Olmarker K, Byröd G, Cornefjord M, Nordborg C, Rydevik B
Department of Orthopaedics, University of Gothenburg, Sahlgren Hospital, Sweden.
Spine (Phila Pa 1976). 1994 Aug 15;19(16):1803-8. doi: 10.1097/00007632-199408150-00003.
The effects of intervention by intravenous injection of methylprednisolone to reduce the nerve root injury after epidural application of autologous nucleus pulposus was studied in an experimental model on the pig cauda equina in 20 animals.
Nucleus pulposus was harvested from a lumbar disc. After lowering the pH of the nucleus pulposus to 3.5 it was placed onto the sacrococcygeal cauda equina. Fifteen of the pigs received a single intravenous injection of 30 mg/kg methylprednisolone, 5 minutes, 24 hours, or 48 hours, respectively, after the application. After 7 days, the nerve conduction velocity was determined, and biopsies of the cauda equina was examined by lightmicroscopy.
In the five pigs that did not receive any methylprednisolone treatment, nerve conduction velocity was reduced, whereas it was normal in the pigs treated 5 minutes and 24 hours after nucleus pulposus application. In pigs treated after 48 hours, nerve conduction velocity was reduced only slightly. At the light microscopic level, significant changes occurred in all series.
This study indicates that the nucleus pulposus-induced effects on nerve function in an experimental pig model may be reduced dramatically by high-dose methylprednisolone administration within 24-48 hours after epidural application of autologous nucleus pulposus. The light microscopic changes were probably not significant for the nerve function. Instead, a morphologic explanation on a subcellular level should probably be sought.
在20只猪马尾的实验模型中，研究静脉注射甲基强的松龙干预对硬膜外应用自体髓核后神经根损伤的影响。
从腰椎间盘获取髓核。将髓核的pH值降至3.5后，置于骶尾马尾上。15只猪在应用髓核后分别于5分钟、24小时或48小时接受一次30mg/kg甲基强的松龙静脉注射。7天后，测定神经传导速度，并对马尾进行活检，通过光学显微镜检查。
在未接受任何甲基强的松龙治疗的5只猪中，神经传导速度降低，而在应用髓核后5分钟和24小时治疗的猪中神经传导速度正常。在48小时后治疗的猪中，神经传导速度仅略有降低。在光学显微镜水平上，所有组均出现显著变化。
本研究表明，在硬膜外应用自体髓核后24 - 48小时内给予高剂量甲基强的松龙，可显著减轻实验猪模型中髓核对神经功能的影响。光学显微镜下的变化可能对神经功能影响不大。相反，可能应在亚细胞水平上寻找形态学解释。
