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[犬马尾横断端端吻合术后的再生]

[Regeneration of the cauda equina after transection and end-to-end anastomosis in the dog].

作者信息

Fujii E

机构信息

Department of Orthopaedic Surgery, School of Medicine, Keio University, Tokyo, Japan.

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1995 Jan;69(1):43-52.

PMID:7699297
Abstract

This study was designed to test surgical techniques for reconstruction of an injured cauda equina. After transection of the intradural lumbar nerve root, end-to-end anastomosis was performed under surgical microscope in the dog. To preserve accurate adaptation of the transected nerve root, the root sheath and the funiculi were carefully sutured with a minimal number of stitches. Regenerated axons in the ventral root appeared distal from the suture at five weeks postoperatively, whereas those in the dorsal root appeared at seven weeks after anastomosis. The histogram and regrowth rate of the ventral root showed regenerative processes similar to those of peripheral nerves, though a little slower. The fact that an evoked potential from the sutured ventral root was recordable after stimulation of the sciatic nerve indicated restoration of nerve conduction. Although further experimental studies are required to develop adequate surgical techniques, microsurgical anastomosis of the transected cauda equina is potentially applicable for appropriate clinical cases of a cauda equina injury.

摘要

本研究旨在测试用于重建受损马尾神经的手术技术。在硬膜内腰神经根横断后,在犬身上于手术显微镜下进行端端吻合。为保持横断神经根的精确对合,用最少数量的缝线仔细缝合神经根鞘和神经束。术后五周,腹侧神经根中的再生轴突出现在缝合处远端,而背侧神经根中的再生轴突在吻合后七周出现。腹侧神经根的直方图和再生率显示出与周围神经相似的再生过程,尽管稍慢一些。刺激坐骨神经后可记录到缝合腹侧神经根的诱发电位,这一事实表明神经传导得以恢复。尽管需要进一步的实验研究来开发合适的手术技术,但横断马尾神经的显微外科吻合术有可能适用于合适的马尾神经损伤临床病例。

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