Clinic Study Of The Long Thoracic Nerve Entrapment

Objective: The purpose of this research is through studying theElectromyography physical check on long thoacic entrapment in thediagnosis of action to improve the understanding of the clinical doctordegree, to reduce misdiagnosis disease, and to compare further researchmethods in the treatment of thoracic surgery long nerve damage clinicaleffect.Methods:The data were collected from our hospital since December2006-May2011, i.e.10cases of patients，their common characteristic isthe bosom, chest wall and axillary department unwell, acupuncturesample pain, the sternocleidomastoid muscle up after the halfway pointmargin significantly tenderness point. Each patient underwent bilateralserratus anterior muscle was tested by using the US Dantec Key pointtype muscle electricity induced routine EMG, nerve piece electric chartinspection. Observation of the spontaneous electrical activity in theresting state and re-raise the response in the state of contraction had beenhad, especially to reduce spontaneous potential or raise the reaction wasan exception. Electroretinogram testing nerve on the ipsilateral andcontralateral long thoracic nerve to the line of compound muscle actionpotential (CAMP) test, determination of the incubation period (Lat) andamplitude (AMP), the test results of Contralateral and ipsilateral waspaired for t test were analyzed, Verify whether a significant difference.Selected10patients, including two cases of neck discomfort, had beendiagnosed as cervical spondylosis, six cases of precordial discomfort, andhad in mind the medical treatment, to his chest from behind the pain.10patients, including6males and4females, age20-60years old, average35.4years of age, course of3months-10years, seven cases of pressure for the left side of card, the right side of the two cases of entrapment, onecases of double side of both cards at the same time the pressureassociated with nerve injury,5cases of patients with winging scapula inone patient pairs flanking scapula, the first conservative treatment of10patients after diagnosis: partial closure of the neural nutrition, physicaltherapy once a week four consecutive times, the symptoms significantlyease the switch to surgical release, and not less than6months follow-up.Results:The Electromyography results, the long thoracic nervedominated by the serratus anterior muscle neurogenic,3side of thepositive sharp wave side of the fibrillation waves, abnormal rate of54%(6/11),the remaining5sides of the11sides to raise the reaction can beseen self-generating activities, MU reduced to a simple phase, abnormalrate of100%(11/11), compound muscle action potential (CMAP)amplitude (AMP), attenuation, The paired t test results show that theAMP there was a significant difference（t=4.055,P<0.05）, Lat was nosignificant difference（t=1.625,P>0.05). The group of10patients withfirst non-surgical treatment, were more than6months of follow-up,7cases of disappearance by3or4times the neck symptoms after localblock therapy, in two cases only partial closure of2, has nearly3years norecurrence; one cases of non-surgical treatment of symptoms, nosignificant improvement instead of surgery, follow-upMore than one year, chest discomfort, pain and other symptomsdisappeared and no recurrence.Conclusion: Electromyography check for diagnosislong thoacic entrapment can provide reliable basis, the non-surgical treatment is themain method for the treatment of long thoracic nerve entrapment, onlywhen non-surgical treatment fails when to consider surgical treatment,and whether non-surgical treatment or surgical treatment, postoperativeresults are satisfactory.