摘要
目的:探索慢性颈脊髓压迫后电生理变化规律,及其与脊髓损伤内在关系。方法:实验于2004-09/2005-08在广西中医学院骨伤科研究所完成。①分组:将42只新西兰兔随机分为2大组,即对照组和实验组,每组分为6,8,12周组,共6小组,每小组7只。②实验组经颈4,5椎体前螺钉多次缓慢加压造成兔慢性颈脊髓受压模型。对照组行颈5手术入路,不置入螺钉,普通饲养,分别于6,8,12周处死取材。③用改良Tarlov法,对其肢体肌力进行评估。肌电诱发电位仪测定体感皮质诱发电位的潜伏期和波幅变化。苏木精-伊红染色进行脊髓组织形态学观察。结果:参加实验动物42只,实验组有6只退出观察,随机补充6只,最终进入结果分析42只兔。①实验组各时间段改良Tarlov法分值差别不明显,在12周改良Tarlov法分值变异性变大,部分动物神经功能趋于好转,而部分动物功能进行性恶化,对照组神经功能正常。②诱发电位潜伏期比术前明显延长,并趋于增加,12周后有所回落,12周实验组4,6,8,12周潜伏期分别是(13.56±1.11),(14.31±0.56),(16.25±0.36),(14.74±1.78)ms;波幅变化较大,趋于逐渐降低,至12周又逐渐增高,12周实验组4,6,8,12周分别是(3.45±0.71),(4.23±1.97),(2.51±0.83),(2.98±0.73)V。③形态学观察示灰质神经元减少,白质脱髓鞘变性。结论:对于慢性脊髓压迫,皮质体感诱发电位潜伏期能反映脊髓损伤程度和预后,可作为临床观察指标,波幅变异性大,无确切临床意义。
AIM： To explore potential and pathological rule after chronic compressive cervical myelopathy and its internal relation with spinal injury. METHODS： The experiment was finished in Institute of Orthopedics and Trauma Department, GuangXi Traditional Chinese Medical University between September 2004 and August 2005. ①Grouping： Forty-two New Zealand rabbits were divided randomly into the control group and experimental group. Each group was divided further into 3 subgroups （6-week, 8-week and 12-week）. Each subgroup had 7 animals.②The animals in the experimental group were made into models of chronic compressive cervical myelopathy, using screw through cervical anterior approach for progressive compression to spinal cord 4, 5. The control group was applied with similar operating approach without screw and compression to spinal cord 5. Relevant animals were sacrificed in 6 weeks, 8 weeks and 12 weeks, respectively. ③Myodynamia of animal was assessed by modified Tarlov＇s assay. Latency and amplitude of somatosensory evoked potentials were measured by the muscle electric inducing apparatus. The pathological changes were evaluated with Hematoxylin and eosin staining.RESULTS： Among the forty-two experimental animals 6 withdraw in the experimental group and complemented 6, so 42 rabbits were involved in the result analysis. ①The difference of score assessed by modified Tarloy＇s assay was not obvious in every time point in the experimental group. Variability of score of modified Tarlov at the 12^th week enlarged. Neural function of part of animals became better, while part of animlas＇ became worse. The neural function in the control group became normal. ②The latency prolonged significantly after operation, and added more as time went by. But it fell partly in the 12^th week. The latencies of the 12-week subgroup were respectively （13.56±1.11 ）, （14.31±0.56）, （16.25 ±0.36）, （14.74±1.78）ms in the 4^th, 6^th, 8^th, and 12^th weeks. The amplitude fell gradually after operation, and rose again until the 12^th week. The 12-week subgroup had the amplitude of （3.45 ±0.71）, （4.23±1.97）, （2.51±0.83）, （2.98±0.73） V in the 4^th, 6^th, 8^th and 12^th weeks, respectively. ③The pathological changes were mainly that neuron in grey matter decreased and white matter became demyelination. CONCLUSION： As for chronic compressive cervical Myelopathy, latency of somatosonsory evoked potentials can show the degree of spinal cord and prognosis, and can be one observational index in clinic. Amplitude has obvious variability and indefinite significance in clinic.
出处
《中国临床康复》
CSCD
北大核心
2006年第12期101-103,共3页
Chinese Journal of Clinical Rehabilitation
基金
广西青年科学基金资助课题(桂科青0339029)~~
