| 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（P<0.05）；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。 |
| 关键词: 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 |
| DOI：10.16781/j.0258-879x.2017.09.1158 |
| 投稿时间：2017-08-15修订日期：2017-09-17 |
| 基金项目: |
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| Establishment of a tethered cord syndrome model with neural axial stretch in pig |
| KONG Qing-jie,WU Zhao,SUN Jing-chuan,WANG Yuan,XU Xi-ming,YANG Yong,SHI Jian-gang* |
(Department of Spine Surgery(Ⅱ), Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author) |
| Abstract: |
| Objective To explore a method for establishment of tethered cord syndrome model with neural axial stretch in pig. Methods Eighteen adult pigs were randomized into three groups. Sham group:L1-5 spinal cords were exposed; control group:L1-5 bilateral pedicle screws were placed after exposure of L1-5 spinal cords; and experiment group:L1-5 spinal cords were exposed, then bilateral pedicle screws were placed, and finally L1-5 intervertebral spaces were extended axially, with six in each group. At different time points, the pigs in the three groups were subjected to X-ray, hindlimb behaviors, urodynamics, somatosensory evoked potential, laser speckle imaging for blood flow and histopathology examination, and the examination results were compared and analyzed. Results In the sham group and control group, there was no obvious change in L1-5 intervertebral space height, hindlimb motor nerve function scores, urodynamics, somatosensory evoked potentials or laser speckle imaging for blood flow before and after operation; and the spinal cord and nerve structure were normal or nearly normal in the histopathology. In the experiment group, compared with before distraction, L1-5 intervertebral height after distraction was significantly increased, hindlimb motor nerve function score was significantly decreased, latency of P-wave of sematosensory evoked potential was significantly extended and the amplitude was significantly decreased, and blood flow on the surface of spinal cord was significantly reduced (P<0.05). We observed low compliance bladder, detrusor-sphincter dyssynergia, varying degrees of neuronal necrosis in the spinal cord, vacuolar degeneration and granular degeneration in the cytoplasm, tissue edema, sparse cell structure, and partial perineurium injury in nerve root after extension of L1-5 intervertebral height. Conclusion The spinal cord and nerve root injury model can be established by loosening posterior column structure and extending intervertebral space, and this model can be used to simulate the clinical tethered cord syndrome patients with sensory and motor dysfunction in the lower extremities, and sphincter dysfunction, which lays a foundation for studying the pathological mechanism and exploring the surgical treatment of tethered cord syndrome. |
| Key words: tethered cord syndrome animal models neural blood flow monitoring somatosensory evoked potentials urodynamics |
