TMS-MEP在脊髓型颈椎病诊断中的意义

TMS- MEP in Diagnosis of Cervical Spondylotic Myelopathy

作者总结５５例ＣＳＭ经手术治疗和ＭＥＰ检测双侧拇短展肌、小指展肌及胫前肌共３３０块靶肌ＭＥＰ结果，肌力正常９６块，其靶肌ＭＥＰ正常８３块，轻度异常７３块；明显异常１７４块；肌力异常２４７块。其靶肌ＭＥＰ绝大多数明显异常或消失，平均每例有两块以上靶肌ＭＥＰ异常占１００％；靶肌肌力正常与否与ＭＥＰ结果总符合率为９０．６％，Ｐ＜０．００５；按病情轻、中、重划分，其靶肌ＭＥＰ异常率分别为３１．６％、７４．６％和９４．６％。本组４９例获术后３周～２年（平均１．２年）复查：靶肌肌力和ＭＥＰ均比术前明显恢复或正常；其中１１例术后５～１０天复查，ＭＥＰ恢复的时间和程度均比靶肌肌力的恢复早和明显。因此，ＭＥＰ测定能对ＣＳＭ的脊髓损害作出直接、准确的诊断。

otor evoked potential transcranial magnetic stimulation (TMS- MEP) was used in cervical spondylotic myelopathy (CSM)confirmed by MRI to determine its diagnosis and prognosis values.330 muscles of 55 patients including abductor pollicis brevis and abductor digiti minimi in the upper limb and tibialis anterior in the lower limb were measured by TMS- MEP.The results showed that TMS- MEP was normal in 83, slight abnornmal in 73 and obviously abnormal or even disappeared in 247. The correlation rate between TMS- MEP and muscle strenght was 90.6% (P >0.005).Forty- nine patients were followed up for an average of 1.2 years. TMS- MEP and muscle strength restored obviously in 134 muscles of 27 patinets with disappearance of TMS- MEP. The restoration of TMS- MEP was more rapid than that of the muscle strength. the authors considered that TMS- MEP is very senstive , accurate and reliable method in both diagnosis and prognosis of CSM.