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脊髓损伤后脊髓内压力与脊髓灌注压:一项观察性研究。

Intraspinal pressure and spinal cord perfusion pressure after spinal cord injury: an observational study.

作者信息

Varsos Georgios V, Werndle Melissa C, Czosnyka Zofia H, Smielewski Peter, Kolias Angelos G, Phang Isaac, Saadoun Samira, Bell B Anthony, Zoumprouli Argyro, Papadopoulos Marios C, Czosnyka Marek

机构信息

Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge;

Academic Neurosurgery Unit, St. George's University of London;

出版信息

J Neurosurg Spine. 2015 Dec;23(6):763-71. doi: 10.3171/2015.3.SPINE14870. Epub 2015 Aug 14.

Abstract

OBJECT

In contrast to intracranial pressure (ICP) in traumatic brain injury (TBI), intraspinal pressure (ISP) after traumatic spinal cord injury (TSCI) has not received the same attention in terms of waveform analysis. Based on a recently introduced technique for continuous monitoring of ISP, here the morphological characteristics of ISP are observationally described. It was hypothesized that the waveform analysis method used to assess ICP could be similarly applied to ISP.

METHODS

Data included continuous recordings of ISP and arterial blood pressure (ABP) in 18 patients with severe TSCI.

RESULTS

The morphology of the ISP pulse waveform resembled the ICP waveform shape and was composed of 3 peaks representing percussion, tidal, and dicrotic waves. Spectral analysis demonstrated the presence of slow, respiratory, and pulse waves at different frequencies. The pulse amplitude of ISP was proportional to the mean ISP, suggesting a similar exponential pressure-volume relationship as in the intracerebral space. The interaction between the slow waves of ISP and ABP is capable of characterizing the spinal autoregulatory capacity.

CONCLUSIONS

This preliminary observational study confirms morphological and spectral similarities between ISP in TSCI and ICP. Therefore, the known methods used for ICP waveform analysis could be transferred to ISP analysis and, upon verification, potentially used for monitoring TSCI patients.

摘要

目的

与创伤性脑损伤(TBI)中的颅内压(ICP)不同,创伤性脊髓损伤(TSCI)后的脊髓内压(ISP)在波形分析方面尚未受到同样的关注。基于最近引入的一种连续监测ISP的技术,本文对ISP的形态学特征进行了观察性描述。研究假设用于评估ICP的波形分析方法可同样应用于ISP。

方法

数据包括18例重度TSCI患者的ISP和动脉血压(ABP)连续记录。

结果

ISP脉搏波形的形态类似于ICP波形,由代表叩击波、潮波和重搏波的3个波峰组成。频谱分析显示存在不同频率的慢波、呼吸波和脉搏波。ISP的脉搏幅度与平均ISP成正比,表明与脑内空间存在类似的指数压力-容积关系。ISP慢波与ABP之间的相互作用能够表征脊髓的自动调节能力。

结论

这项初步观察性研究证实了TSCI中ISP与ICP在形态学和频谱方面的相似性。因此,用于ICP波形分析的已知方法可转移至ISP分析,并经验证后可能用于监测TSCI患者。

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