, Sirin H, Selçuki D, Arac N, Ertaş M, Colakoğlu Z
Department of Neurology, Ege University, Medical School Hospital Bornova, Izmir, Turkey.
Clin Neurol Neurosurg. 1994 May;96(2):124-9. doi: 10.1016/0303-8467(94)90045-0.
Electrical stimulation (ES) of lumbosacral nerve roots using a needle electrode inserted to the laminar level at the midline of Th12-L1 or L1-2 intervertebral interspace, was compared with magnetic stimulation using a 9-cm diameter coil (MCS) at the L3-4 or L4-5 spine levels, Compound muscle action potentials (CMAP) were superficially recorded from homologous muscles in both sides in 15 normal control subjects and in 20 patients with lumbosacral radiculopathy. Soleus muscles were used for S1, tibialis anterior (TA) for L5, and rectus femoris (RF) muscles for L4 roots. According to the clinical or radiological diagnosis (CAT, MRI and/or myelography) conventional needle EMG was capable to localise the root lesion in 16 of 20 patients (80%) and ES localised the root involvement in 18 of 20 patients (90%); the diagnostic value of MCS was lower, about 65% (13 of 20 patients). Although ES is uncomfortable and invasive, it is superior to needle EMG in localising unilateral or multiple lumbosacral root involvement. At present, MCS is not suitable for the diagnosis of lumbar radiculopathy.
将针电极插入胸12与腰1或腰1与腰2椎间隙中线的椎板水平，对腰骶神经根进行电刺激（ES），并与在腰3与腰4或腰4与腰5脊柱水平使用直径9厘米的线圈进行磁刺激（MCS）相比较。在15名正常对照受试者和20名腰骶神经根病患者中，从双侧同源肌肉表面记录复合肌肉动作电位（CMAP）。比目鱼肌用于检测S1神经根，胫前肌（TA）用于检测L5神经根，股直肌（RF）用于检测L4神经根。根据临床或放射学诊断（计算机断层扫描、磁共振成像和/或脊髓造影），传统针极肌电图能够在20例患者中的16例（80%）定位根性病变，电刺激能够在20例患者中的18例（90%）定位根性受累；磁刺激的诊断价值较低，约为65%（20例患者中的13例）。尽管电刺激会带来不适且具有侵入性，但在定位单侧或多发性腰骶神经根受累方面优于针极肌电图。目前，磁刺激不适用于腰椎神经根病的诊断。
