选择性脊神经后根切断术中神经小束电刺激阈值的临床分析

CLINICAL ANALYSIS OF ELECTRICAL STIMULATION THRESHOLD OF NERVE FASCICLE DURING SELECTIVE POSTERIOR RHIZOTOMY/

研究选择性脊神经后根切断术（ｓｅｌｅｃｔｉｖｅｐｏｓｔｅｒｉｏｒｒｈｉｚｏｔｏｍｙ，ＳＰＲ）中，电刺激阈值观察与肢动收缩直接观察法区别肌梭传入纤维的可行性，并探索神经小束的电刺激阈值与痉挛的临床关系。对３６例ＳＰＲ中使用电刺激阈值法所取得各脊神经后根内的神经小束的电刺激阈值进行统计学处理，分析彼此间的联系和可能的临床意义。结果表明：在ＳＰＲ术中所切断的神经小束与保留束的电刺激阈值有高度显著性差异，每一神经根内切断神经小束与保留神经小束的电刺激阈值亦有显著差异。证明，用脊神经后根内神经小束的电刺激阈值方法来施行ＳＰＲ简单、可靠。

This experiment was to study the feasibility from direct observation of muscle contraction of the lower extremity from electrical stimulation threshold of nerve fascicle in identifying the Iα intrafusal afferent fibers during selective posterior rhizotomy (SPR) and to investigate the clinical relationship between the muscle spasm and the electrical stimulation of nerve fascicles. The electrical stimulation threshold of all nerve fascicles in 36 cases during SPR were analysed statistically. The results showed that there was a significant difference between the electrical stimulation threshold of the severed nerve fascicles and intact nerve fascicles no matter the nerve root or each posterior nerve rootlet was examined. It was simple and reliable for surgeons to identify correctly the Iα intrafusal afferent fibers intraoperatively from direct observation of the electrical stimulation threshold of nerve fascicle.