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SELECTIVE DORSAL ROOT BLOCKADE USING SPINAL ENDOSCOPY AND ELECTRO-PHYSIOLOGY

使用脊柱内窥镜和电生理学选择性背根阻滞

基本信息

批准号：
10470237
负责人：
CHINZEI Mieko
金额：
$ 2.75万
依托单位：
THE UNIVERSITY OF TOKYO
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10470237/
关键词：
Spinal endoscopy Spinal evoked potential Selective root blockade 選択的後根ブロック

项目摘要

1) We developed a method of accurately identifying the dorsal roots for the corresponding afferent nerves.:We used an endoscope with an external diameter of 1.8 mm. Goats were anesthetized and mechanically ventilated. After small laminectomy on lower thoracic vertebrae, we inserted this endoscope into subarachnoid space and observed structures in the space. Then we inserted an eight polar catheter-type electrode into the visualized space to record evoked potentials. The each pole could be distinguished by marks. Using endoscopy, we tried to determine the spatial relationship between these poles and dorsal root. We chose the neighboring pairs of poles sequentially from the tip of catheter for bipolar recording. We inserted electrodes into Th11 or Th12 intercostal nerves. We obtained sequential recordings of potentials from dorsal surface of the cord evoked by stimulating each intercostal nerve. With the endoscope, we could determine the spatial relationship between the recording electrode and dorsal roots. Shapes of evoked potentials changed characteristically according to the relative position between roots and poles. By combining endoscopy with the electro-physiological technique, we could identify the dorsal roots for the corresponding afferent nerves using the recording electrode as a cue.2) We applied blockade on the roots under endoscopic view and evaluated the selectivity of the blockade.:Under endoscopic view, we applied a dose of 3 ml, 0.3 ml and 0.05 ml of 3% lidocaine solution on the dorsal root regarded as Th1 1. We obtained sequential recordings of evoked potentials after blockade and tried to determine the effects of blockade. We could determine the extension of blockade by obtaining sequential recordings of evoked potentials changing the site of stimulation and recording. We could also evaluate the selectivity of the blockade using this technique. This method can provide a useful tool for selective dorsal root blockade.

1)我们开发了一种准确识别相应传入神经背根的方法。我们使用的内窥镜外径为1.8毫米。山羊麻醉和机械通气。在下胸椎小椎板切除术后，我们将此内窥镜插入蛛网膜下腔，观察空间内的结构。然后我们将一个八极导管型电极插入可视化空间以记录诱发电位。每一个极点都可以通过标记来区分。利用内窥镜，我们试图确定这些极和背根之间的空间关系。我们从导管头端开始依次选择相邻的电极对进行双极记录。我们将电极插入Th11或Th12肋间神经。我们获得了刺激每根肋间神经引起的脊髓背侧电位的顺序记录。通过内窥镜可以确定记录电极与背根的空间关系。诱发电位的波幅随根极相对位置的不同而发生特征性变化。将内窥镜技术与电生理技术相结合，以记录电极为线索，识别相应传入神经的背根。2）在内窥镜视野下对背根进行阻滞，评价阻滞的选择性。在内窥镜视野下，我们在背根上应用剂量为3 ml、0.3 ml和0.05 ml的3%利多卡因溶液，将其视为Th11。我们获得了连续记录的诱发电位后封锁，并试图确定封锁的影响。我们可以通过改变刺激和记录部位获得诱发电位的连续记录来确定阻滞的范围。我们还可以使用这种技术评估封锁的选择性。该方法为选择性背根阻滞提供了一种有效的方法。