经颅磁刺激运动诱发电位评价神经根型颈椎病射频治疗疗效的临床研究

A clinical study of transcranial magnetic stimulation motor evoked potential in evaluation of radiofrequency tthheerraapy for cervical spondylotic radicular disease

目的:观察经颅磁刺激运动诱发电位(TMS-MEP)评价神经根型颈椎病射频治疗疗效的作用,以探讨经颅磁刺激运动诱发电位在判断神经根型颈椎病治疗疗效的应用价值。方法:选取2013年12月~2017年12月本院康复医学科住院的神经根型颈椎病患者30例作为治疗组,健康成年人(对照组)20例。研究组进行颈椎间盘射频热凝术治疗,测定两组头部、C7、臂丛、Erb’s点及肘点诱发电位潜伏期、中枢运动传导时间(CMCT),同时用颈椎病临床评价量表(CASCS)测定研究组术前术后功能障碍程度。结果:研究组TMS-MEP潜伏期、运动传导时间较对照组延长(P<0.01);研究组术后功能障碍指数及诱发电位潜伏期较术前改善(P<0.01)。结论:TMS-MEP对周围神经损伤比较敏感,能较早反映神经根型颈椎病的损伤程度,可用于指导临床手术治疗和判断预后。

Objective:To observe the effect of transcranial magnetic stimulation exercise evoked potentials(TMS-MEP)on the efficacy of radiofrequency therapy for cervical spondylotic radiculopathy,Objective to investigate the value of transcranial magnetic stimulation in the diagnosis of cervical spondylosis of nerve root type.Methods:30 patients with cervical spondylosis with radiculopathy hospitalized in the department of rehabilitation medicine of our hospital from December 2013 to December 2017 were selected as the treatment group and 20 healthy adults(control group).In the treatment group,radiofrequency thermocoagulation of cervical intervertebral disc was performed,and the latency period of evoked potential at the head,C7,brachial plexus,Erb’s point and elbow point and central motor conduction time(CMCT)of the two groups were measured.Meanwhile,the degree of functional dysfunction in the treatment group before and after operation was measured by clinical evaluation scale of cervical spondylosis(CASCS).Results:The TMS-MEP latent period and the exercise conduction time of the treatment group were longer than the control group(P<0.01);Functional dysfunction index and evoked potential latency were improved in the study group before operation(P<0.01).Conclusion:TMS-MEP is sensitive to peripheral nerve injury,it can reflect the degree of injury of cervical spondylotic radiculopathy,and can be used to guide clinical operation and Judge prognosis.