Takahashi K, Miyazaki T, Takino T, Matsui T, Tomita K
Department of Orthopaedic Surgery, Ishikawa Prefectural Central Hospital, Japan.
Spine (Phila Pa 1976). 1995 Mar 15;20(6):650-3.
The relationship between epidural pressure and lumbar posture was assessed in patients with lumbar spinal stenosis.
This study was performed to assess the relationship between epidural pressure and lumbar posture in patients with lumbar spinal stenosis.
The study was performed on 10 patients who had cauda equina symptoms at the L4-L5 level. The catheter transducer was inserted into the epidural space through L5-S1 interlaminar space and placed at the L4-L5 disc level. This transducer was connected with an amplifier and a recorder. Epidural pressure was continuously measured in various postures.
Local epidural pressure at the stenotic level was low in lying and sitting postures, and high in standing postures. Pressure was increased with extension, but decreased with flexion. The highest pressure was 116.7 +/- 38.4 mm Hg in standing with extension.
Epidural pressure was significantly related to posture. These pressure changes correlated with the development of cauda equina symptoms. The increase of epidural pressure by posture may induce compression of the cauda equina. These pressure changes may explain the postural dependency in eliciting symptoms.
评估腰椎管狭窄症患者硬膜外压力与腰椎姿势之间的关系。
本研究旨在评估腰椎管狭窄症患者硬膜外压力与腰椎姿势之间的关系。
对10例在L4-L5水平出现马尾神经症状的患者进行研究。将导管换能器通过L5-S1椎间隙插入硬膜外间隙，并放置在L4-L5椎间盘水平。该换能器与放大器和记录仪相连。在各种姿势下连续测量硬膜外压力。
狭窄水平处的局部硬膜外压力在仰卧位和坐位时较低，在站立位时较高。压力随伸展增加，但随屈曲降低。伸展站立时的最高压力为116.7±38.4 mmHg。
硬膜外压力与姿势显著相关。这些压力变化与马尾神经症状的发生相关。姿势引起的硬膜外压力增加可能导致马尾神经受压。这些压力变化可能解释了症状诱发中的姿势依赖性。
