经前路颈椎多节段椎管扩大术的实验研究

目的设计颈椎前路椎管扩大术式并探讨该术式的可行性,为颈椎管多节段狭窄症提供新的手术方法。方法标本实验:选用4具C1～T1尸体颈椎标本,去除前方肌肉,保留后侧肌肉及固有韧带,解剖出横突孔,沿椎动脉走行,穿入直径3mm橡胶管,注入造影剂。沿C4～6椎体前正中纵行劈开,依次横向撑开3、6、9、12mm,并用木块填塞,三维CT下观察椎管前后径、横径、截面积、两侧椎动脉的直径、间距,神经根管变化。动物实验:用4只成年绵羊,麻醉后暴露出C3,4颈椎前方,将C3,4椎体纵向劈开,横向撑开9mm,取同侧胫骨9mm×9mm×15mm骨块植入撑开区。术后观察四肢运动恢复情况。结果标本在撑开3、6、9mm后,椎管前后径平均增加1.14%、3.53%、5.15%,横径增加7.92%、14.62%、22.74%,截面积增加8.52%,17.99%,25.01%;在撑开3、6、9mm时,两侧椎动脉走行间距平行,撑开12mm时,在C3,4和C6,7椎间椎动脉间距相差2mm,但走行无折屈、受压。撑开前后神经根管各径及长度无变化。标本在撑开3、6、9mm时未见骨折,撑开12mm时2具左侧、1具右侧椎板靠近棘突部骨折,均为裂纹骨折,无移位。4只绵羊术后第2d四肢可以自由行走,无神经、血管损伤征兆。结论经前路颈椎体纵向劈开扩大术,可以增加椎管容积、不影响脊柱三柱稳定结构。动物实验表明椎体横向撑开一定范围内(≤9mm)对颈髓及周围组织无损伤迹象。实验结果初步证实经前路颈椎椎管扩大术安全有效。     

Direct evidence for the link between monoaminergic descending pathways and motor activity:: II. A study with microdialysis probes implanted in the ventral horn of the spinal cord

In order to define precisely the relation between descending monoaminergic systems and the motor system, we measured in the ventral horn of spinal cord of adult rats the variations of extracellular concentrations of 5-HT, 5-HIAA, DA and MHPG. Measurements were performed during rest, endurance running on a treadmill, and a post-exercise period, with microdialysis probes implanted permanently for 45 days. We found a slight decrease in both 5-HT and 5-HIAA during locomotion with a more marked decrease during the post-exercise period compared to the mean of rest values. In contrast, the concentration of DA and MHPG increased slightly during the exercise and decreased thereafter. These results, when compared with those of a previous study, which measured monoamines in the spinal cord white matter [C. Gerin, D. Bécquet, A. Privat, Direct evidence for the link between monoaminergic descending pathways and motor activity: I. A study with microdialysis probes implanted in the ventral funiculus of the spinal cord, Brain Res. 704 (1995) 191–201], highlight the complex regulation of the release of monoamines that occurs in the ventral horn.     

Crossed inhibition of the soleus H reflex during passive pedalling movement

We hypothesized that sensory input from the moving leg induces presynaptic inhibition of the soleus H reflex pathway in the contralateral stationary leg. The results showed a crossed inhibition during passive pedalling movement of the leg, which was not removed by low levels of tonic contraction of soleus in the stationary leg. The inhibition was correlated exponentially to the rate of the movement (R²=0.934, P<0.05) and was not dependent on the quadrants through which the moving leg was passing. Static flexion of the stationary leg caused ipsilateral inhibition of the reflexes (t=5.590, P<0.05), independent of the orientations of the other leg. We concluded that sensory inflow from the moving leg induces presynaptic inhibition in the stationary leg, that a complex transformation of the sensory input in the spinal cord or brain underlies the tonic crossed inhibition and phasic ipsilateral inhibition, and that descending motor commands exert a powerful control over these sensorimotor modulatory mechanisms.     

High resolution nuclear magnetic resonance imaging of the spinal cord in experimental demyelinating disease

Summary Chronic recurrent experimental allergic encephalomyelitis was induced in a strain 13 guinea pig by inoculation of isologous spinal cord homogenate. The spinal cord was obtained after perfusion with 4% paraformaldehyde and examined with nuclear magnetic resonance (NMR) imaging. Proton NMR spin echo images (repetition time: 3 s; echo times: 20 and 60 ms) were obtained from intact, isolated spinal cord in a 4.7 Tesla, 50 mm bore magnet. The slice thickness of the images was 380 m and the inplane resolution was 40×40 m. The images showed superficial areas of low signal intensity in the lateroventral regions of the white matter, in some instances with a seam of higher signal intensity. Neuropathologically, these abnormalities corresponded exactly to areas of demyelination. Control images did not show these abnormalities. The present high resolution imaging allowed a correlation between demyelination and abnormal NMR signals in a small laboratory animal with an inflammatory demyelinating disease.Supported by the Belgian Foundation of Medical Scientific Research (FGWO, grant 3.0096.86 and grant 3.0019.86), by the Institute for the promotion of Scientific Research in Industry and Agriculture (IWONL) and by the Scientic Research Planning Office of the Belgian Government (DPWB), contract no. 87/92-120     

Spinal cord transplants enhance the recovery of locomotor function after spinal cord injury at birth

Summary Fetal spinal cord transplants placed into the site of a neonatal spinal cord lesion alter the response of immature CNS neurons to injury. The transplants prevent the retrograde cell death of immature axotomized neurons and support the growth of axons into and through the site of injury. In the present experiments we used a battery of locomotor tasks to determine if these transplants are also capable of promoting the recovery of motor function after spinal cord injury at birth. Embryonic (E14) spinal cord transplants were placed into the site of a spinal cord over-hemisection in rat pups. Three groups of animals were used: 1) normal control animals, 2) animals with a spinal cord hemisection only, and 3) animals with a spinal cord transplant at the site of the hemisection. Eight to twelve weeks later, the animals were trained and videotaped while crossing runways requiring accurate foot placement and footprinted while walking on a treadmill. The videotapes and footprints were analyzed to obtain quantitative measures of locomotor function. Footprint analysis revealed that the animals' base of support during locomotion was increased by a neonatal hemisection. The base of support in animals with transplants was similar to control values. Animals with a hemisection rotated their hindlimbs further laterally than did control animals during locomotion. A transplant at the site of injury modified this response. Normal animals were able to cross a grid runway quickly with only a few errors. In contrast, animals with a hemisection took a longer time and made more errors while crossing. The presence of a transplant at the site of injury enabled the animals to cross the grid more quickly and to make fewer errors than the animals with a hemisection only. Animals that received the transplants demonstrated qualitative and quantitative improvements in several parameters of locomotion. Spinal cord transplants at the site of neonatal spinal cord injury result in enhanced sparing or recovery of motor function. We suggest that this transplant induced recovery of function is a consequence of the anatomical plasticity elicited by the transplants.     

Ultrastructural synaptology of Clarke's column

Summary An electron microscopic analysis of the synapses in Clarke's column of the cat, using fresh short term degeneration, long term degeneration for detection of the persisting elements, and a newly devised two-step degeneration technique using fresh short term degeneration for further analysis of the persisting synaptic elements in chronic degeneration cases. — Three kinds of synaptic terminals can be identified in the lower part (L₃ segmental level) of Clarke's column: (1) very large (so-called giant) axon terminals with spheric vesicles of primary muscle afferents establishing multiple (climbing-type) contacts mainly with the large dorsal spinocerebellar tract neurons; (2) small bouton-type terminals having spheric synaptic vesicles and originating mainly from spinal interneurons, localized below L₄ in the lumbar enlargement and contacting small distal dendrites and cell bodies of small cells; (3) two types of nerve terminals, originating from local neurons, and characterized by flattened vesicles. One type of (3) contacts mainly the large Clarke neurons directly, whereas the other establishes axo-axonic synapses with the giant terminals (1) of primary muscle affer ents. The possible functional significance of these findings is discussed.     

H-reflexes are smaller in dancers from The Royal Danish Ballet than in well-trained athletes

Summary The size of the maximalH-reflex (H _max) was measured at rest and expressed as a percentage of the maximalM-response (M _max) in 17 untrained subjects, 27 moderately trained subjects, 19 well-trained subjects and 7 dancers from the Royal Danish Ballet. TheH _max/M _max was significantly larger in the moderately and well-trained subjects than in the untrained subjects but smaller in the ballet dancers. It is therefore suggested that both the amount and the type of habitual activity may influence the excitability of spinal reflexes.     

Time course and effective sites for inhibition from midbrain periaqueductal gray of spinal dorsal horn neuronal responses to cutaneous stimuli in the cat

Summary Inhibition of spinal dorsal horn neuronal responses to noxious (50 °C) skin heating by stimulation of the midbrain periaqueductal gray (PAG) was quantitatively investigated in cats anesthetized with sodium pentobarbital and nitrous oxide. Systematic variation of the interval between onset of PAG stimulation (PAGS) and onset of noxious skin heating revealed that a marked reduction of spinal unit heat-evoked discharges occured immediately upon onset of PAGS, and ceased immediately at offset of PAGS with a post-stimulation excitatory rebound. Stimulation at sites in both ventral and dorsal PAG produced inhibition, the strength of which increased sometimes in a linear manner with increasing strength of PAGS. Thresholds for the generation of descending inhibition were higher in dorsal than ventral PAG. PAGS also inhibited spinal unit responses to non-noxious skin stimulation (brushing of hairs). Descending inhibition from PAG is considered as a possible mechanism for analgesia produced by stimulation of PAG and other brainstem structures.The work was supported by a grant from the Deutsche Forschungsgemeinschaft (Zi 110)     

交感神经在肺泡缺氧性肺血管收缩反应中的作用

在大鼠毁髓模型上观察缺氧与不缺氧情况下电刺激肺血管的脊髓交感中枢时体、肺循环的变化。常氧时电刺激脊髓T_(1～3)节段时P_(pa)、PVR增高(P<0.05);毁髓去神经支配大鼠吸入12%O_2低氧气体后仍能引起肺血管收缩反应(HPV),但PVR上升幅度较正常大鼠降低。在缺氧基础上电刺激T_(1～3)节段引起P_(pa)、PVR大幅度增高(P<0.05),约为常氧时电刺激效应的二倍;酚妥拉明可抑制这一反应。提示交感神经兴奋对HPV的形成有一定的促进作用。缺氧时体循环对交感兴奋的反应减弱。     

The relationship between the lumbosacral enlargement and the conus medullaris during the period of fetal development and adulthood

The spinal cord is situated within the vertebral canal by the third month of intrauterine life. The spinal cord possesses two symmetrical enlargements, which constitute the segments of the plexuses the cervical enlargement for the brachial plexus and the lumbosacral enlargement for the lumbar and sacral plexus. In our study, we aimed to investigate the relationship between the termination level of the lumbosacral enlargement (TLLE) and that of the conus medullaris (TLCM) during the period of fetal development and adulthood. We used a total of 75 cases 25 fetuses (male 16, female 9) whose crown-rump length ranged between 90–190 mm, 25 premature and full-term neonates (male 17, female 8) whose post-menstrual ages ranged between 33–55 weeks, and 25 adults (male 12, female 13) aged between 22–72 years. The dissection technique for fetuses, ultrasonography for premature and full-term newborns, and magnetic resonance imaging (MRI) for adults were used to determine lumbosacral enlargement and TLCM. The differences between the TLCM and the termination level of the largest part of the transverse diameter of the lumbosacral enlargement were investigated. The differences between the TLLE and TLCM were found in different ratios from the period of fetal development to adulthood. Therefore, during medical treatment and surgical procedures this should be taken into account to avoid complications.