Department of Orthopedic Surgery, Shaanxi Provincial People's Hospital, Xi'an, China.
School of Materials Science, Northwestern Polytechnical University, Xi'an, China.
J Neurotrauma. 2022 Aug;39(15-16):1039-1049. doi: 10.1089/neu.2021.0439. Epub 2022 Mar 30.
This study investigates the effect of extended laminectomy (EL) on spinal cord injury (SCI) caused by spinal shortening, and further, the timing and the optimal length of removal. Dogs received spinal column shortening at T13 segment, following which the control group underwent regular laminectomy while other groups underwent laminectomy with an additional 1-lamina length removed 6h after shortening ("1-lamina EL 6 h"), an extra 1.5-lamina length resected at 6 h or 12 h after shortening ("1.5-lamina EL 6 h" and "1.5-lamina EL 12 h"), and an extra 2-lamina length removed at 6 or 12 h after shortening ("2-lamina EL 6 h" and 2-lamina EL 12 h"), respectively. Somatosensory evoked potential (SSEP) and neurological function were recorded periodically; spinal cord blood flow (SCBF) and nerve cell apoptosis were detected. The results showed that resection of an additional 1-lamina length appeared inadequate to relieve the sharp kinking of the spinal cord, whereas the kinking disappeared with an additional 2-lamina length resection. The "1-lamina EL 6 h" and "1.5-lamina EL 12 h" groups showed no significant differences from the control in latency of SSEP, SCBF, hindlimb function and apoptosis. By contrast, significant recovery of SSEP, SCBF and hindlimb function as well as reduction of apoptosis were presented in other three groups. The "2-lamina EL 6 h" group, in particular, showed the most prominent recovery. In conclusion, an additional resection of two laminae at 6 h after shortening showed the best effect in alleviating SCI. Timely and adequately extended laminectomy could be a potential therapeutic strategy for SCI attributable to spinal shortening.
本研究探讨了延长椎板切除术（EL）对脊柱缩短引起的脊髓损伤（SCI）的影响，进一步探讨了手术时间和切除的最佳长度。狗的 T13 段脊柱缩短后，对照组行常规椎板切除术，而其他组则在缩短后 6 小时行额外切除 1 个椎板（“6 小时 1 个椎板 EL”）、6 小时或 12 小时后切除额外 1.5 个椎板（“6 小时 1.5 个椎板 EL”和“12 小时 1.5 个椎板 EL”），或缩短后 6 或 12 小时行额外切除 2 个椎板（“6 小时 2 个椎板 EL”和“12 小时 2 个椎板 EL”）。定期记录体感诱发电位（SSEP）和神经功能；检测脊髓血流（SCBF）和神经细胞凋亡。结果显示，切除额外的 1 个椎板不足以缓解脊髓的急剧扭曲，而切除额外的 2 个椎板可使扭曲消失。与对照组相比，“6 小时 1 个椎板 EL”和“12 小时 1.5 个椎板 EL”组 SSEP、SCBF、后肢功能和凋亡的潜伏期无显著差异。相比之下，其他三组 SSEP、SCBF 和后肢功能均有显著恢复，凋亡减少。尤其是“6 小时 2 个椎板 EL”组，恢复最明显。总之，缩短后 6 小时行额外切除 2 个椎板可缓解 SCI。及时、充分的延长椎板切除术可能是一种治疗因脊柱缩短引起的 SCI 的潜在治疗策略。
