Simpson R L, Fern S A
Division of Plastic and Reconstructive Surgery, Nassau County Medical Center, East Meadow, New York, USA.
Orthop Clin North Am. 1996 Apr;27(2):381-8.
Multiple compressions along a nerve have a cumulative effect on condition, both antegrade and retrograde. This nerve compromise renders the nerve more susceptible to a second source of compression. The proximal source of compression may be subclinical yet partially responsible for the cumulative compression syndrome. The primary "crush" may be anatomic or metabolic in origin. Strict attention to the patient's history and physical findings permit separation of the multiple compressions, making the choice of surgical decompression easier. Provocative testing and work simulation are important in examination, as is EMG testing. Complete medical evaluation can aid in diagnosing patients presenting with peripheral nerve compression and additional risk factors. Surgical decompression of a nerve with multiple levels of compression may not relieve all symptoms. Dynamic compressions in the work place and other nonsurgical types of compression must be identified so the prognosis for complete recovery is improved.
沿神经的多次压迫对神经状况具有顺行和逆行的累积效应。这种神经损伤使神经更容易受到第二个压迫源的影响。近端压迫源可能是亚临床的，但对累积性压迫综合征有部分责任。原发性“挤压”可能源于解剖学或代谢方面。严格关注患者的病史和体格检查结果有助于区分多次压迫，从而使手术减压的选择更容易。激发试验和工作模拟在检查中很重要，肌电图检查也是如此。全面的医学评估有助于诊断出现周围神经压迫及其他危险因素的患者。对存在多级压迫的神经进行手术减压可能无法缓解所有症状。必须识别工作场所的动态压迫和其他非手术类型的压迫，以便改善完全康复的预后。
