神經根刺激檢查在腰薦部神經根病變的診斷價值

Nerve Root Stimulation in the Diagnosis of Lumbosacral Radiculopathy

張權維(Chein-Wei Chang) ； 連倚南(I-Nan Lien)

《中華民國復健醫學會雜誌》 17期 (1989/12) Pp. 1-4

https://doi.org/10.6315/JRMA.198912.0005

摘要

以直接神經根剌激方法及針肌電圖來檢查40位臨床上疑有第五腰椎或第一薦椎神經根病變的病人，用單極針插入第五腰椎及第一薦椎旁邊的深部側棘肌靠近神經根作電剌激檢查，配合肌電圖電腦程式之應用，可測得運動神經電位波的反應時間、振幅及面積，並比較其左右兩側的差異；由20位正常人對照組所得數據加上2個標準差作為判定不正常的下限標準，結果在17位臨床上有神經根病變的病人中，肌電圖有10位(58.8%)不正常，但神經根剌激檢查有16位(94.1%)振幅不正常，13位(76.5%)面積不正常，在另一組23位無神經根病變只有主觀症狀的病人中，肌電圖有9位(39.1%)不正常，但神經根剌激檢查有19位(82.6%)振幅不正常，15位(65.2%)面積不正常。由此結果，我們認為神經根剌激檢查在腰薦部神經根病變的診斷上，是一個敏感且定量化的檢查，比傳統式肌電圖更具診斷價值。

並列摘要

Direct nerve root stimulation was compared with needle electromyography (EMG) in 40 patients suspected with L5 or S1 radiculopathy. Monopolar needle inserted into deep paraspinal muscles was used for the nerve root stimulation. The minimal latency, amplitude and area of negative phase of compound muscle action potential from myotomal muscles were recorded with an assistance of a computer program. Significant abnormality was considered in patients more than 2SD from control mean values. In 17 patients with a clinical evidence of radiculopathy, needle EMG wes abnormal in 10(58.8%)but nerve stimulation test showed an abnormal amplitude difference in 16(94.1%)and an abnormal area difference in 13 (76.5%). In 23 patients with only subjective symptoms of radiculopathy, needle EMG was abnormal in 9(39.1%), while there were 19(82.6%) with abnormal amplitude difference and 15(65.2%)with abnormal area difference by nerve root stimulation. Direct berve root stimulation is recognized as sensitive test in the diagnosis of lumbosacral radiculopath.

並列關鍵字

nerve root simulation ； radiculopathy