摘要
目的研究颈椎过伸伤伴中央脊髓综合征(CCS)患者急性期运动诱发电位(MEP)特征及其与脊髓损伤程度的关系。方法回顾性分析2018年12月至2021年7月同济大学附属同济医院骨科收治的45例急性颈椎过伸伤伴CCS(观察组)患者资料和20例健康志愿者(健康对照组)资料。采用magpro x100型磁刺激仪对观察组患者和健康对照组受试者进行经颅磁刺激诱发的MEP检查,在双侧拇短展肌进行记录。对比健康对照组,描述观察组患者MEP波形的潜伏期、波幅及运动阈值的特点;分析观察组患者MEP潜伏期与脊髓损伤程度[美国脊髓损伤协会(ASIA)总分、运动功能(上肢运动评分UEMS)]的关系;根据MEP诱发状态不同,将观察组患者分为静息组(n=19)、易化组(n=18)、无波形组(n=8),比较组间的脊髓损伤程度(ASIA总分)和脊髓功能独立性(SCIM-Ⅲ得分),并分析MEP诱发状态与脊髓损伤程度(ASIA总分)的关系。结果与健康对照组相比,观察组患者MEP潜伏期[(30.16±6.32)ms]更长、波幅[(0.54±0.30)mV]更小、运动阈值(65%±11%)更高,差异均有统计学意义(P<0.05);观察组患者的MEP潜伏期与ASIA总分(r=-0.730,P<0.001)、UEMS(r=-0.740,P<0.001)均呈显著负相关。3组患者的ASIA总分和SCIM-Ⅲ得分比较差异均有统计学意义(P<0.05),并且MEP诱发状态与脊髓损伤程度(ASIA总分)显著相关(r=0.668,P<0.001)。结论急性颈椎过伸伤伴CCS患者的MEP潜伏期延长,波幅较小,运动阈值较高,其中MEP潜伏期与脊髓损伤程度和上肢运动功能均有强相关性,MEP诱发状态与脊髓损伤程度也密切相关。
Objective To study the correlation between the acute-phase characteristics of motor evoked potential(MEP)and severities of spinal cord injury in patients with acute cervical hyperextension injury and central cord syndrome(CCS).Methods Retrospectively analyzed were the data of 45 patients with acute cervical hyperextension injury and CCS(observation group)who had been admitted to Department of Orthopedics,Tongji Hospital Affiliated to Tongji University from December 2018 to July 2021 and 20 healthy controls.Examination of transcranial magnetic stimulation-induced MEP was performed in patients with CCS and healthy controls using a magpro x100 magnetic stimulator,and recording was conducted in bilateral abductor pollicis brevis(APB).The characteristics of MEP waveform latency,amplitude and motor threshold were described and compared between the healthy control and observation groups;the correlations were analyzed between the MEP latency and the severity of spinal cord injury[American Spinal Injury Association(ASIA)total score and motor function of Upper Extremity Motor Subscores(UEMS)]in the observation group.According to different MEP-induced states,the patients in the observation group were divided into a resting group(n=19),a facilitation group(n=18),and a no-waveform group(n=8).The severity of spinal cord injury(ASIA total score)and the functional independence of the spinal cord(SCIM-Ⅲscore)were compared among the 3 groups to analyze the correlation between the MEP-induced state and the severity of spinal cord injury(ASIA total score).Results The observation group had a significantly longer MEP latency[(30.16±6.32)ms],a significantly smaller amplitude[(0.54±0.30)mV]and a significantly higher motor threshold[(65%±11%)]than the healthy control group(all P<0.05).The MEP latency in the observation group was significantly correlated with ASIA total score(r=-0.730,P<0.001)and UEMS(r=-0.740,P<0.001).The ASIA total score and SCIM-Ⅲscore were significantly different among the 3 groups(P<0.05),and the MEP-induced s
作者
赵丽娟
王建杰
顾春雅
陈玉辉
曾至立
谢宁
麻彬
于研
徐委
胡笑
任亦龙
程黎明
Zhao Lijuan;Wang Jianjie;Gu Chunya;Chen Yuhui;Zeng Zhili;Xie Ning;Ma Bin;Yu Yan;Xu Wei;Hu Xiao;Ren Yilong;Cheng Liming(Department of Orthopaedics,Tongji Hospital Affiliated to Tongji University&Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration,Ministry of Education,Shanghai 200065,China;Department of Neurology,Tongji Hospital Affiliated to Tongji University,Shanghai 200065,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第7期570-576,共7页
Chinese Journal of Orthopaedic Trauma
基金
上海市中西医临床协作试点项目(ZY(2018-2020)-FWTX-1005)
上海市重中之重重点学科建设计划(2017ZZ02004)
上海市临床重点专科项目(shslczdzk05503)。
关键词
中央脊髓综合征
急性
运动诱发电位
颈椎过伸伤
Central cord syndrome
Acute
Motor evoked potentials
Hyperextension injuries
