요추부 다열근의 침 전극 삽입법 : 자기공명영상을 이용한 Haig와 Stein 방법의 재현
Needle Electrode Insertion into the Lumbar Multifidus Muscle:Simulation of the techniques by Haig and Stein Using Magnetic Resonance Image
- 주제(키워드) Magnetic resonance imaging , Electromyography , Needles , Multifidus
- 발행기관 고려대학교 대학원
- 지도교수 권희규
- 발행년도 2009
- 제출일 2009-01-07
- 학위수여년월 2009. 2
- 학위명 석사
- 학과 일반대학원 의학과
- 세부전공 재활의학
- 원문페이지 29 p
- 실제URI http://www.dcollection.net/handler/korea/000000007842
- 본문언어 한국어
- 제출원본 000045530846
초록/요약
Objective: Multifidus muscle has been reported being useful in identification of the root level involved in the diagnosis of lumbosacral radiculopathy. The purpose of this study was to compare the accuracy of the Haig’s and Stein’s techniques for needle electrode placement in the lumbar multifidus muscle by using magnetic resonance image(MRI). Methods: Lumbar MRI findings in 30 patients with low back pain were evaluated. We searched the deep fiber of multifidus muscle on coronal image and traced it at the axial image of lumbar MRI. We simulated the Haig’s and the Stein’s techniques of needle electrode insertion into 60 multifidus muscles of both sides on the axial image at each level of L3, L4, L5 and evaluated whether the tip of the needle electrode was in the deep fiber of the lumbar multifidus or not. The cases in which the techniques were not applicable were excluded. The two techniques were evaluated by calculating the accuracy rate for needle placement in the bilateral multifidus muscles and compared using Mcnemar’s test. Results: A total 44 out of 56 trials(78.6%) and 22 out of 46 trials (47.8%) were successfully delivered to the targeted multifidus muscles around the L3 spine using the Haig’s and the Stein’s techniques, respectively. Thirty three of 56 trials(58.9%) and 17 of 50 trials(34.0%) at the level of L4 spine were successfully done using the Haig’s and the Stein’s techniques, respectively. Eighteen of 51 trials(35.3%) and 14 of 48 trials(29.2%) at the level of L5 spine were within the deep fiber of multifidus muscle with Haig and Stein’s technique respectively. There were significant differences in the accuracy between two techniques at the level of the L3 and L4 spines, but not at the level of L5 spine. Conclusion: This study highlights nonoptimizing accuracy of previous two previous techniques for needle electrode insertion into the multifidus muscle. The technique needs to be modified to increase the accuracy.
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