超声波是评估腓总神经压迫性神经病的电诊断辅助工具

IF 1.6 4区医学 Q3 ORTHOPEDICS

Hss Journal Pub Date : 2024-10-20 DOI:10.1177/15563316241285898

Stephen J DeMartini, Amanda M Faust, Nathan P Olafsen, David M Brogan, Christopher J Dy

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引用次数: 0

摘要

背景：腓总神经（CFN）压迫性神经病越来越多地被认为是导致足下垂和跌倒的病因之一。电诊断（EDX）检查被广泛用于评估这种病症，但此类检查具有侵入性且费用昂贵。目的：我们试图研究超声与神经传导检查（NCS）和肌电图（EMG）在诊断 CFN 压缩性神经病时的关联性：我们进行了一项回顾性研究，确定了从 2015 年 1 月 1 日至 2023 年 6 月 30 日期间接受 CFN 减压术的 104 名患者。如果患者在因压迫性神经病接受 CFN 减压术前接受过超声检查和 NCS/EMG 检查，且手术时年龄大于 18 岁，则纳入该患者。如果患者因外伤或先天性损伤而导致神经卡压，或只进行了腓浅神经减压术而未进行 CFN 减压术，则排除在外。采用排除标准后，仍有17名患者留在队列中：结果：复合肌肉动作电位（CMAP）振幅异常者的平均超声横截面积和侧-侧（STS）比明显高于复合肌肉动作电位振幅正常者。与 STS 比值正常者相比，STS 比值异常时出现 CMAP 振幅异常的概率要高出 18 倍。STS 比值每增加一个单位，CMAP 振幅就会降低 2.79 mV：这项回顾性研究发现，超声可为 CFN 压缩性神经病的 EMG/NCS 诊断提供补充信息。需要进一步研究 CFN 压迫性神经病超声检查结果与手术减压结果之间的关系。

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Ultrasound as a Complementary Tool to Electrodiagnostics in the Evaluation of Compressive Neuropathy of the Common Fibular Nerve.

Background: Compressive neuropathy of the common fibular nerve (CFN) is increasingly recognized as an etiology for foot drop and falls. Electrodiagnostic (EDX) studies are widely used to evaluate this condition, but such tests are invasive and costly. As with carpal and cubital tunnel syndromes, there may be patients with characteristic symptoms of CFN compressive neuropathy but normal EDX studies in which ultrasound may aid in decision-making.

Purpose: We sought to examine the association between ultrasound and nerve conduction studies (NCS) and electromyography (EMG) in the diagnosis of compressive neuropathy of the CFN.

Methods: We performed a retrospective review identifying 104 patients who underwent CFN decompression from January 1, 2015, to June 30, 2023. Patients were included if they had both ultrasound and NCS/EMG prior to CFN decompression for compressive neuropathy and if they were older than 18 years at time of surgery. Patients were excluded if they had entrapment secondary to trauma, iatrogenic injury, or if they had had superficial fibular decompression alone without CFN decompression. After applying exclusion criteria, 17 patients remained in the cohort.

Results: Mean ultrasound cross-sectional area and side-to-side (STS) ratios were significantly higher in those with abnormal compound muscle action potential (CMAP) amplitudes versus those with normal CMAP amplitudes. The probability of having an abnormal CMAP amplitude when STS ratio was abnormal was 18 times greater compared with those with normal STS ratio. With each unit increase in STS ratio, CMAP amplitude was reduced by 2.79 mV.

Conclusions: This retrospective review found that ultrasound may provide complementary diagnostic information to EMG/NCS for compressive neuropathy of the CFN. Further study is needed to examine the relationship between ultrasound findings for CFN compressive neuropathy and results of surgical decompression.

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来源期刊

Hss Journal Medicine-Surgery

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The HSS Journal is the Musculoskeletal Journal of Hospital for Special Surgery. The aim of the HSS Journal is to promote cutting edge research, clinical pathways, and state-of-the-art techniques that inform and facilitate the continuing education of the orthopaedic and musculoskeletal communities. HSS Journal publishes articles that offer contributions to the advancement of the knowledge of musculoskeletal diseases and encourages submission of manuscripts from all musculoskeletal disciplines.