The Effect of Lumbar Laminectomy on Vascular Permeability and Adhesion of The Cauda Equina : A Pathophysiological Study in Rats

为了阐明腰椎粘连性蛛网膜炎的早期组织学变化，我们评估了椎板切除术后大鼠马尾神经血管通透性的变化。Wistar大鼠L5 ~ L 6椎板切除后分为以下五组：1.伊文思蓝白蛋白示踪研究2。镧示踪剂研究3.辣根过氧化物酶分布4.荧光异硫氰酸酯-葡聚糖示踪研究，和5。在硬膜上注射高岭土的椎板切除大鼠中，静脉注射^3H-甲基葡萄糖后，评估了其在马尾和其他器官组织中的供应和扩散。未处理的大鼠用作对照。椎板切除术引起马尾神经血管通透性增加，尤其是在椎板切除区域。椎板切除术后早期，内皮细胞的细胞间主动运输和紧密连接开放加重。马尾神经的通透性增加与马尾神经的粘连有关。与对照组相比，给药组大鼠马尾部同位素分布（血肌酐百分比）增加。这些结果表明，椎板切除术后硬膜外炎症的最小化可能会减少术后腰椎粘连性蛛网膜神经根炎的发生。

To clarify the early histological changes of lumbar adhesive arachnoiditis, we evaluated vascular permeability changes in the cauda equina after laminectomy in rats. Wistar rats laminectomized from L5 to L6 were divided into the following five series : 1. Evans blue albumin tracer study 2. Lanthanum tracer study 3. Horseradish peroxidase distribution 4. Fluorescent isothiocyanate-dextran tracer study, and 5. Supply and diffusion of ^3H-methylglucose in the cauda equina and other organ tissues after intravenous injection was evaluated in the laminectomized rats with kaolin administration on the dura mater. Untreated rats were used as control. Laminectomy induced an increase of vascular permeability of the cauda equina especially at laminectomized area. There were aggravated intercellular active transportation in the endothelial cell and opening of the tight junction at an early stage following laminectomy. The permeability aggravation was correlated with the adhesion of the cauda equina. There was an increase of isotopes distribution (percent of blood DPM) in the cauda equina of rats which was administrated kaolin compared with control rats. These results suggest that minimization of the extradural inflammation after laminectomy may reduce the occurrence of postoperative lumbar adhesive arachnoradiculitis.