临床预测C5脊髓神经活力的临床预测器在全臂损伤中的脊髓神经活力
Kitty Y Wu1, Derek B Asserson1, Michelle F Loosbrock1
1From the Departments of Orthopedic Surgery.
Plastic and reconstructive surgery
|July 4, 2023
概括
在泛臂损伤中识别可重建的C5脊髓神经是手术规划的关键. 手术前的因素,如阳性Tinel测试和CT骨髓图上完整的C5神经,可以预测C5神经的活力.
科学领域:
- 神经外科 神经外科
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
背景情况:
- 在泛臂损伤中区分前关节和后关节损伤对于有效的重建规划至关重要.
- 准确的手术前确定可行的C5脊髓神经有助于在这些复杂的损伤中做出手术决策.
研究的目的:
- 确定手术前的临床和诊断因素,准确地预测C5脊髓神经在患有全脉损伤的患者中的生存能力.
- 开发C5脊髓神经可重建性的预测模型,以指导手术干预.
主要方法:
- 从2001年到2018年,对311名患有泛臂损伤的患者进行了回顾性审查.
- 收集的数据包括人口统计,临床检查结果,诊断成像 (CT骨髓图) 和电诊断结果.
- 使用多变量逻辑回归分析来确定C5神经活力的预测因素,C5活力通过手术内探索和电生理学测试得到证实.
主要成果:
- 在43%的患者中发现了可行的C5脊髓神经.
- 活跃C5神经的预测因素包括CT骨髓图上完整的C5神经 (OR,5.4),阳性Tinel测试 (OR,2.6),以及特定的肌肉强度等级.
- 一个多变量模型包含了积极的Tinel测试,CT骨髓图上完整的C5神经,半膜升高和中侧脊髓动,证明了良好的预测准确性 (AUC,0.77).
结论:
- 一个积极的Tinel测试和一个完整的C5神经在CT骨髓图是可行的C5神经的显著预测.
- 发现半膜升高和中椎副脊髓动可以预测根部脱落.
- 这些发现有助于在手术前评估和手术规划泛臂损伤.
相关概念视频
Spinal Nerves: Plexus I
1.1K
Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
1.1K
Spinal Nerves: Plexus II
708
The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
708
Local Anesthetics: Differential Sensitivity of Nerve Fibers
876
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
876


