肌电图在脊髓型颈椎病诊断与鉴别诊断中的应用  

Application of electromyography in the diagnosis and differential diagnosis of cervical spondylotic myelopathy

作　　者：诸兴明[1] 万琦[1] 杜宇平[1] 

机构地区：[1]解放军第101医院神经科,江苏214044

出　　处：《脊柱外科杂志》2008年第4期214-216,共3页Journal of Spinal Surgery

摘　　要：目的探讨肌电图检查在脊髓型颈椎病诊断与鉴别诊断中的应用价值。方法对脊髓型颈椎病(CSM)患者25例和肌萎缩侧索硬化症(ALS)患者23例行胸锁乳突肌、胸段脊旁肌和多肢体肌的常规肌电图(EMG)检查,另外还检测上肢的躯体感觉诱发电位(SEP)。结果CSM组患者三肢体肌、胸段脊旁肌和胸锁乳突肌EMG异常率分别为4.00%、4.00%、8.00%,SEP异常率为80.00%,ALS组三肢体肌、胸段脊旁肌和胸锁乳突肌EMG异常率分别为56.52%、73.91%、91.30%,SEP异常率为8.70%,2组间差异有统计学意义(P<0.01)。CSM组有2例合并ALS,2例为ALS;ALS组有2例合并CSM。结论胸锁乳突肌、胸段脊旁肌和多肢体肌的EMG检查和上肢的SEP检查有助于CSM诊断与鉴别诊断。Objective To investigate the value of electromyography （EMG） in the diagnosis and differential diagnosis of cervical spondylotic myelopathy （CSM）. Methods Twenty-five cases of CSM and 23 cases of amyotrophic lateral sclerosis （ALS） were tested by electromyography in the muscles of limbs, thoracic paraspine and sternocleidomastoid. Additionally, somatesensory evoked potential （SEP） in limb were tested. Results The abnormal rates of EMG were 4. 00%, 4. 00% and 8.00% in the muscles of limbs, thoracic paraspine and sternocleidomastoid for CSM group, 56.52%, 73.91% and 91.30% for ALS group, and there was significant difference between the 2 groups （ P 〈 0. 01 ）. The abnormal rate of SEP was 80. 00% for CSM group, 8.70% for ALS group, and there was also significant difference between the 2 groups （P 〈 0.01 ）. Two patients in CSM group were accompanied with ALS, and 2 patients in CSM group were diagnosed as ALS, and 2 patients in ALS group were accompanied with CSM. Conclusion Tests of EMG and SEP are helpful for distinguishing CSM from ALS.

关 键 词：颈椎 颈椎病 肌萎缩 

分 类 号：R681.531.1[医药卫生—骨科学]