Tibial nerve SEPs in diagnosing lumbar spinal stenosis: The utility of segmental evaluation using P15 and N21.
Tibial nerve SEPs in diagnosing lumbar spinal stenosis: The utility of segmental evaluation using P15 and N21.
复制标题
胫神经 SEP 在诊断腰椎管狭窄症中的应用：使用 P15 和 N21 进行分段评估的实用性。
DOI：
10.1016/j.cnp.2023.03.001
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Sonoo M
中科院分区：
文献类型：
--
作者：
Matsukura K;Hokkoku K;Mukai T;Oishi C;Kanbayashi T;Takahashi T;Sonoo M
目的探讨胫神经体感诱发电位（SEP）中坐骨大孔P15电位在诊断腰椎管狭窄症（LSS）中的价值。方法回顾性分析经MRI证实的马尾或圆锥/上圆锥区LSS患者的胫神经SEP表现。记录P15和N21电位，以下结果定义为定位异常：1）P15潜伏期正常，P15-N21间期延长或N21缺失; 2）N21振幅与P15振幅的比值降低。作为非定位异常，还评价了N21和P38潜伏期。胫神经F波的结果也investigated. ResultsFrom的进入标准，包括18例，马尾病变和圆锥/上圆锥病变分别为15。在67%的患者中发现了SEP的局部异常，其敏感性显著高于延迟P38潜伏期（28%），且敏感性高于N21异常（39%），尽管这并不显著。11例感觉症状和体征均缺乏的患者中有6例观察到局部异常。14例F波检查中胫神经F波异常者占36%，SEP定位异常者占64%。P15振幅被压低4例（22%），这可能表明在LSS的背根神经节的参与，虽然它的潜伏期是正常的，甚至为这些patients.Conclusionstibial神经SEP与记录的P15和N21电位达到足够高的灵敏度在诊断LSS。他们的优势超过F-波，因为他们可以本地化病变在马尾或圆锥/上圆锥level. Significance胫神经SEPs是有前途的LSS评估，特别是在记录感觉道参与的情况下缺乏感觉症状/体征。
ObjectiveTo establish the utility of the additional evaluation of the P15 potential generated at the greater sciatic foramen in the tibial nerve somatosensory evoked potentials (SEPs) in diagnosing lumbar spinal stenosis (LSS).MethodsWe retrospectively reviewed tibial nerve SEP findings in patients having MRI-confirmed LSS at the cauda equina or conus/epiconus region. P15 and N21 potentials were recorded and the following findings were defined as localizing abnormalities: 1) normal P15 latency either with prolonged P15-N21 interval or with absent N21; 2) decreased ratio of the N21 amplitude to P15 amplitude. As non-localizing abnormalities, N21 and P38 latencies were also evaluated. Tibial nerve F-wave findings were also investigated.ResultsAccording to the entry criteria, 18 patients were included, 15 with cauda equina lesions and 3 with conus/epiconus lesions. Localizing abnormalities in SEPs were found in 67% of patients, achieving significantly higher sensitivity than delayed P38 latency (28%), and higher sensitivity than N21 abnormalities (39%), though this was not significant. Localizing abnormalities were observed even in 6 out of 11 patients lacking both sensory symptoms and signs. Tibial nerve F-wave was abnormal in 36% of 14 patients with F-wave examinations, whereas the localizing abnormalities in SEPs were found in 64% of the same patient population. P15 amplitude was depressed in 4 patients (22%), which may indicate the involvement of the dorsal root ganglion in LSS, although its latency was normal even for these patients.ConclusionsTibial nerve SEPs with the recording of P15 and N21 potentials achieved sufficiently high sensitivity in diagnosing LSS. They have the advantage over F-wave in that they can localize the lesion at the cauda equina or conus/epiconus level.SignificanceTibial nerve SEPs are promising in evaluating LSS, especially in documenting sensory tract involvement in cases lacking sensory symptoms/signs.
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DOI：
--
发表时间：
1976
期刊：
影响因子：
--
作者：
C. Arnoldi;A. Brodsky;J. Cauchoix;H. V. Crock;G. F. Dommisse;M. Edgar;F. Gargano;R. Jacobson;W. Kirkaldy;A. Kurihara;A. Ld;I. Macnab;G. McIvor;P. Newman;K. Paine;L. Russin;J. Sheldon;M. Tile;M. Urist;W. E. Wilson;L. Wiltse
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L. Wiltse
影响因子：
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作者：
Mondelli, M.;Aretini, A.;Sicurelli, F.
通讯作者：
Sicurelli, F.
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影响因子：
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作者：
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以胫神经 SEP 中的 P15 作为连接电位的示例。
DOI：
10.1016/0168-5597(92)90037-c
发表时间：
1992
期刊：
Electroencephalography and clinical neurophysiology
影响因子：
--
作者：
M. Sonoo;K. Genba;T. Iwatsubo;T. Mannen
通讯作者：
T. Mannen
影响因子：
2
作者：
Takai, Keisuke;Matsumoto, Takahiro;Taniguchi, Makoto
通讯作者：
Taniguchi, Makoto