腰椎间盘突出症体感诱发电位诊断及法医学意义

目的探讨体感诱发电位(SEP)对腰椎间盘突出症(LDH)的诊断价值。方法对60例LDH患者和30例正常人行皮节体感诱发电位(DSEP)和胫后神经体感诱发电位(PTNSEP)检查。结果DSEP的异常率为93.3%,显著高于PTNSEP检测的异常率(43.3%)(P<0.001)。L3-4椎间盘以L4DSEP异常为主,L4-5椎间盘突出以L5DSEP异常为主,L5S1椎间盘突出以S1DSEP异常为主。结论DSEP与腰骶神经根损伤有良好的相关性,弥补了影像学检查的不足,既可判定单根神经根的功能状态,又可辅助定位诊断,是一种敏感的辅助诊断LDH的电生理方法。

The diagnostic value of SEP in LDH and its forensic significance

Objective To evaluate the diagnostic value of somatosensory evoked potential(SEP) in lumbosacral disc herniation(LDH). Methods Posterior tibial nerve somatosensory evoked potential(PTNSEP) and dermatomal somatosensory evoked potential(DSEP) were recorded from 60 patients with radiculopathy caused by LDH and 30 healthy subjects. Results DSEP was abnormal in 56 cases(93.3%) and PTNSEP was abnormal in 26 cases(43.3%).The significant difference was observed(P<0.001).The abnormality of DSEP from L4 dermatome was detected mainly in patients with L3-4 LDH, the abnormality of DSEP from L5 dermatome was detected mainly in patients with L4-5 LDH, the abnormality of DSEP from L5S1 dermatome was detected mainly in patients with S1 LDH.DSEP can reflect the compressed extent of nerve root. Conclusions There was a good correlation of DSEP with lumbosacral nerve root injury,which supplement the information that can not be provided by imaging examingation.DSEP is a sensitive electrophysic method that not only is used to evaluate single nerve root function,but also is helpful in the location of the lesion.