猪脊髓栓系综合征神经轴性牵拉模型的建立

发布时间：2018-01-06 11:16

  本文关键词：猪脊髓栓系综合征神经轴性牵拉模型的建立　出处：《第二军医大学学报》2017年09期 　论文类型：期刊论文

  更多相关文章： 脊髓栓系综合征 动物模型 神经血流监测 躯体感觉诱发电位 尿动力学

【摘要】：目的探讨建立猪脊髓、神经根轴性牵拉损伤模型模拟脊髓栓系综合征的方法。方法将18只成年家猪随机分为3组,每组6只。假手术组:暴露L1~5脊髓;对照组:暴露L1~5脊髓后于L1~5双侧椎弓根置入螺钉;实验组:暴露L1~5脊髓并于双侧椎弓根置入螺钉后,均匀撑开L1~5椎间隙。于各时间点对3组动物行X线片、后肢行为学、尿流动力学、体感诱发电位、激光散斑血流成像及组织病理学检查并对结果进行比较分析。结果假手术组和对照组术前、术后L1~5椎体间高度、后肢运动神经功能评分、尿流动力学、体感诱发电位及激光散斑血流成像检查结果均无明显变化,组织学观察脊髓、神经结构基本正常。实验组动物撑开后L1~5的椎体间高度较撑开前增高,后肢运动神经功能评分降低,体感诱发电位P波的潜伏期延长、波幅下降,脊髓表面的血流减少(P0.05);撑开后出现低顺应性膀胱、逼尿肌-括约肌协同功能障碍;脊髓组织可见不同程度的神经细胞坏死,胞质内可见颗粒变性和空泡变性;神经根组织可见组织水肿、细胞结构疏松,部分神经束膜损伤。结论通过松解猪腰椎后柱结构均匀撑开椎间隙的方法可以建立脊髓、神经根轴性牵拉损伤模型,该模型能够模拟临床脊髓栓系综合征患者的下肢感觉、运动功能和括约肌功能障碍,为深入探讨脊髓栓系综合征的病理机制以及手术治疗方式奠定了实验基础。
[Abstract]:Objective to establish pig spinal cord, nerve root axial stretch injury model simulation method of tethered cord syndrome. Methods 18 adult pigs were randomly divided into 3 groups, 6 rats in each group. Sham operation group: exposure of L1~5 spinal cord; control group: exposure of L1~5 spinal cord at L1~5 after bilateral pedicle screw placement; experimental group: the exposure of L1~5 spinal cord and bilateral pedicle screw, uniform distraction L1~5 intervertebral space. At each time point of 3 groups of animal X-ray, hindlimb behavior, urodynamics, somatosensory evoked potential, laser speckle imaging and histopathological examination and the results were compared. Results the sham operation group and the control group before surgery, postoperative L1~5 intervertebral height, hindlimb motor function scores, urodynamics, somatosensory evoked potentials and laser speckle imaging examination results showed no significant changes, histological observation of spinal cord nerve, the normal structure. The experimental group of animals Open the L1~5 material interbody distraction height is increased before, hind limb motor function scores decreased, somatosensory evoked potential P wave latency, amplitude decreased, reduce the surface of the spinal cord blood flow (P0.05); after the unfolding of low compliance bladder, detrusor sphincter coordination dysfunction; spinal cord tissue showed different degrees of nerve cell necrosis in the cytoplasm of granular degeneration and vacuolar degeneration; nerve root tissue edema, cell structure is loose, part of perineurial injury. Conclusion by loose column structure solution of porcine lumbar intervertebral disc after uniform distraction can establish the spinal cord, nerve root axial stretch injury model, the model can simulate clinical spinal cord syndrome of patients with lower limb sensory, motor function and sphincter dysfunction, which lays the foundation for further study on pathological mechanism of tethered spinal cord syndrome and surgical treatment.

【作者单位】： 第二军医大学长征医院脊柱二科;
【分类号】：R-332;R744
【正文快照】： [Acad J Sec Mil Med Univ,2017,38(9):1158-1164]脊髓栓系综合征(tethered cord syndrome,TCS)是一组复杂的临床综合征[1]。传统定义上,TCS是指由于各种原因导致脊髓圆锥受到牵拉,出现低位圆锥[2],引起脊髓发生病理改变、圆锥缺血、电生理活动性降低,以及氧代谢活动障碍等病，

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