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椎板切除术对脊髓血流的影响。

Effects of laminectomy on spinal cord blood flow.

作者信息

Anderson D K, Nicolosi G R, Means E D, Hartley L E

出版信息

J Neurosurg. 1978 Feb;48(2):232-8. doi: 10.3171/jns.1978.48.2.0232.

Abstract

The effect of a one-segment (L-2) laminectomy on spinal cord blood flow (SCBF) was determined by the reference sample method using isotope-labeled microspheres. The SCBF was measured before laminectomy (control) and at 15 minutes postlaminectomy with the dura exposed (Series 1), 1 hour postlaminectomy with the laminectomy site closed (Series 2), 24 hours postlaminectomy with the laminectomy site closed (Series 3), and 24 hours postlaminectomy with the dura exposed (Series 4). With the laminectomy site open, SCBF was significantly depressed (22% to 45%) along the entire length of the spinal cord at 15 minutes postlaminectomy. At 1 hour postlaminectomy (with the laminectomy site closed), SCBF approached control values, although areas with significantly lowered flow were still observed in all portions of the spinal cord. By 24 hours postlaminectomy, SCBF had returned to prelaminectomy levels. However, if within 1 hour preceding the 24-hour SCBF measurement, the laminectomy site was reopened, SCBF tended to fall at and caudad to the laminectomy site. These data indicate that laminectomy can cause a significant decline in SCBF. At the present time, the mechanism(s) for this laminectomy-induced depression of SCBF are unknown, although a temperature-induced vasoconstriction is suspected.

摘要

采用同位素标记微球的参考样本法,测定了单节段(L-2)椎板切除术对脊髓血流量(SCBF)的影响。分别在椎板切除术前(对照)、椎板切除术后15分钟硬脑膜暴露时(系列1)、椎板切除术后1小时椎板切除部位闭合时(系列2)、椎板切除术后24小时椎板切除部位闭合时(系列3)以及椎板切除术后24小时硬脑膜暴露时(系列4)测量SCBF。椎板切除部位开放时,椎板切除术后15分钟脊髓全长的SCBF显著降低(22%至45%)。椎板切除术后1小时(椎板切除部位闭合),SCBF接近对照值,尽管在脊髓所有部位仍观察到血流明显降低的区域。到椎板切除术后24小时,SCBF已恢复到术前水平。然而,如果在24小时SCBF测量前1小时内重新打开椎板切除部位,SCBF往往会在椎板切除部位及其尾侧下降。这些数据表明,椎板切除术可导致SCBF显著下降。目前,这种由椎板切除术引起的SCBF降低的机制尚不清楚,尽管怀疑是温度诱导的血管收缩。

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