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腕管压力以剂量依赖方式改变正中神经功能:一种腕管综合征的兔模型。

Carpal tunnel pressure alters median nerve function in a dose-dependent manner: a rabbit model for carpal tunnel syndrome.

作者信息

Diao Edward, Shao Fang, Liebenberg Ellen, Rempel David, Lotz Jeffrey C

机构信息

Department of Orthopaedic Surgery, University of California, San Francisco, 500 Parnassus MU-320W, San Francisco, CA 94143-0728, USA.

出版信息

J Orthop Res. 2005 Jan;23(1):218-23. doi: 10.1016/j.orthres.2004.05.014.

Abstract

BACKGROUND

An in vivo animal model for carpal tunnel syndrome (CTS) is presented which allows for graded application of pressure to the median nerve within the carpal canal. We hypothesized that such pressure would cause electrophysiologic changes in the median nerve in a dose-related manner, with NCS/EMG changes consistent with CTS in humans.

METHODS

In 40 New Zealand white rabbits, ranging from 2 to 2.5 kg, angioplasty catheters were placed in the carpal tunnel in the forepaws and pressures ranging from 50 to 80 mmHg applied to one side while the contralateral side served as the control and remained uninflated. Pressure was applied until a 15% increase in distal motor latency was obtained for 2 consecutive weeks by nerve conduction studies.

RESULTS

All the experimental limbs exhibited a 15% increase in distal motor latency. None of the control limbs showed a significant increase in distal motor latency. In the experimental animals the 15% delay was achieved in approximately 4-5 weeks in the 50-70 mmHg groups and in approximately 1 week in the 80 mmHg group.

CONCLUSION

This new animal model for CTS demonstrates a direct cause and effect relationship between carpal tunnel pressure and median nerve dysfunction. We anticipate that this in vivo model with clinically relevant outcomes will facilitate identification of injury mechanisms, and will serve as a basis for future development of novel interventions and treatments.

摘要

背景

本文介绍了一种用于腕管综合征(CTS)的体内动物模型,该模型能够对腕管内的正中神经进行分级施压。我们假设这种压力会以剂量相关的方式导致正中神经发生电生理变化,其神经传导速度/肌电图(NCS/EMG)变化与人类CTS一致。

方法

选取40只体重在2至2.5千克之间的新西兰白兔,将血管成形术导管置于前爪的腕管内,对一侧施加50至80毫米汞柱的压力,而对侧作为对照,不充气。持续施加压力,直到通过神经传导研究连续两周获得远端运动潜伏期增加15%。

结果

所有实验肢体的远端运动潜伏期均增加了15%。对照肢体均未显示远端运动潜伏期有显著增加。在实验动物中,50至70毫米汞柱组在约4至5周内实现了15%的延迟,80毫米汞柱组在约1周内实现了延迟。

结论

这种新的CTS动物模型证明了腕管压力与正中神经功能障碍之间存在直接的因果关系。我们预计这种具有临床相关结果的体内模型将有助于确定损伤机制,并将为未来新型干预措施和治疗方法的开发奠定基础。

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