无骨折脱位型颈髓损伤患者短潜伏期体感诱发电位及F波与神经功能的相关性分析

Analysis of the correlation between short latency somatosensory evoked potentials as well as F waves and neurological function in patients with cervical spinal cord injury without fracture and dislocation

目的:探讨无骨折脱位型颈髓损伤(CSCI)患者短潜伏期体感诱发电位(SLSEP)及F波与脊髓损害程度的相关性。方法:对确诊为CSCI的32例患者进行分析,另选取20例正常志愿者作为对照组。记录两组的双上肢正中神经SLSEP、双下肢胫神经SLSEP、双上肢正中神经F波、双上肢尺神经F波检测结果,同时对两组结果进行比较。所有患者记录入院时颈椎MRI脊髓损伤信号长度,以及采用美国脊髓损伤协会A-SIA神经功能分级及运动评分对神经功能进行评价。最后对患者组进行SLSEP、F波与MRI脊髓损伤信号长度.A-SIA运动评分的相关性进行分析。结果:下肢P40潜伏期、P40波幅、上肢N20潜伏期、N20波幅、正中神经F波、尺神经F波在两组中的差异均有统计学意义;患者组P40潜伏期延长、P40波幅下降、N20潜伏期延长、N20波幅下降及正中神经、尺神经F波潜伏期延长与MRI脊髓损伤信号长度、A-SIA运动评分有相关性。结论:CSCI患者SEP、F波异常与伤后神经功能损害程度相关,联合MRI、临床运动功能评估,是对感觉、运动系统神经功能检测的补充。

Objective: To investigate the correlation between short latency somatosensory evoked potential (SLSEP) as well as F waves and spinal cord injury in patients with cervical spinal cord injury (CSCI) without fracture and dislocation. Methods: Thirty-two patients with CSCI without fracture and dislocation were analyzed, along with other 20 normal volunteers selected as the control group. The detection results o￡ SLSEP of the upper limbs, the SLSEP of the lower extremity, the F waves of the median nerves of the upper limbs, and the F waves of the upper limb ulnar nerves in the two groups were recorded , and the comparison of the results between them was conducted. The signal length of the cervical spine MRI spinal cord injury for all patients were recorded and observed for the neurological grading and the evaluation of neurological function based on the American Spinal Cord Injury Association (A-SIA). Finally, the correlative analysis of SLSEP, F waves and MRI spinal cord injury signal length and A-SIA exercise scores was performed in the patient group. Results: There was statistical significance between the two groups in P40 latency, P40 amplitude, upper limb N20 latency, N20 amplitude, median nerve F waves and ulnar nerve F waves in the lower limbs;There was correlation between the prolonging of P40 latency, the decrease of P40 amplitude, and the prolonging of N20 latency, the decrease of N20 amplitude, the prolonging of median nerve F waves as well as ulnar nerve F waves and MRI spinal cord injury signal length and A-SIA motor scores. Conclusion: SEP and F waves abnormalities in patients with CSCI without fracture and dislocation are related to post-injury neurological function. Combination between MRI and clinical motor function assessment serves as a supplement for neurological functions of the sensory and motor system .