正常人及非特异性腰痛患者脊神经后支的体感诱发电位

Somatosensory evoked potentials of posterior ramus of spinal nerve in normal humans and patients with non-specific low back pain

目的 探讨非特异性腰痛的产生机制。方法 遵循随机、双盲、对照的原则，测定了18例正常人和33例非特异性腰痛患者L1至L3脊神经后支（PRSN）的皮层体感诱发电位（CSEP）。采用绝缘针电极，透视下经皮穿刺达脊神经后支干部的远端进行刺激，于皮层体感代表区记录电位值。结果 正常人PRSN的CSEP的潜伏期和波幅双侧对比无显著差异。非特异性腰痛患者邵氏点（主诉痛区上溯三节段，同侧横突根部的压痛点）处PRSN的CSEP的潜伏期较对侧延长，波幅较对侧降低，波形有缺失、离散、反相等改变；而非邵氏点水平双侧对比无显著差异。结论 非特异性腰痛很可能是由PRSN主干部受机械刺激所致。

Objective To explore the mechanism of non-specific low back pain (NLBP). Method A random, double blind and controlled test has been finished. Cerebral somatosensory evoked potentials (CSEP) of L1-L3 posterior rami of spinal nerves (PRSN) were determined in 18 normal volunteers and 33 patients with NLBP. Guided by fluoroscopy, an insulated stimulating electrode was inserted to the end of the stem part of PRSN, then stimulation (10 mA, 0.2 ms currents) was sent. Recording electrodes were located in contralateral sculp corresponding to the special cerebral cortex of somatosensory area. Results There was no significant difference between two sides in normal peoples. While in the patients, the CSEP of PRSN in the Shao's points (two to three segments above the chief pain area) reveal an delayed latency and reduced amplitude compared with the contralateral side. The curves were often distorted. However, there are no significant differences between 2 sides in other level in NLBP patients. Conclusion Mechanical stimulations to the stem part of PRSN might cause NLBP.