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目的评价脊髓栓系综合征(tethered cord syndrome,TCS)患儿的神经损伤。方法2001年5月～2006年5月对105例TCS患儿行胫神经体感诱发电位(posterior tibial nerve somato- sensory evoked potential study,PTN-SEP)和胫神经、腓总神经运动神经传导(motor conductive veloc- ity,MCV)检测,以及盆底肌肌电图检查。结果TCS患儿皮层电位以及马尾电位潜伏期延长,胭窝处周围电位潜伏期无延长。胫神经MCV异常率34%,58%波幅降低,腓总神经MCV异常率24%,33%波幅降低。盆底肌肌电随着神经损伤程度的加重,由静息状态无自发电位,可见持续收缩电位,小力收缩运动单位电位波幅、时限、多相波升高,大力收缩募集相基本正常,发展到静息状态有自发电位,无或有极少量持续收缩动作电位,小力、大力收缩无动作电位。结论神经电生理检测对判断TCS患儿的神经损害程度及范围,了解预后具有重要的价值。
Objective To evaluate the neurological injury in children with tethered cord syndrome (TCS). Methods From May 2001 to May 2006, 105 children with TCS underwent tibial nerve somato-sensory evoked potential study (PTN-SEP) and tibial nerve, common motor nerve conduction veloc- ity, MCV) examination, and pelvic floor EMG examination. Results TCS children with cortical potential and cauda equina potential latency prolongation, pimples around the potential latency of no extension. The abnormal rate of tibial nerve MCV was 34%, the amplitude of 58% was decreased, and the abnormal rate of MCV in the common peroneal nerve was 24% and 33% respectively. With the severity of nerve injury, pelvic floor myoelectricity increased from resting state without spontaneous potential, showing sustained contraction potential, small force contraction unit of motion amplitude, time limit, polyphase wave rise, strong contraction basically normal recruitment, development To rest have spontaneous potential, no or a very small amount of continuous contraction of action potential, small force, strong contraction no action potential. Conclusion Neuroelectrophysiological test has important value in judging the extent and scope of nerve damage in children with TCS and understanding prognosis.