肌电图检查对颈椎间盘突出症的诊断价值

The diagnostic value of electromyogram to the protrusion of cervical intervertebral disc

目的：颈椎间盘突出症为临床常见病，为准确定位依断，我们采用由单一脊神经后支支配的颈棘间肌等颈部深层肌群肌电图检查法，对颈椎间盘突出症患者进行定位诊断。方法：对３４ 例经临床和影像学检查确认为颈椎间盘突出的患者，进行颈部深层肌肌电图测定。结果：与临床及影像学诊断的符合率为９７ ％ 。颈部深层肌异常电位３３ 例，其中失神经电位２８ 例，阳性率８ ２３ ％ 。 Ｃ５ ～６ 椎间盘突出为好发部位，其肌电图异常电位发生率也最高。结论：异常电位的出现与临床症状的轻重有紧密的关系，失神经电位与手／ 臂／ 肩麻木的符合率为８２３ ％ ； 异常电活动与颈、肩、背痛的符合率为９７ ％ ， 且随着电活动的减少，患者疼痛也相应减轻。说明这是一项定量的、无损伤性的定位诊断检查法。

Aim:The protrusion of cervical intervertebral disc a the commomly encountered disase.For precise level diagnosis,we used electromyogram(EMG) to examine splenius muscle of neck and semispinal muscle of neck,which are dominated by single motor branch of posterior ramus of spinal nerve.Methods:34 patients with protrusion of cervical intervertebral disc whose diagnoses were confirmed by clinical and image examination were examined by EMG of deep layer muscle of neck.Results:The coincidence rate of the results of EMG and clinical diagnosis was 97%.33 patients presented abnormal potential in deep layer muscle of neck,28 patients presented denervate potential.The positive rate was 82.3%.C 5～6 was the predilection site of protrusion disc,and the incidence rate of abnormal potential was the highest in all sites.Conclusions:The occurrence of abnormal potential was closely related with seriousness of clinical symptoms.The coincidence rate of denervate potential and hand/arm/shoulder numbness was 82.3%;that of abnormal potential and neck/shoulder/back pain was 97%.With decrease of potential,pain was abated.These results suggest that EMG is an quantitative and intact method for level diagnosis.