超声骨刮匙对离体猪脊髓硬脊膜的影响
Dural Changes Induced by an Ultrasonic Bone Curette in an Excised Porcine Spinal Cord.
作者信息
Ota Rizou, Iwaki Eri, Sakai Kentaro, Haraguchi Tomohiro, Kaneko Yasuyuki, Sekiguchi Satoshi, Yamaguchi Ryoji, Naganobu Kiyokazu
机构信息
Veterinary Teaching Hospital, Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan.
Inuyama Animal General Medical Center, 29, Haguro Omishita, Inuyama-shi 484-0894, Japan.
出版信息
Vet Sci. 2022 Oct 28;9(11):601. doi: 10.3390/vetsci9110601.
In spinal surgery, ultrasonic bone curettes are considered unlikely to cause mechanical injury to the dura; however, there is little evidence to support this claim. We investigated the effect of direct contact with an ultrasonic bone curette on the dura and the protective effect of covering the dura with a cotton pattie using an excised porcine spinal cord. The ultrasonic bone curette was pressed against the porcine spinal cord with constant force and activated for 1 s, with or without covering the dura with a cotton pattie. The dural surface and cross-section were observed using electron and light microscopy. When the ultrasonic bone curette was applied directly against the dura, most specimens showed non-perforating dural injuries. However, none of the specimens showed dural perforation. Histological changes were also observed. The use of a cotton pattie reduced the occurrence of these changes, although it did not prevent them when ultrasonic vibration was applied with a large force. We considered ultrasonic bone curettes to have a low risk of dural perforation and, thus, to be a safe surgical device as long as they did not accidentally make strong contact with the dura.
在脊柱外科手术中,超声骨刮匙被认为不太可能对硬脊膜造成机械损伤;然而,几乎没有证据支持这一说法。我们使用切除的猪脊髓,研究了超声骨刮匙直接接触硬脊膜的影响以及用棉片覆盖硬脊膜的保护作用。将超声骨刮匙以恒定力压在猪脊髓上并激活1秒,硬脊膜覆盖棉片或未覆盖棉片。使用电子显微镜和光学显微镜观察硬脊膜表面和横截面。当超声骨刮匙直接作用于硬脊膜时,大多数标本显示为非穿透性硬脊膜损伤。然而,没有一个标本显示硬脊膜穿孔。还观察到了组织学变化。使用棉片减少了这些变化的发生,尽管当以较大力量施加超声振动时,棉片并不能防止这些变化。我们认为超声骨刮匙导致硬脊膜穿孔的风险较低,因此,只要它们不会意外地与硬脊膜发生强烈接触,就是一种安全的手术器械。
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