Rooney Gemma E, Endo Toshiki, Ameenuddin Syed, Chen Bingkun, Vaishya Sandeep, Gross Louann, Schiefer Terry K, Currier Bradford L, Spinner Robert J, Yaszemski Michael J, Windebank Anthony J
Department of Neurology and Molecular Neuroscience, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
J Neurosurg Spine. 2009 Oct;11(4):432-7. doi: 10.3171/2009.4.SPINE08784.
Glial scar and cystic formation greatly contribute to the inhibition of axonal regeneration after spinal cord injury (SCI). Attempts to promote axonal regeneration are extremely challenging in this type of hostile environment. The objective of this study was to examine the surgical methods that may be used to assess the factors that influence the level of scar and cystic formation in SCI.
In the first part of this study, a complete transection was performed at vertebral level T9-10 in adult female Sprague-Dawley rats. The dura mater was either left open (control group) or was closed using sutures or hyaluronic acid. In the second part of the study, complete or subpial transection was performed, with the same dural closure technique applied to both groups. Histological analysis of longitudinal sections of the spinal cord was performed, and the percentage of scar and cyst formation was determined.
Dural closure using sutures resulted in significantly less glial scar formation (p = 0.0248), while incorporation of the subpial transection surgical technique was then shown to significantly decrease cyst formation (p < 0.0001).
In this study, the authors demonstrated the importance of the vasculature in cyst formation after spinal cord trauma and confirmed the importance of dural closure in reducing glial scar formation.
胶质瘢痕和囊肿形成在很大程度上导致脊髓损伤(SCI)后轴突再生受到抑制。在这种不利环境中促进轴突再生极具挑战性。本研究的目的是探讨可用于评估影响SCI中瘢痕和囊肿形成程度的因素的手术方法。
在本研究的第一部分,对成年雌性Sprague-Dawley大鼠在T9-10椎体水平进行完全横断。硬脑膜要么保持开放(对照组),要么用缝线或透明质酸进行缝合。在研究的第二部分,进行完全或软膜下横断,并对两组应用相同的硬脑膜闭合技术。对脊髓纵切片进行组织学分析,并确定瘢痕和囊肿形成的百分比。
用缝线闭合硬脑膜导致胶质瘢痕形成显著减少(p = 0.0248),而采用软膜下横断手术技术则显示可显著减少囊肿形成(p < 0.0001)。
在本研究中,作者证明了脉管系统在脊髓创伤后囊肿形成中的重要性,并证实了硬脑膜闭合在减少胶质瘢痕形成中的重要性。