Abstract:
The sciatic nerve is the body\'s largest peripheral nerve. Along with their two terminal divisions (tibial and fibular), their anatomic location makes them particularly vulnerable to trauma and iatrogenic injuries. A thorough understanding of the functional anatomy is required to adequately localize lesions in this lengthy neural pathway. Proximal disorders of the nerve can be challenging to precisely localize among a range of possibilities including lumbosacral pathology, radiculopathy, or piriformis syndrome. A correct diagnosis is based upon a thorough history and physical examination, which will then appropriately direct adjunctive investigations such as imaging and electrodiagnostic testing. Disorders of the sciatic nerve and its terminal branches are disabling for patients, and expert assessment by rehabilitation professionals is important in limiting their impact. Applying techniques established in the upper extremity, surgical reconstruction of lower extremity nerve dysfunction is rapidly improving and evolving. These new techniques, such as nerve transfers, require electrodiagnostic assessment of both the injured nerve(s) as well as healthy, potential donor nerves as part of a complete neurophysiological examination.
摘要:
坐骨神经是人体最大的周围神经。连同他们的两个末端分区(胫骨和腓骨),他们的解剖位置使他们特别容易受到创伤和医源性伤害。需要对功能解剖结构有透彻的了解,才能在这个漫长的神经通路中充分定位病变。神经的近端疾病可能是具有挑战性的,要在一系列可能性中精确定位,包括腰骶部病理学,神经根病,或梨状肌综合征.正确的诊断是基于全面的病史和体格检查,然后将适当地指导辅助检查,如成像和电诊断测试。坐骨神经及其末端分支的疾病使患者致残,康复专业人员的专家评估对于限制其影响很重要。应用在上肢建立的技术,下肢神经功能障碍的外科重建正在迅速改善和发展。这些新技术,比如神经转移,需要对受损神经和健康神经进行电诊断评估,潜在的供体神经作为完整的神经生理学检查的一部分。