Glennie R Andrew, Urquhart Jennifer C, Staudt Michael D, Lawendy Abdel-Rahman, Gurr Kevin R, Bailey Christopher S
*Division of Orthopaedics, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada; and †Center for Critical Illness Research, Lawson Health Research Institute, London Health Sciences Center, London, Ontario, Canada.
Spine (Phila Pa 1976). 2014 Sep 1;39(19):E1123-31. doi: 10.1097/BRS.0000000000000483.
Immunohistochemical and behavioral study using a rat model of acute cauda equina syndrome (CES).
To determine the effect of duration of extradural cauda equina compression (CEC) on bladder, sensory, and motor functions.
Cauda equina syndrome is a devastating injury treated with surgical decompression. Controversy exists regarding the optimal timing of surgery. Animal models of CES have focused on motor recovery but have not evaluated pain behavior or bladder function.
A 4-mm balloon-tipped Fogarty catheter was inserted between the fifth and sixth lumbar lamina into the dorsal epidural space and inflated to compress the nerve roots at the L5 level. Maximal inflation was maintained at a constant balloon pressure of 304 Kpa for 1 or 4 hours. The catheter was inserted but not inflated in sham animals. During a 4-week period, pain behavior, bladder function, and locomotor function were assessed. Postmortem bladders and the lesion site were collected for analysis.
Mechanical allodynia was 2-fold greater in 1-hour CEC rats than 4-hour CEC (P=0.002) and sham-operated (P=0.001) rats at 4 weeks after injury. Hind limb locomotor function was not different between groups at 4 weeks after injury. Both the 1-hour and 4-hour CEC group rats retained greater volumes of urine than the sham-operated rats throughout the 4-week period (P<0.05). At 4 weeks, bladder weight and volume were 2-fold greater in the 4-hour CEC group than in the 1-hour CEC group (P=0.006 and P=0.01, respectively). Histology of the bladder wall revealed an overall thinning after 4-hour CEC. Histology of the lesion site revealed a greater overall severity of injury after 4-hour CEC than after 1-hour CEC (P=0.04) and sham operation (P=0.002).
Our data suggest that recovery of motor function is less affected by the timing of decompression compared with bladder function and pain behavior. Early decompression preserved bladder function but was associated with allodynia.
N/A.
使用急性马尾综合征（CES）大鼠模型进行免疫组织化学和行为学研究。
确定硬膜外马尾神经压迫（CEC）持续时间对膀胱、感觉和运动功能的影响。
马尾综合征是一种通过手术减压治疗的严重损伤。关于手术的最佳时机存在争议。CES动物模型主要关注运动恢复，但未评估疼痛行为或膀胱功能。
将一根4毫米球囊尖端的Fogarty导管插入第五和第六腰椎椎板之间进入背侧硬膜外间隙，并充气以压迫L5水平的神经根。在304千帕的恒定球囊压力下保持最大充气1或4小时。在假手术动物中插入导管但不充气。在4周期间，评估疼痛行为、膀胱功能和运动功能。收集死后的膀胱和损伤部位进行分析。
在损伤后4周，1小时CEC大鼠的机械性异常性疼痛比4小时CEC大鼠（P = 0.002）和假手术大鼠（P = 0.001）高2倍。损伤后4周，各组间后肢运动功能无差异。在整个4周期间，1小时和4小时CEC组大鼠的尿量均比假手术大鼠多（P < 0.05）。在4周时，4小时CEC组的膀胱重量和体积比1小时CEC组大2倍（分别为P = 0.006和P = 0.01）。膀胱壁组织学显示4小时CEC后总体变薄。损伤部位组织学显示4小时CEC后的损伤总体严重程度比1小时CEC后（P = 0.04）和假手术后（P = 0.002）更大。
我们的数据表明，与膀胱功能和疼痛行为相比，减压时机对运动功能恢复的影响较小。早期减压可保留膀胱功能，但与异常性疼痛有关。
无。
