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Clinical indicants and electrophysiological patterns of sciatic nerve in patients after total hip replacement

Clinical indicants and electrophysiological patterns of sciatic nerve in patients after total hip replacement

来源:medRxiv_logomedRxiv
英文摘要

Abstract BackgroundThe incidence of sciatic nerve (SN) damage after a total hip replacement (THR) is 10 percent. The underdiagnosis of paucisymptomatic sciatic neuropathy may lead to the unsatisfactory outcome of the treatment in these patients featured by frequent chronic pain syndrome. This research was aimed at the evaluation of the dynamics of clinical and electrophysiological patterns in SN after THR. Material and methodsThe research involved 16 individuals 45 to 68 years old with primary idiopathic coxarthrosis who underwent THR in the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ‘V.I. Razumovsky Saratov State Medical University’, the Russian Federation Ministry of Healthcare. We compared the findings of clinical and neurologic examinations (VAS, muscle strength, and sensitivity evaluation) as well as ENMG before surgeries and 14 days after them. ResultsIn the evaluation of the clinical score in 9 patients, we observed some negative changes featured by paresthesia around the area of the SN innervation. The analysis of changes in ENMG findings revealed the decrease in M-response amplitudes of both peroneal and tibial nerves by more than 10 percent of the age-appropriate normal value; this was more prominent in patients who had undergone the lengthening of extremities in more than 3 cm. ConclusionTHR is associated with a higher risk of traction and entrapment changes in SN that lead to the progress of their neuropathies in the post-operative period. ReviewersAssoc. Prof. Ulyanov V.Yu., MD, DSc;Assoc. Prof. Gulyaev D.A., MD, DSc

Tolkachev V.S.、Chekhonatsky A.A.、Korshunova G.A.、Ostrovskij V.V.、Bazhanov S.P.

Department of Innovation Projects for Neurosurgery and Vertebrology, Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ??V.I. Razumovsky Saratov State Medical University?ˉ, the Russian Federation Ministry of Healthcare (NIITON SGMU)Head of the Neurosurgery Department, Federal State Budgetary Educational Institution of Higher Education ??V.I. Razumovsky Saratov State Medical University?ˉ, the Russian Federation Ministry of HealthcareDepartment of Innovation Projects for Neurosurgery and Vertebrology, Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ??V.I. Razumovsky Saratov State Medical University?ˉ, the Russian Federation Ministry of Healthcare (NIITON SGMU)Director of the Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ??V.I. Razumovsky Saratov State Medical University?ˉ, the Russian Federation Ministry of Healthcare (NIITON SGMU)Head of the Department of Innovation Projects for Neurosurgery and Vertebrology, Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, Federal State Budgetary Educational Institution of Higher Education ??V.I. Razumovsky Saratov State Medical University?ˉ, the Russian Federation Ministry of Healthcare (NIITON SGMU)

10.1101/2021.10.11.21264505

临床医学神经病学、精神病学外科学

sciatic nervetotal hip replacementneuropathy

Tolkachev V.S.,Chekhonatsky A.A.,Korshunova G.A.,Ostrovskij V.V.,Bazhanov S.P..Clinical indicants and electrophysiological patterns of sciatic nerve in patients after total hip replacement[EB/OL].(2025-03-28)[2025-05-14].https://www.medrxiv.org/content/10.1101/2021.10.11.21264505.点此复制

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