髖關節置換手術後左小腿失去知覺及神經傳導異常檢查結果分析-骨科

髖關節置換手術左小腿失去知覺？

---

我在去年11月14日作左側髖關節置換手術，手術後就發現
左腿小腿後側自膝蓋以下至腳踝部分沒有知覺，觸摸感覺像是隔了一層很厚的東西，而且沒有知覺所以麻麻的。小腿後筋非常而且僵硬，腳掌無法往上翹，往下翹是可以的，腳踝腫脹。
醫師在今年二月22日安排神經傳導暨肌電圖檢查，醫師只說坐骨神經有一部分拉傷，會復原的。但因醫學專業，我看不懂檢查報告，就把他列出來，麻煩醫師給我建議!謝謝。
The nerve conduction studies showed:
(1) reduced CMAP amplitude in the left peroneal and tibial nerve,
(2) slowing of motor conduction velocities in bilateral tibial nerve,
(3) absent SNAP in the left sural and superficial peroneal nerve,
(4) reduced SNAP amplitude and slowing of sensory conduction
velocity in the right superficial peroneal nerve.

The electromyogrpahy study showed:
(1) active denervation changes, mild neurogenic polyphasic waves and
reduced recruitment in the left tibialis anterior muscle,
(2) active denervation changes, mild neurogenic polyphasic waves with
giant MUAPs up to 4K and reduced recruitment in the left gastrocnemius
muscle (medial head),
(3) active denervation changes, mild to moderate neurogenic polyphasic
waves and reduced recruitment in the left biceps femoris muscle,
(4) moderate neurogenic polyphasic waves in the left L5 lumbar paraspinal
muscle.

The above findings suggest:
(1) a left sciatic neuropathy,
(2) coexisting a relatively chronic lumbosacral radiculopathy,
(3) an underlying sensorimotor polyneuropathy may also be considered.
Advise clinical correlation.

---

杜杜，60~69歲男性，詢問日期：2024/04/17