RESEACH OF MICROHEMODYNAMICS IN PATIENTS WITH LUMBAR SPINAL CANAL STENOSIS USING THE HIGH MAGNIFICATION CONTACT ENDOSCOPE

高倍接触内窥镜对腰椎管狭窄症患者微血流动力学的研究

• 批准号: 13671541
• 负责人: DEZAWA Akira
• 金额: $ 1.98万
• 依托单位: TEIKYO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671541/
• 关键词: Microcirculation; Microrheology; Contact endoscopy; Intermittent Claudication; Lumbar spinal canal stenosis; Microhemodynamics; Cantact endoscopy; intermittent Claudication; microhemodynamics; 微小循環; 腰部脊柱管狭窄症; 間欠性跛行; 接触型拡大視内視鏡; Sludge現象; 血漿分離

Contact endoscope provides the 80-150-fold magnification and gains the same magnitude of illumination and resolution as the microscope. It is useful tool of measuring blood flow on the surface of spinal nerve root in surgery for neurogenic intermittent claudication due to spinal canal stenosis.A@ The recorded data in DVD (especially the change of the speed of erythrocyte and the change of blood vessel) was analyzed by the original computer software (IPlabo)The pathogenesis of intermittent claudication has gained increasing attention in the study of ischemia of spinal nerve root.We were evaluated to support the increased changes of blood flow after an infusion of prostaglandine and the electrical stimulation of the peripheral nerve (tibial posterior and peroneal nerve). Two conclusions can be drawn from this study. A contact endoscopic procedure affords excellent visualization for obtaining the blood flow on spinal nerve root easily and safely. This newly developed endoscope will allow … More the application of other orthopaedic research in case of the synovial disease.Assessment of qualitative and quantitative changes in the microcirculation of nerve roots, such as the diameter of blood vessels and the low rate of erythrocytes, was observed during lumbar interbody fusion. To ascertain changes in the microcirculation of nerve roots before and after retraction during lumbar interbody fusion surgery.The changes in microhemodynamics caused by nerve root retraction have not yet been elucidated.Subjects were patients with lumbar spinal canal stenosis who underwent lumbar interbody fusion. Changes in the microcirculation of nerve roots were examined in the L5 nerve root in 26 patients and SI nerve root in 3 patients. Through the use of video images captured by contact endoscope and stored in a computer,erythrocytes were automatically followed to measure flow rate and the diameter of blood vessels.Plasma skimming, where blood cells and plasma flow separately, was seen in 3 of the 29 patients (10.3%) prior to retraction of the nerve root and in 8 of the 29 patients (27.6%) following retraction. Intravascular erythrocyte agglutination (IEA), where erythrocytes flow in clumps due to changes in the charge state of erythrocytes, was seen in blood vessels larger than 100 μm in three patients (10.3%) after retraction.Following nerve root retraction, the flow rate of erythrocytes through blood vessels decreased an average of 23.9% (p<0.005).A contact endoscope was used to observe the microhemodynamics of nerve roots before and after retraction of the nerve root during lumbar interbody fusion surgery, and a decrease in the flow rate of erythrocytes was observed. Less

接触式内窥镜提供80-150倍的放大倍数，并获得与显微镜相同的照度和分辨率。在椎管狭窄所致神经源性间歇性跛行的手术中，它是测量脊神经根表面血流量的有用工具。A@利用原始计算机软件(IPlabo)对DVD上记录的数据(特别是红细胞速度和血管变化)进行分析。间歇性跛行的发病机制在脊神经根缺血的研究中越来越受到重视。我们被评估支持注入前列腺素和电刺激周围神经(胫骨后神经和腓神经)后血流量的增加。从这项研究可以得出两个结论。接触式内窥镜手术提供了良好的可视化，可以方便、安全地获得脊神经根上的血流。这种新开发的内窥镜将允许…更多的是骨科其他研究在滑膜疾病中的应用。在腰椎间融合术中，观察神经根微循环的定性和定量变化，如血管内径和低红细胞比率。目的：探讨腰椎间融合术中神经根牵拉前后微循环的变化，目前尚未阐明神经根牵拉引起的微循环变化。研究对象为腰椎管狭窄症患者行椎间融合术。观察26例L5神经根和3例SI神经根微循环的变化。通过使用接触式内窥镜采集的视频图像并存储在计算机中，自动跟踪红细胞以测量血流速度和血管内径。29例患者中，3例(10.3%)在神经根牵拉前看到血细胞和血浆分开流动，8例(27.6%)在神经根牵拉后出现血浆撇除现象。回缩后3例(10.3%)在大于100μm的血管内可见红细胞凝集，即红细胞的电荷状态改变导致红细胞聚集成团。随着神经根回缩，红细胞流经血管的速率平均下降23.9%(p&lt；0.005)。在腰椎间融合术中，使用接触式内窥镜观察神经根回缩前后神经根的微血流动力学，发现红细胞流率下降。较少

项目成果

出沢 明: "腰部脊柱管狭窄症の術中神経根展開前後の微小循環の変化"臨床整形外科. 37 4(in press). (2002)

Akira Idezawa：“腰椎管狭窄术中神经根展开前后的微循环变化”《临床骨科》37 4（出版中）。

出沢 明, 草野信一: "腰部脊柱管狭窄症の術中神経根展開前後の微小循環の変化"臨床整形外科. 37. 365-372 (2002)

Akira Idezawa、Shinichi Kusano：“腰椎管狭窄术中神经根展开前后微循环的变化”《临床骨科》37. 365-372 (2002)。

出沢 明, 南和彦, 木川泰宏: "腰部脊柱管狭窄症の微小循環からみた神経根の血流の可視化と動態解析"別刷整形外科. 38. 31-35 (2001)

Akira Idezawa、Kazuhiko Minami、Yasuhiro Kikawa：“从腰椎管狭窄的微循环角度进行神经根血流的可视化和动态分析”骨科转载。38。31-35（2001）。

出沢 明: "coutact endoscopeの腰部脊柱管狭窄症への応用"臨床整形外科. 36・4. 515-520 (2001)

Akira Idezawa：“Coutact内窥镜在腰椎管狭窄症中的应用”临床骨科36・4（2001）。

出沢 明: "神経根と馬尾の内視鏡所見"腰部脊柱管狭窄症 New Mook. No9. 322-328 (2001)

Akira Idezawa：“神经根和马尾的内窥镜检查结果”腰椎管狭窄 New Mook No9（2001）。