Nakamura K, Machida H, Tanaka H, Kobayashi M, Hoshino Y, Iizuka T, Kurokawa T
Nihon Seikeigeka Gakkai Zasshi. 1981 Aug;55(8):747-54.
There exists the view that ischemia in the spinal cord accounts for the paralysis caused by cervical spondylotic myelopathy (CSM), but little work has been done to study the change of spinal cord blood flow (SCBF) in CSM. To clarify this situation, the experimental model designed by Tanaka (1978) was used as a model of CSM (Fig. 1). Among 27 cats in which the spinal canal was narrowed between C4 and C6, 13 cats developed delayed paralysis 33 weeks after operation in an average. Spinal cord blood flow was measured by the reference sample method using isotopelabeled microspheres of 15 +/- 3 mu in diameter. The mean SCBF values for each spinal segments in normal animals ranged from 23.0 g/min . 100 g in T11 to 40.2 g/min . 100 g in C8, resulting in that blood flow in the cervical and lumbar enlargements was constantly higher than that in the other regions of the cord (Fig. 3). The mean blood flow values for the gray matter, ventral white matter, lateral white matter, and dorsal white matter in cervical region were 99.1, 5.0, 5.9, and 11.4 g/min . 100 g respectively, without significant difference between each spinal segments (Fig. 4). In an animal with acute spinal cord compression, the SCBF decreased significantly 15 minutes after spinal cord compression was induced (Figs. 5, 6). On the other hand, in two delayed paralysis animals SCBF in the narrowed segments was within normal limits (Figs. 5, 6). These results suggest that paralysis as seen in CSM may develop without ischemia of the spinal cord.
有一种观点认为，脊髓缺血是导致脊髓型颈椎病（CSM）所致瘫痪的原因，但针对CSM中脊髓血流（SCBF）变化的研究却很少。为了阐明这种情况，采用了田中（1978年）设计的实验模型作为CSM模型（图1）。在27只脊髓在C4和C6之间变窄的猫中，平均有13只猫在术后33周出现延迟性瘫痪。使用直径为15±3μm的同位素标记微球，通过参考样本法测量脊髓血流。正常动物各脊髓节段的平均SCBF值范围为：T11节段为23.0g/min·100g，C8节段为40.2g/min·100g，结果显示颈膨大及腰膨大处的血流持续高于脊髓其他区域（图3）。颈段灰质、腹侧白质、外侧白质和背侧白质的平均血流值分别为99.1、5.0、5.9和11.4g/min·100g，各脊髓节段之间无显著差异（图4）。在急性脊髓压迫的动物中，诱导脊髓压迫15分钟后SCBF显著下降（图5、6）。另一方面，在两只出现延迟性瘫痪的动物中，狭窄节段的SCBF在正常范围内（图5、6）。这些结果表明，CSM中所见的瘫痪可能在脊髓无缺血的情况下发生。
