Bypassing Spinal Cord Injury: Surgical Reconstruction of Afferent and Efferent Pathways to the Urinary Bladder after Conus Medullaris Injury in a Rat Model
Bypassing Spinal Cord Injury: Surgical Reconstruction of Afferent and Efferent Pathways to the Urinary Bladder after Conus Medullaris Injury in a Rat Model
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绕过脊髓损伤：大鼠模型中脊髓圆锥损伤后膀胱传入和传出通路的手术重建
DOI：
10.1055/s-0028-1090599
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发表时间：
2008-09
期刊：
影响因子：
--
通讯作者：
侯春林
中科院分区：
文献类型：
--
作者：
侯春林
通过将左侧 L5 腹侧根 (VR) 硬膜内微吻合到右侧 S2 VR，以恢复纯运动神经再支配，同时将 L5 背根 (DR) 硬膜外节后脊神经转移至 S2 DR，以实现纯粹感觉到感觉神经再支配，从而建立大鼠模型中因脊髓圆锥损伤引起的失张力膀胱的传入和传出神经功能。通过电生理学研究以及膀胱内压力测量和组织学检查来评估反射弧的早期功能。结果表明，在 L6 和 S4 水平之间的水平脊髓损伤之前和之后，左侧 S2 DR 的单焦点刺激在左侧水泡丛处引发了诱发电位。针对左侧 L5-S2 DR 吻合的一系列刺激成功启动了膀胱收缩。在诱导截瘫前后，可达到的膀胱压力和膀胱平滑肌复合体动作电位幅度没有变化，与对照组相当。在神经移植物的远端部分可见明显的轴突出芽。大鼠脊髓损伤后，失张力膀胱中的传入和传出神经通路可以通过骶上运动到运动和感觉到感觉神经转移来重建。这种重建策略在临床应用中具有巨大的潜力。
Afferent and efferent nerve function in the atonic bladder caused by conus medullaris injury in a rat model was established by intradural microanastomosis of the left L5 ventral root (VR) to right S2 VR to restore pure motor-to-motor reinnervation coupled with extradural postganglionic spinal nerve transfer of L5 dorsal root (DR) to S2 DR for pure sensory-to-sensory reinnervation. Early function of the reflex arc was evaluated by electrophysiological study, as well as by intravesicular pressure measurement and histological examination. The results demonstrated that single focal stimulation of the left S2 DR elicited evoked potentials at the left vesicular plexus before and after horizontal spinal cord damage between the L6 and S4 level. Bladder contraction was successfully initiated by trains of stimuli targeting the left L5-S2 DR anastomosis. Achievable bladder pressures and amplitude of bladder smooth muscle complex action potentials were unchanged before and after induced paraplegia and comparable to those of the control. Prominent axonal sprouting was seen in the distal part of nerve graft. Both afferent and efferent nerve pathways in the atonic bladder can be reconstructed by suprasacral motor-to-motor and sensory-to-sensory nerve transfer after spinal cord injury in rats. This reconstructive strategy has significant potential in clinical application.
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影响因子：
2.1
作者：
D. Chuang;P. Chang;Shaw‐Yi Cheng
通讯作者：
D. Chuang;P. Chang;Shaw‐Yi Cheng
DOI：
10.1038/sc.1994.52
发表时间：
1994-05-01
期刊：
PARAPLEGIA
影响因子：
--
作者：
XIAO, CG;GODEC, CJ
通讯作者：
GODEC, CJ
DOI：
--
发表时间：
1967
期刊：
Review of surgery
影响因子：
--
作者：
Carlsson Ca;T. Sundin
通讯作者：
Carlsson Ca;T. Sundin
DOI：
10.1016/s0022-5347(17)45141-x
发表时间：
1986-10
期刊：
The Journal of urology
影响因子：
--
作者：
B. Vorstman;S. Schlossberg;L. Kass;C. Devine
通讯作者：
B. Vorstman;S. Schlossberg;L. Kass;C. Devine
DOI：
--
发表时间：
1993-08
期刊：
The Urologic clinics of North America
影响因子：
--
作者：
A. A. Selzman-A.;N. Hampel
通讯作者：
A. A. Selzman-A.;N. Hampel