외상성 척수손상환자의 진단에서 중추운동전도시간의 유용성

Abstract

Objective : This study was performed to learn about usefulness of central motor conduction time (CMCT) in the diagnosis of the traumatic spinal cord injury. Method : The objects were three patient groups, who were diagnosed each with cervical (n=32), thoracic (n=25) and lumbar (n=6) spinal cord injuries and had a history of inpatient treatment after surgical intervention, and the control group of 20 ordinary people. Each of 4 groups did not show the difference in age, height and weight. In order to find out CMCT, latency of motor-evoked potential was measured using transcranial magnetic stimulator. And onset latency of compound motor action potential and latency of F wave were measured with an electrical diagnostic test equipment. Using this method, the examinations at both sides of abductor pollicis brevis (APB) and abductor hallucis (AH) muscles were implemented, and CMCT (APB), CMCT (AH) and CMCT (APB)/CMCT (AH) ratio were obtained. Results : The cervical spinal cord injury patient group showed the delayed CMCT (APB) and CMCT (AH), compared with thoracic and lumbar spinal cord injury patients. And CMCT (APB)/CMCT (AH) ratio was significantly higher , compared with thoracic and lumbar spinal cord injury patients. The thoracic and lumbar spinal cord injury patient group showed the delayed CMCT (AH) , compared with the control group. And CMCT (APB)/CMCT (AH) ratio was noticeably lower , compared with the control group. There was no significant difference of CMCT (APB)/CMCT (AH) between the cervical spinal cord injury patient group and the control group. Conclusion : In case of the traumatic spinal cord injury patients, CMCT (APB), CMCT (AH) and CMCT (APB)/CMCT (AH) ratio can be used to help diagnose the damaged area, but they are not adequate to be used as a screening test. Therefore, it is considered that they can contribute to accurate early diagnosis and effective rehabilitation together.