The basic wave pattern of lumbar root potentials and clinical application

腰椎根电位基本波型及临床应用

• 批准号: 61480322
• 负责人: TANAKA Hiromi
• 金额: $ 3.84万
• 依托单位: Saitama Medical Center The Saitama Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1986
• 资助国家: 日本
• 起止时间: 1986 至 1987
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480322/
• 关键词: Lumbar spinal root potentials; Group I fiber; <alpha>-motor fiber; 硬膜外記録; 腰部神経根電位; M波; H反射; 運動神経線維; 後根の伝導; 前根の伝導

We routinely use the morphological examination for an objective deagnosis assisting clinical examinations in lumbar root radicuropathy. We,however, not infrequently encounter the clinical cases in which the level diagnosed by clinical examination does not coincide the result of myelography. In these cases electrophysiological examination are needed. It is desirable to devise more direct electrophysiological examinations which allow us to record electrical activities of the nervous system revealing the actual state of nerve conduction. Requirements for such examination would be as follows; 1) easy applicability in the out-patient clinic, 2) minimal risk on execution, and 3) selective recording of the afferent and efferent nerve volleys, if possible.The investigation was carried out on 15 patients with the lumbar disc herniationand the spinal stenosis, and also five neurologically normal adult volunteers. Tibial or peroneal nerve was stimulated with the surface electrodes, and lumbar roo … More t potential was recorded in the epidural space L5/S1,L4/5 and L3/4. Evoked EMG responses were monitored simultaneously with SRP.Two kinds of potentials with aifferent latencies were recorded from the epidural electrodes by stimulation of the tibial nerve with the intensity evoking both H and M responses in the soleus muscle. The relationship of the amplitude between SRP and the corresponding H-reflex and M-response was examined. From these result the liminal stimulation at the M-threshold would allow us to monitor the conduction of the posterior root and the supra maximal stimulation of the M-response do that in anterior root.In posterior and anterior of LDH and LSS, 1)positivisation, 2)polyphasic wave and 3)pathological low amplitude were examined. 11 cases of the examined 15 cases had the positivisation and/or polyphasic potentials in the posterior or anterior root. The pathological waves were not observed in the remaining 4 cases. But 3 of those 4 cases showed the pathological low amplitude by using the quantitative method for estimating the low amplitude. We found the present examination satisfactory despite some problems still remained. Less

我们通常使用形态学检查客观诊断辅助临床检查腰根神经根病。然而，我们经常遇到临床病例，其中临床检查诊断的水平与脊髓造影结果不一致。在这种情况下，需要进行电生理检查。我们希望设计更直接的电生理检查，使我们能够记录神经系统的电活动，揭示神经传导的实际状态。这种检查的要求如下：1)易于在门诊应用；2)执行时风险最小；3)如果可能，选择性记录传入和传出神经截击。研究对象为15例腰椎间盘突出症和椎管狭窄症患者，以及5例神经功能正常的成年志愿者。体表电极刺激胫神经或腓神经，腰椎神经，硬膜外间隙L5/S1、L4/5和L3/4记录更多的t电位。诱发肌电反应与SRP同时监测。通过刺激胫骨神经，在硬膜外电极上记录两种不同潜伏期的电位，其强度可引起比目鱼肌的H和M反应。研究了SRP的振幅与相应的h反射和m反应的关系。从这些结果来看，在m阈处的阈限刺激可以让我们监测后根的传导，而在前根的m反应的最大上刺激可以做到这一点。在LDH和LSS后、前方分别检测1)阳性、2)多相波和3)病理低振幅。15例患者中有11例出现后根或前根阳性和/或多相电位。其余4例未见病理波。用定量方法估计低振幅，4例中有3例表现为病理性低振幅。尽管还存在一些问题，我们认为目前的检查是令人满意的。少

项目成果

Tanaka Hiromi: "Identification of action potentials in <alpha>-motor fibers recorded in lumbo-sacral spinal roots and relation between The potentials and muscle power" Brain.

Tanaka Hiromi：“识别腰骶脊髓根中记录的 <α> 运动纤维的动作电位以及电位与肌肉力量之间的关系” 大脑。

渡辺仁一 他: 第35回東日本臨床整形外科学会にて発表.

Jinichi Watanabe 等人：在第 35 届东日本临床骨科学会上发表演讲。

田中弘美 他: 第16回日本脳波・筋電図学会学術大会にて発表.

Hiromi Tanaka 等：在日本脑电图和肌电图学会第 16 届学术会议上发表。

田中弘美: 日本整形外科学会雑誌. 61. 903 (1987)

Hiromi Tanaka：日本骨科学会杂志 61. 903 (1987)。

田中弘美 他: 第1回日本整形外科学会基礎学術集会にて発表.

Hiromi Tanaka 等：在日本骨科学会第一届基础学术会议上发表。