深层椎旁肌肌电图在脊神经根受损中的定位价值

Diagnosis of electromyography in deep paraspinal muscles for spinal neurodokon lesion

目的 探索脊神经根受损定位诊断中的精确定位检测指标。方法 对 2 0 0例脊神经根受损患者先行传统定位检查 ,在此基础上 ,根据肢体异常肌群的根性分布等情况 ,再行相应深层椎旁肌的探查 ,同时行健侧椎旁肌的对照检查。结果 2 0 0例 473块患侧椎旁肌 10 0 %阳性 ,健侧 10 5块对照肌 10 0 %阴性。凡肢体异常肌群呈根性分布均在相应深层椎旁肌上得到了阳性验证。其中 18例轻症仅表现为患侧 5 3块椎旁肌阳性和 4个H反射的延长 ,而无其他指标的改变。结论 深层椎旁肌肌电图的阳性改变在脊神经根受损的诊断中是一个最早出现的精确定位检测指标 ,具有极高的敏感性和特异性。

Objective To explore an examined index for the convenience of the diagnosis of spinal neurodokon lesion location. Methods 200 cases with spinal neurodokon lesion were first determined by traditional location method.Then,they were examined with electromyograhpy(EMG) in deep paraspinal muscles.The outcome of EMG between the involved side and uninvolved side in paraspinal muscles was self-comparison.The uninvolved side was as control group. Results Among the 473 deep paraspinal muscles of 200 cases in involved side,the abnormal EMGs were positive(100%),the EMGs of 105 deep paraspinal muscles of uninvolved side in control group were normal(100%).But the abnomal EMGs were all presented in abnormal muscles caused by neurodokon lesion,which were corresponded with deep paraspinal muscles.Among them,abnormal EMGs and delay of H-reflex were only found in 53 paraspinal muscles of 18 milder cases without any index changes. Conclusion It is shown that the EMG test in deep paraspinal muscles is sensitive,specific and early determinative location method for diagnosis of neurodokon lesion,it is also an examined index in evaluation of neurodokon lesion location.