A new electrophysiological method for the diagnosis of extraforaminal stenosis at L5-s1.
A new electrophysiological method for the diagnosis of extraforaminal stenosis at L5-s1.
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DOI：
10.4184/asj.2014.8.2.145
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发表时间：
2014-04
影响因子：
2.3
通讯作者：
Tsutsui S
中科院分区：
文献类型：
--
作者：
Iwasaki H;Yoshida M;Yamada H;Hashizume H;Minamide A;Nakagawa Y;Kawai M;Tsutsui S
回顾性研究。研究电诊断技术作为一种新方法在L5-S1椎间孔外狭窄临床诊断中的有效性。我们利用现有的电生理评估技术介绍了一种新的有效方法来诊断腰骶连接处椎间孔外狭窄。入组了124例第五腰椎神经根病患者的连续系列，包括一组74例椎管狭窄患者和第二组50例L5-S1椎间孔外狭窄患者。该技术涉及将一对针状电极插入第五腰脊神经的椎间孔出口区，用于提供电刺激。记录每个胫骨前肌的复合肌肉动作电位。椎间孔外狭窄患者的远端运动潜伏期（DML）范围为11.2 - 24.6毫秒。相比之下，椎管狭窄患者的DML范围为10.0至17.2毫秒。在比较两组中的每一组的DML以及同时比较每名患者的患侧与健侧的DML的差异之后，我们得出结论，两组之间存在统计学显著差异（p<0.01）。使用受试者工作特性曲线分析，计算出的截止值分别为15.2毫秒和1.1毫秒。该方法使用DML测量方法，使我们能够识别和定位病变，这在诊断L5-S1椎间孔外狭窄方面具有优势。
A retrospective study. To examine the effectiveness of using an electrodiagnostic technique as a new approach in the clinical diagnosis of extraforaminal stenosis at L5-S1. We introduced a new effective approach to the diagnosis of extraforaminal stenosis at the lumbosacral junction using the existing electrophysiological evaluation technique. A consecutive series of 124 patients with fifth lumbar radiculopathy were enrolled, comprising a group of 74 patients with spinal canal stenosis and a second group of 50 patients with extraforaminal stenosis at L5-S1. The technique involved inserting a pair of needle electrodes into the foraminal exit zone of the fifth lumbar spinal nerves, which were used to provide electrical stimulation. The compound muscle action potentials from each of the tibialis anterior muscles were recorded. The distal motor latency (DML) of the potentials ranged from 11.2 to 24.6 milliseconds in patients with extraforaminal stenosis. In contrast, the DML in patients with spinal canal stenosis ranged from 10.0 to 17.2 milliseconds. After comparing the DML of each of the 2 groups and at the same time comparing the differences in DML between the affected and unaffected side of each patient, we concluded there were statistically significant differences (p<0.01) between the 2 groups. Using receiver operating characteristic curve analysis, the cutoff values were calculated to be 15.2 milliseconds and 1.1 milliseconds, respectively. This approach using a means of DML measurement enables us to identify and localize lesions, which offers an advantage in diagnosing extraforaminal stenosis at L5-S1.