脑瘫手术中肌电图监测的应用

Application of electromyography in selective posterior rhizotomy for spastic cerebral palsy

目的探讨肌电图(EMG)监测在选择性脊神经后根切断术(SPR)治疗痉挛性脑瘫中的作用。方法对34例痉挛性脑瘫病人施行SPR手术,对下肢多组肌群采用EMG监测,观察刺激脊神经后根小束时肌肉出现运动反应的阈值及肌肉收缩范围。结果对后根小束进行电刺激时,肌肉收缩可局限于该神经根节段支配的肌群,也可扩散到同侧或对侧的其他肌群。结论EMG对提高手术效果,探讨手术中电生理监测方法的科学性,研究电生理标准与疗效的关系等,均能提供有益的帮助。

Objective To assess the value of electromyography (EMG) in selective posterior rhizotomy (SPR) for spastic cerebral palsy. Methods Thirty-four patients with spastic cerebral palsy underwent SPR from L2 to S1 under monitoring with EMG recorded from the muscles of both lower limbs. The threshold intensity of electrical stimulation to the spinal rootlets and patterns of sustained responses were also investigated. Results Upon stimulation of the spinal rootlet, responses could be recorded immediately either from the muscle groups in association with the stimulated rootlet, or from the ipsilateral and contralateral muscle groups in the lower limbs. Conclusions EMG recordings may help improve the effects of SPR and evaluate the reliability of electrophysiological methods, which may also provide valuable assistance in investigating the relations between the electrophysiological criteria and the therapeutic effects of the operation.