Hyun Seung-Jae, Lee Chang-Hyun, Kwon Ji Woong, Yoon Cheol-Yong, Lim Jae-Young, Kim Ki-Jeong, Jahng Tae-Ahn, Kim Hyun-Jib
Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Korean J Spine. 2013 Mar;10(1):14-8. doi: 10.14245/kjs.2013.10.1.14. Epub 2013 Mar 31.
The purpose of this study is to compare a neuroprotective effect of thoracic cord neuromodulation to that of sacral nerve neuromodulation in rat thoracic spinal cord injury (SCI) model.
Twenty female Sprague Dawley rats were randomly divided into 4 groups: the normal control group (n=5), SCI with sham stimulation group (SCI, n=5), SCI with electrical stimulation at thoracic spinal cord (SCI + TES, n=5), and SCI with electrical stimulation at sacral nerve (SCI + SES, n=5). Spinal cord was injured by an impactor which dropped from 25mm height. Electrical stimulation was performed by the following protocol: pulse duration, 0.1ms; frequency, 20 Hz; stimulation time, 30 minutes; and stimulation duration at thoracic epidural space and S2 or 3 neural foramina for 4 weeks. Locomotor function, urodynamic study, muscle weights, and fiber cross sectional area (CSA) were investigated.
All rats of the SCI + TES group expired within 3 days after the injury. The locomotor function of all survived rats improved over time but there was no significant difference between the SCI and the SCI + SES group. All rats experienced urinary retention after the injury and recovered self-voiding after 3-9 days. Voiding contraction interval was 25.5±7.5 minutes in the SCI group, 16.5±5.3 minutes in the SCI+SES group, and 12.5±4.2 minutes in the control group. The recovery of voiding contraction interval was significant in the SCI + SES group comparing to the SCI group (p<0.05). Muscle weight and CSA were slightly greater in the SCI + SES than in the SCI group, but the difference was not significant.
We failed to establish a rat spinal cord stimulation model. However, sacral neuromodulation have a therapeutic potential to improve neurogenic bladder and muscle atrophy.
本研究旨在比较大鼠胸段脊髓损伤（SCI）模型中胸段脊髓神经调节与骶神经神经调节的神经保护作用。
将20只雌性Sprague Dawley大鼠随机分为4组：正常对照组（n = 5）、SCI假刺激组（SCI，n = 5）、胸段脊髓电刺激的SCI组（SCI + TES，n = 5）和骶神经电刺激的SCI组（SCI + SES，n = 5）。脊髓由从25mm高度落下的撞击器损伤。电刺激按以下方案进行：脉冲持续时间0.1ms；频率20Hz；刺激时间30分钟；在胸段硬膜外间隙和S2或3神经孔处刺激持续4周。研究运动功能、尿动力学、肌肉重量和纤维横截面积（CSA）。
SCI + TES组的所有大鼠在损伤后3天内死亡。所有存活大鼠的运动功能随时间改善，但SCI组和SCI + SES组之间无显著差异。所有大鼠在损伤后均出现尿潴留，并在3 - 9天后恢复自主排尿。SCI组的排尿收缩间隔为25.5±7.5分钟，SCI + SES组为16.5±5.3分钟，对照组为12.5±4.2分钟。与SCI组相比，SCI + SES组排尿收缩间隔的恢复有显著差异（p<0.05）。SCI + SES组的肌肉重量和CSA略大于SCI组，但差异不显著。
我们未能建立大鼠脊髓刺激模型。然而，骶神经调节具有改善神经源性膀胱和肌肉萎缩的治疗潜力。
