超声引导下骶管注射神经妥乐平和综合康复治疗重度骶丛神经损伤后遗症期的个案报道

doi:10.3969/j.issn.1006-9771.2025.04.013

Abstract

Abstract:

Objective To observe the effect of ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation on severe sacral plexus injury after sacral fracture.
Methods A case with severe sacral plexus injury ten months after sacral fracture was reviewed. He accepted ultrasound-guided sacral canal injection of Neurotropin along with comprehensive rehabilitation, and was assessed with American Spinal Injury Association Impairment Scale (AIS) impairment scale, manual muscle testing, Visual Analog Scale (VAS), modified Barthel Index (MBI), Short-form of Health Survey (SF-36) and Functional Gait Assessment (FGA), and measured the nerve conduction velocity and the structural organization of the sacrococcygeal ligament using nerve conduction velocity tests, electromyography (EMG) and ultrasound examination before and after treatment.
Results After four weeks and ten weeks of treatment, the muscle strength, and scores of MBI, FGA and SF-36 increased, while the ASIA score improved from grade D to grade E, and VAS score decreased. During follow-up, the VAS score and physical pain and general health status scores of the SF-36 increased. After ten weeks of treatment, nerve conduction velocity increased, latency shortened, and the amplitude of evoked action potentials increased. The presence of spontaneous sharp waves decreased, and the peak of active potentials increased. The peak of active potentials in the right gluteus maximus, vastus lateralis and gastrocnemius muscles increased. The structural organization of the sacrococcygeal ligament appeared clearer and more orderly. No adverse reaction was observed.
Conclusion Ultrasound-guided sacral canal injection of Neurotropin combined with comprehensive rehabilitation is effective on pain, activities of daily living and quality of life for patients with severe sacral plexus injury during the sequelae period.

Key words: sacral plexus injury, ultrasound-guided sacral canal injection, Neurotropin, rehabilitation

CLC Number:

R687.3

ZHU Haifeng, QIAN Guifeng, DAN Yuqin, GAO Jingchun, TANG Tingting, HUO Ming, XIE Shaodong. Ultrasound-guided sacral canal injection of Neurotropin and comprehensive rehabilitation for the aftermath of severe sacral plexus injury: a case report[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 476-483.

Figures/Tables 6

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References 48

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神经	刺激/记录电极	神经传导速度/(m·s^-1)		潜伏期/ms		诱发动作电位振幅/mV
神经	刺激/记录电极	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
胫神经	踝/拇展肌	41.1	44.3	4.7	3.5	14.1	16.9
腓总神经	腘窝/拇展肌	40.3	46.2	13.4	11.7	12.0	13.3
腓浅神经	踝/趾短伸肌	46.5	52.3	3.7	3.5	11.4	11.7

肌肉	自发电位正锐波		主动电位峰值/mV
肌肉	治疗前	治疗后	治疗前	治疗后
右臀大肌	+	3-	3.26	4.18
右股外侧肌	3-	3-	3.53	4.01
右腓肠肌	3+	2+	0.10	1.49

Ultrasound-guided sacral canal injection of Neurotropin and comprehensive rehabilitation for the aftermath of severe sacral plexus injury: a case report

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评定方法	治疗前	治疗4周	治疗10周	随访	评定方法	治疗前	治疗4周	治疗10周	随访
AIS分级	D级	E级	E级	E级	MMT
FGA评分	6	23	30	30	左下肢	4级	5级	5级	5级
MBI评分	55	85	100	100	右下肢	3级	4级	5级	5级
吃饭	10	10	10	10	SF-36
洗澡	5	5	5	5	生理功能	20	65	90	95
修饰	5	5	5	5	生理职能	0	25	100	100
穿衣	5	10	10	10	躯体疼痛	22	74	90	84
大便控制	5	10	10	10	一般健康状况	40	67	70	65
小便控制	5	10	10	10	精力	35	75	100	100
如厕	5	5	10	10	社会功能	44	44	89	89
转移	5	10	15	15	情感职能	0	67	100	100
步行	5	10	15	15	精神健康	60	80	96	96
上下楼	5	10	10	10	健康变化	0	75	100	100

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