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背根入髓区损伤对节段性、上行性和下行性冲动所诱发脊髓电位的影响。

Effects of dorsal root entry zone lesion on spinal cord potentials evoked by segmental, ascending and descending volleys.

作者信息

Fujioka H, Shimoji K, Tomita M, Denda S, Hokari T, Tohyama M

机构信息

Department of Anesthesiology, Niigata University School of Medicine, Japan.

出版信息

Acta Neurochir (Wien). 1992;117(3-4):135-42. doi: 10.1007/BF01400610.

Abstract

The spinal cord potentials (SCPs) were recorded from the dorsal root entry zone (DREZ) and posterior epidural space in patients before and after dorsal root entry zone lesion (DREZL) during general anaesthesia. The SCPs from the DREZ activated by segmental, ascending and descending volleys were basically the same in fundamental waveform as those recorded from the posterior epidural space. Segmentally activated slow negative (N1) wave, reflecting synchronized activities of dorsal horn neurones, and positive (P2) wave, thought to indicate primary afferent depolarization, were affected by DREZL in all 4 subjects tested, even by contralateral stimulation, suggesting that these components of the segmental SCPs in man partly reflect the activities of the contralateral dorsal horn. The spike-like potentials activated by ascending volleys were not affected by DREZL, while the subsequent slow components were decreased in the lesioned level. This may indicate that ascending spinal cord tracts are not affected by the operation, and suggests that the origin of the slow components by ascending volleys lies at least in part in the segmental dorsal horn. The slow negative and positive components, recorded at a remote segment from DREZL, in response to the descending volleys, were augmented after DREZL, suggesting that activation of ascending or descending inhibition through a feedback loop via the supraspinal structures might occur at least transiently following DREZL. All components of the SCPs activated by descending volleys were decreased or disappeared in recording from the lesioned level, as expected. Thus, intra-operative recording of the SCPs during DREZL might be beneficial for monitoring and studying human spinal cord function.

摘要

在全身麻醉期间,记录了背根入髓区(DREZ)损伤(DREZL)前后患者的脊髓电位(SCPs),记录部位为背根入髓区和硬脊膜后间隙。由节段性、上行性和下行性冲动激活的DREZ的SCPs,其基本波形与从硬脊膜后间隙记录的基本相同。反映背角神经元同步活动的节段性激活慢负波(N1)和被认为指示初级传入去极化的正波(P2),在所有4例受试对象中均受到DREZL的影响,即使是对侧刺激时也是如此,这表明人类节段性SCPs的这些成分部分反映了对侧背角的活动。由上行性冲动激活的棘状电位不受DREZL影响,而损伤节段的后续慢成分减少。这可能表明脊髓上行传导束不受手术影响,并提示上行性冲动所致慢成分的起源至少部分位于节段性背角。在远离DREZL的节段记录到的对下行性冲动的反应中,慢负成分和正成分在DREZL后增强,这表明在DREZL后可能至少短暂地通过经由脊髓上结构的反馈回路发生了上行或下行抑制的激活。正如预期的那样,在损伤节段记录时,由下行性冲动激活的SCPs的所有成分均减少或消失。因此,在DREZL期间术中记录SCPs可能有助于监测和研究人类脊髓功能。

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