肌电图检查有助于确定神经根型颈椎病最佳手术时机  

ELECTROMYOGRAM ON SURGICAL TREATMENT CHOICE OF CERVICAL SPONDYLOTIC RADICULOPATHY

作　　者：朱琳[1] 朱玲[1] 白雪[1] 马银霞[1] 于绍斌[1] 邸旭辉[1] 

机构地区：[1]河北医科大学第三医院肌电图室,河北石家庄050051

出　　处：《河北医科大学学报》2014年第5期497-500,共4页Journal of Hebei Medical University

基　　金：河北省卫生厅科研基金资助项目(20110115)

摘　　要：目的观察根据肌电图(electromyogram,EMG)检查结果判断神经根型颈椎病(cervical spondylotic radiculopathy,CSR)严重程度及术后神经功能恢复程度。方法 60例CSR患者接受颈椎前路减压植骨融合术治疗,术前根据EMG检查结果分为3组:轻度异常组16例、中度异常组19例和重度异常组25例。记录3组患者术前与术后6个月的颈椎功能障碍指数(neck disability index,NDI),比较3组患者术后NDI改善率的差别。结果术后轻度异常组NDI评分由中度功能障碍恢复为轻度功能障碍;中度异常组由中度功能障碍恢复为轻度功能障碍;重度异常组由重度功能障碍恢复为中度功能障碍。与轻度异常组比较,中、重度异常组术后NDI改善率差异均有统计学意义(P<0.05);与中度异常组比较,重度异常组术后NDI改善率差异有统计学意义(P<0.05)。结论 EMG检查显示运动单位电位时限增宽、波幅增高,而腋神经运动潜速率正常是CSR手术治疗的最佳电生理指征。Objective To investigate the method of evaluating the severity of cervical spondylotic radiculopathy （CSR） and effects of the operation according to the results of electromyogram （EMG）. Methods Sixty patients with CSR undergoing anterior cervical decompression and fusion,were divided into three groups according to the results of EMG： mildly abnormal group （16 patients）, moderately abnormal group （19 patients） and severely abnormal group （25 patients）. The patients＇ neck disability index（NDI） before surgery and 6 months after surgery were recorded. The postoperative NDI improvement rates of three groups were compared. Results The postoperative NDI scores of mildly abnormal group returned from moderate dysfunction to mild dysfunction. The postoperative NDI scores of moderately abnormal group returned from moderate dysfunction to mild dysfunction. The postoperative NDI scores of severely abnormal group returned from severe dysfunction to moderate dysfunction. Compared with mildly abnormal group, the postoperative NDI improvement rates of moderately abnormal group and severely abnormal group were statistically significant （P 〈 0.05 ）. Compared with moderately abnormal group, the postoperative NDI improvement rates of severely abnormal group were statistically significant （P 〈 0.05 ）. Conclusion Motor unit potentials with increased duration and amplitude in EMG tests accompanied by normal axillary nerve conduction velocity are the best electrophysiological indications for surgical treatment of CSR.

关 键 词：颈椎病 肌电描记术 外科手术 

分 类 号：R741.044[医药卫生—神经病学与精神病学]