Ohashi T, Morimoto T, Kawata K, Yamada T, Sakaki T
Department of Neurosurgery, Nara Medical University, Shijo-cho, Kashihara, Japan.
Acta Neurochir (Wien). 1996;138(3):322-9. doi: 10.1007/BF01411744.
Simultaneous measurements of spinal cord blood flow and arterial diameter at areas adjacent to a site of spinal cord injury were carried out to determine changes in CO(2) reactivity and autoregulation. The spinal cord injury was made at T10 level by the epidural clip compression method. A spinal window was drilled at an area either 7 mm caudal or 7 mm rostral to the injury site for the measurement of spinal cord blood flow and arterial diameter at the same time. Spinal cord blood flow was decreased at both spinal windows, especially at the rostral window. Arterial diameter was also decreased significantly at both sites. The ischaemic zone evaluated histologically tended to expand more diffusely in the rostral direction than in the caudal direction. In the pre-injury stage, both CO(2) reactivity and autoregulation were present in the spinal cord. Following the clip injury, CO(2) reactivity and autoregulation were both impaired in the areas 7 mm adjacent to the impact site. Correlation coefficients suggested that the rostral spinal cord tended to sustain more injury than the caudal spinal cord. The histologically proven spinal cord ischaemia following the injury may have resulted from the decreased arterial diameter and impaired CO(2) reactivity and dysautoregulation of the spinal cord.
同时测量脊髓损伤部位附近区域的脊髓血流量和动脉直径,以确定二氧化碳反应性和自动调节功能的变化。采用硬膜外夹压法在T10水平造成脊髓损伤。在损伤部位尾侧7mm或头侧7mm处钻一个脊髓窗,同时测量脊髓血流量和动脉直径。两个脊髓窗处的脊髓血流量均减少,尤其是头侧窗。两个部位的动脉直径也显著减小。组织学评估的缺血区在头侧方向比尾侧方向更倾向于广泛扩展。在损伤前阶段,脊髓同时存在二氧化碳反应性和自动调节功能。夹伤后,在撞击部位相邻7mm区域,二氧化碳反应性和自动调节功能均受损。相关系数表明,头侧脊髓比尾侧脊髓更容易受到损伤。损伤后组织学证实的脊髓缺血可能是由于动脉直径减小、二氧化碳反应性受损和脊髓自动调节功能障碍所致。