125例退行性腰椎管狭窄症患者的神经电生理学表现

The electroneurophysiological feature of 125 patients with degenerative lumbar spinal stenosis

目的：根据腰椎管狭窄症（LSS）患者的神经电生理学表现来推断神经根受压程度的可行性。方法：对125例I．SS患者行双下肢胫神经、腓总神经、腓肠神经的传导速度（NCV）、F波、H反射，以及双下肢肌肉及椎旁肌进行肌电图（EMG）检查，然后按神经传导动作电位波幅和肌肉的神经原性损害分成正常组、轻度异常组和重度异常组。结果：神经电生理检查正常27例；轻度异常44例，表现为周围神经复合肌肉动作电位（cMAP）波幅轻度异常和（或）部分肌肉神经原性损害；重度异常54例，表现为多发性周围神经CMAP波幅明显降低或未测出，下肢肌肉和多节段椎旁肌神经原性损害。结论：根据神经电生理检查可以推断神经根受压程度，指导LSS患者的治疗。EMG重度异常的LSS患者，说明其多神经根受压，损伤程度重，应及时手术，且可能术后恢复时间长。

Objective： To investigate the degree of nerve root compression according to the electroneuro physiology of patients with degenerative lumbar spimal slenosis（LSS）. Methods： EMG examination was perormed in NCV, F waves , H-refleks of the tibial nerve, common peroneal nerves and sural nerve nuero, the mus- cles of lower limbs and paravertebral muscles. Results： Normal electronervsphysiology was shown in 27cases; Mild abnormality in 44 cases： Peripheral nerve CMAP amplitude was mild abnormal,or/and part of the muscles was neurogenically damaged. Severe abnormality in 54 cases： Multiple peripheral nerve CMAP amplitude de- creased obviously,or was not checked out. and Lower limb muscles and multiple segmental vertebral muscles were neurogenic damaged; EMG examination reference the degree of nerve root compression can guide LSS clini- cal treatment. Conclusion：The patients with severely abnormal EMG need surgery in time and the postop- erative recovery needsa a long time.