Recent advances in neuroanatomy: The myotome update.
Recent advances in neuroanatomy: The myotome update.
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神经解剖学的最新进展：肌组更新。
DOI：
10.1136/jnnp-2022-329696
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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：
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作者：
Higashihara M;Yamazaki H;Izumi Y;Kobayashi M;Nodera H;Oishi C;Iwata A;Murayama S;Kaji R;Sonoo M;Sonoo M
肌肉的肌节是诊断脊髓和周围神经疾病的基础。尽管肌节图在临床神经病学中至关重要，但令人惊讶的是，许多教科书中的肌节图彼此之间存在不可忽视的不一致性。许多作者甚至没有清楚地说明他们图表的基础。关于肌节识别的原始数据的研究相当罕见。19世纪世纪的一项经典研究在尸体上追踪神经过程，尽管有一定的局限性，但仍然对现有的图表产生了重大影响。在人类中的其他稀缺研究包括通过手术期间的根刺激进行识别，根性撕脱或脊髓损伤的临床观察以及对患有单一神经根病或某些神经丛病的患者的临床和肌电图调查。最近的一些研究提出了关于某些肌肉的肌节的新理论。正中手内在肌的T1神经支配是一个典型的例子。我们增加了一些新的发现，如T1神经支配的前臂屈肌的正中神经支配，除了旋前圆肌和桡侧腕屈肌，C5神经支配的肱桡肌，和两个C6指示肌，旋前圆肌和桡侧腕短伸肌。肌节图表的准确性提高将改善神经病学的定位。
The myotome of a muscle is the basis for diagnosing spinal and peripheral nerve disorders. Despite its critical importance in clinical neurology, myotome charts presented in many textbooks, surprisingly, show non-negligible discordances with each other. Many authors do not even clearly state the bases of their charts. Studies that have presented with raw data regarding myotome identification are rather rare. A classic study in the 19th century that pursued the nerve course in cadavers still has a substantial influence on existing charts, despite its definite limitations. Other scarce studies in humans include identification by root stimulation during surgery, clinical observations in root avulsion or spinal cord injury and clinical and electromyographical investigations in patients with single radiculopathies or certain plexopathies. A few recent studies have proposed new theories regarding the myotomes of some muscles. T1 innervation of the median intrinsic hand muscles is a typical example. We have added a number of new findings, such as T1 innervation of the forearm flexor muscles innervated by the median nerve except the pronator teres and flexor carpi radialis, C5 innervation of the brachioradialis, and two C6 indicator muscles, pronator teres and extensor carpi radialis brevis. Increased accuracy of the myotome charts will improve the localisation in neurology.