Perfusion-limited recovery of evoked potential function after spinal cord injury
Perfusion-limited recovery of evoked potential function after spinal cord injury
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DOI：
10.1097/00007632-200005150-00004
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发表时间：
2000-05-15
期刊：
影响因子：
3
通讯作者：
LaManna, JC
中科院分区：
文献类型：
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作者：
Carlson, GD;Gorden, CD;LaManna, JC
研究设计.本研究旨在确定在残余压迫期间进行性脊髓损伤是否由低血流量和缺血引起。本实验的目的是确定持续性脊髓压迫对时间依赖性减压后局部血流和诱发电位恢复的影响。创伤后的脊髓损伤通常与残余脊髓压迫有关。虽然有报道脊髓挫伤后血流量减少，但残余脊髓移位对血流量再灌注或神经功能恢复的影响仍不清楚。麻醉18只比格犬，在精确的负荷条件下背侧负荷T13脊髓，直至诱发电位振幅降低50%。在该功能终点，脊髓移位维持90分钟。在减压后3小时内定期测量体感诱发电位。应用荧光微球技术在脊髓减压术中及减压后定时测量脊髓局部血流量。在停止动态脊髓压迫后5分钟内，所有犬均无诱发电位信号。18只犬中有7只减压后诱发电位恢复。基线时局部脊髓血流量为21.8 +/- 1.9 mL/100 g。min（平均值+/- SE），停止动态加压后降至3.9 +/- 0.9 mL/100 g min。尽管在持续压迫过程中脊髓-活塞界面压力消散了最大界面压力的87%，但平均血流量仅恢复到基线流量的34%。诱发电位功能恢复的7只犬血流量增加至11.3 ± 2.7 mL/100 g。减压前即刻（P ≤ 0.05）min。在11只减压后诱发电位功能未恢复的犬中，持续按压时局部血流没有改善。减压后诱发电位功能的恢复与持续移位过程中血流的更大回流和减压相关血流的更大再灌注相对应。
Study Design. The current study was designed to determine whether progressive spinal cord damage during residual compression is caused by low blood flow and ischemia.Objectives. The purpose of this experiment was to determine the effects of sustained spinal cord compression on regional blood flow and evoked potential recovery after time-dependent decompression.Summary of Background Data. Spinal cord injury after trauma is commonly associated with residual cord compression. Although decreased blood flow has been reported after spinal cord contusion, the effect of residual spinal cord displacement on reperfusion of blood flow or recovery of neurologic function remains unclear.Methods. Eighteen beagles were anesthetized, and the spinal cord at T13 was loaded dorsally under precision loading conditions until evoked potential amplitudes were reduced by 50%. At this function endpoint, spinal cord displacement was maintained for 90 minutes. Somatosensory-evoked potentials were measured at regular intervals until 3 hours after decompression. Regional spinal cord blood flow was measured with a fluorescent microsphere technique at regular lime points during and after spinal cord decompression.Results. Within 5 minutes after dynamic cord compression was discontinued, evoked potential signals were absent in all dogs. Evoked potential recovery was observed after decompression in 7 of 18 dogs. Regional spinal cord blood flow at baseline, 21.8 +/- 1.9 mL/100 g . min (mean +/- SE), decreased to 3.9 +/- 0.9 mL/100 g min after dynamic compression was discontinued. Although spinal cord-piston interface pressure dissipated by 87% of maximum interface pressure during sustained compression, mean blood flow recovered to only 34% of baseline flow. in the 7 dogs that recovered evoked potential function, blood flow increased to 11.3 +/- 2.7 mL/100 g . min immediately before decompression (P less than or equal to 0.05). In the 11 dogs that did not recover evoked potential function after decompression, regional blood flow did not improve during sustained compression.Conclusions.; Recovery of evoked potential function after decompression corresponded with a greater return of blood flow during sustained displacement and greater reperfusion of blood flow associated with decompression.