Larsson R, Cai H, Zhang Q, Oberg P A, Larsson S E
Department of Orthopaedics, University Hospital, Linkoping, Sweden.
Occup Med (Lond). 1998 Apr;48(3):189-94. doi: 10.1093/occmed/48.3.189.
This study pertains to the 71 patients who had received a diagnosis of cervico-brachial pain syndrome after thorough clinical examination of a total series of 300 patients, who had been referred to the National Insurance Hospital in Tranås because of chronic neck pain that interfered with their ability to work. Changes in trapezius muscle blood flow and EMG were examined and related to the anamnesis and physical findings. The microcirculation in the upper part of the right and left trapezius muscles was examined simultaneously by using optical laser-Doppler single-fibres after insertion into the muscle directly via the skin. Continuous recordings were made during stepwise increased static contraction determined electro-myographically. Signal processing was performed on-line by computer. MRT of the cervical spine was performed in 12 patients. None showed nerve root affliction. Ten showed a bulging intervertebral disc and two, a narrowed nerve hole (lateral stenosis). The muscle blood flow (LDF) was significantly lower in the most painful side compared with the opposite side in the group of 41 patients with predominantly unilateral pain (21 women and 20 men). A lowered blood flow was also found when the 21 females in this group was compared with a normal control group of 20 healthy women. The patients had lower rms-EMG and EMG mean power frequency (MPF) in the painful side compared with the opposite side. A further lowering of the MPF was observed with induced fatigue. It was concluded that the chronic neck pain in cervico-brachial syndrome can become visualized by the finding of lowered blood flow of the trapezius muscle which seems to be an expression of the chronic neck pain.
本研究涉及71例患者，这些患者在对总共300例因慢性颈部疼痛影响工作能力而被转诊至特拉纳斯国家保险医院的患者进行全面临床检查后，被诊断为颈臂痛综合征。研究检查了斜方肌血流量和肌电图的变化，并将其与病史及体格检查结果相关联。通过使用光学激光多普勒单纤维，经皮肤直接插入左右斜方肌上部，同时检查其微循环。在通过肌电图测定逐步增加静态收缩的过程中进行连续记录。信号处理由计算机在线完成。对12例患者进行了颈椎磁共振成像检查。均未显示神经根受累。10例显示椎间盘膨出，2例显示神经孔狭窄（侧隐窝狭窄）。在41例以单侧疼痛为主的患者（21名女性和20名男性）中，最疼痛一侧的肌肉血流量（激光多普勒血流仪测量值）显著低于对侧。将该组中的21名女性与20名健康女性的正常对照组进行比较时，也发现血流量降低。与对侧相比，患者疼痛侧的均方根肌电图和肌电图平均功率频率较低。随着疲劳诱发，平均功率频率进一步降低。得出的结论是，颈臂综合征中的慢性颈部疼痛可通过斜方肌血流量降低这一发现显现出来，这似乎是慢性颈部疼痛的一种表现。
