Application of the collision technique and development of fast-recovery preamplifier for detecting conduction delicits in lumbar spinal stenosis.

碰撞技术的应用和快速恢复前置放大器的开发用于检测腰椎管狭窄症的传导缺陷。

• 批准号: 11671442
• 负责人: TANI Toshikazu
• 金额: $ 2.18万
• 依托单位: Kochi Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11671442/
• 关键词: Lumbar spinal stenosis; Radiculopathy; Electrodiagnosis; Cauda equina action potential; Collision technique; fast-recovery preamplifier

Clinically recorded lumbosacral evoked potentials after peripheral nerve stimulation are less sensitive than might be expected for a single radicular lesion. Direct nerve root stimulation, despite its potential advantage, is not practical because of an overloading stimulus artifact. A collision technique should circumvent these problems. For a single L-5 radicular lesion produced in rats by constant, localized compression, sequential changes of epidurally recorded potentials after sciatic nerve stimulation (Group 1) or direct L-5 root stimulation (Group 2) were compared to those after a combination of L-6 root and sciatic nerve stimulation (Group 3). At every step of recording, the N1 peak amplitude was significantly smaller in group 2 and 3 than in group 1, whereas there was no significant difference between group 2 and 3. Thus, the collision technique in gourp 3 achieved nearly the same diagnostic yield as the direct L5 root stimulation in group 2 by blocking the unwanted impulses transmitted via the L6 root.In clinical practice, unlike animal experiments, it is difficult to control the stimulus artifact by shielding the stimulator from the surrounding tissues and thereby reducing spread of stimulus current. To circumvent this problem, we developed a fast-recovery preamplifier. This preamplifier interposed between the recording electrodes and the amplifier allows opening the conduction path at the moment of large stimulus input and closing the path with the wane of its magnitude. The printed circuit plate of the preamplifier was made of glass epoxy because of an excellent high frequency specificity of the material. It was shielded from the outside electric noise by being doubly encased in two aluminum boxes. In addition, the electric noise occurring when the switch closes and opens was minimized by using the MCD-5221 switch.

外周神经刺激后临床记录的腰骶诱发电位对单个神经根损伤的敏感性低于预期。直接神经根刺激，尽管其潜在的优势，是不实际的，因为过载的刺激伪影。碰撞技术应该可以避免这些问题。对于一个单一的L-5神经根损伤大鼠产生的恒定，局部的压力，连续变化的神经记录电位后坐骨神经刺激（组1）或直接L-5根刺激（组2）进行了比较，那些后的组合L-6根和坐骨神经刺激（组3）。在记录的每一步，N1峰值振幅在第2组和第3组中显著小于第1组，而在第2组和第3组之间没有显著差异。因此，碰撞技术在LFP 3中实现了几乎相同的诊断率作为直接L5根刺激组2通过阻断不必要的脉冲通过L 6根传输。在临床实践中，不像动物实验，这是很难控制的刺激伪影屏蔽刺激器从周围组织，从而减少刺激电流的传播。为了解决这个问题，我们开发了一种快速恢复的方法。插入在记录电极和放大器之间的该放大器允许在大刺激输入的时刻打开传导路径，并且随着其幅度的减弱关闭该路径。由于玻璃环氧树脂材料具有优良的高频特性，所以该器件的印刷电路板由玻璃环氧树脂制成。它被两个铝盒双重包裹，与外界的电子噪音隔绝。此外，通过使用MCD-5221开关，使开关闭合和断开时产生的电噪声最小化。

项目成果

Taniguchi S.: "Mini-symposium ; Lumbar spinal canal stenosis, (iii) Decompression surgery for lumbar spinal stenosis"Current Orthop. 13. 184-190 (1999)

Taniguchi S.：“小型研讨会；腰椎管狭窄，(iii) 腰椎管狭窄减压手术”当前矫形术。

Tani T: "Intraoperative electroneurography in the assessment of the level of operation for cervical spondylotic myclopathy in the elderly."J Bone Joint Surg. 82-B. 269-274 (2000)

Tani T：“术中神经电图评估老年人颈椎病的手术水平。”J Bone Joint Surg。

Taniguchi S: "Mini-symposium ; Lumbar spinal canal slenosis, (iii) Decompression surgery for lumbar spinal stenosis."Current Orthop. 13. 184-190 (1999)

Taniguchi S：“小型研讨会；腰椎管狭窄，(iii) 腰椎管狭窄减压手术。”当前矫形术。

Tani T: "Sequential changes of orthodromie sensory nerve action potentials induced by experimental compression of the median nerve at the wrist."Clin Neurophysiol. 112. 136-144 (2001)

Tani T：“腕部正中神经实验性压迫引起的顺向感觉神经动作电位的连续变化。”《临床神经生理学》。

Tani T.: "Sequential changes of orthodromic sensory nerve action potentials induced by experimental compression of the median nerve at the wrist."Clin Neurophysiol. 112. 136-144 (2001)

Tani T.：“腕部正中神经实验性压迫引起的顺向感觉神经动作电位的连续变化。”《临床神经生理学》。