Sensory nerve action potential amplitude is rarely reduced in lumbosacral radiculopathy due to herniated disc
Sensory nerve action potential amplitude is rarely reduced in lumbosacral radiculopathy due to herniated disc
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DOI：
10.1016/j.clinph.2012.07.020
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发表时间：
2013-02-01
影响因子：
4.7
通讯作者：
Sicurelli, F.
中科院分区：
文献类型：
--
作者：
Mondelli, M.;Aretini, A.;Sicurelli, F.
目的：正常的感觉神经动作电位（SNAP）振幅是一个经典的神经造影规则，无论是否损害位于背根神经节（DRG）的近端，如在神经根病。本研究的目的是检查SNAP减少腰骶神经根病患者由于椎间盘突出症（HD）。方法：共108例腰骶神经根病患者前瞻性入组。诊断基于临床表现和磁共振成像（MRI）。进行L4-S1肌节的肌电描记，腓神经和胫神经的运动神经造影，隐神经、腓浅神经和腓肠神经的感觉神经造影。结果：7例L5神经根病患者腓浅神经SNAP幅度不对称，占12.1%，1例S1神经根病患者腓肠神经SNAP幅度不对称，占2.4%。所有这些患者有椎间孔HD.Conclusions：SNAP幅度减少的感觉神经起源于受损的根是目前只有在7%的神经根病，可能是由于背根神经节的压缩时，位于近侧的椎间孔或intraspinalcanal.Significance：保存SNAP幅度神经根病仍然是一个电生理学的教条，有一点例外。如果SNAP幅度的降低影响其他神经，则应寻找神经根病以外的原因。(C)2012年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: Normal sensory nerve action potential (SNAP) amplitude is a classical neurographic rule whether damage is located proximal to the dorsal root ganglion (DRG) as in radiculopathy. The study's aim is to check SNAP reduction in patients with lumbosacral radiculopathy due to herniated disc (HD).Methods: A total of 108 consecutive patients with lumbosacral monoradiculopathy were prospectively enrolled. The diagnosis was based on clinical findings and magnetic resonance imaging (MRI). Electromyography of muscles of L4-S1 myotomes, motor neurography of peroneal and tibial nerves and sensory neurography of saphenous, superficial peroneal and sural nerves were performed. Percentage decrease in SNAP amplitude of nerves between healthy and affected sides was calculated.Results: Significant SNAP amplitude asymmetry was observed in superficial peroneal nerve in seven patients with L5 (12.1%) and in sural nerve in one patient with S1 (2.4%) radiculopathies. All these patients had foraminal HD.Conclusions: SNAP amplitude reduction of sensory nerve originating from damaged root is present only in 7% of radiculopathies and is likely due to DRG compression when located proximal to the spinal foramen or within the intraspinal canal.Significance: Preservation of SNAP amplitude in radiculopathy remains an electrophysiological dogma with a little exception. If the reduction of SNAP amplitude affects other nerves, causes other than radiculopathy should be sought. (C) 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.