Observations at the craniocervical junction with simultaneous caudal traction of the spinal cord
Observations at the craniocervical junction with simultaneous caudal traction of the spinal cord
复制标题
颅颈交界处的观察，同时尾部牵引脊髓
DOI：
10.1007/s00381-006-0286-1
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
W. Oakes
中科院分区：
文献类型：
--
作者：
R. Tubbs;M. Loukas;M. Shoja;W. Oakes
前言有人认为脊髓尾侧牵引可导致后脑尾侧下降。（n= 12;死后不到6小时），没有CIM，对脊髓圆锥施加远端张力（75 N），同时观察颈脊髓，脑干，枕大骨瓣减压及C1后弓切除术后，脊髓（脊髓圆锥）上的尾侧张力表明尾侧脑干和颈脊髓的移动可忽略不计（小于1 mm）。未发现小脑扁桃体运动。此外，在切断腰硬脊膜盲囊和腰硬脊膜神经袖后，远端牵引仅产生脑干和颈髓的尾侧下降2至3 mm。再次，没有运动的小脑扁桃体是visualized.ConclusionsOur的研究结果在一个新鲜的尸体模型表明，这是不可能的，尾固定的远端脊髓的结果在下方位移的小脑扁桃体，并由此产生的基亚里I畸形或横断终丝可能扭转扁桃体异位。现在有必要进行体内动物研究来验证我们的发现。
IntroductionSome have opined that caudal traction of the spinal cord may result in caudal descent of the hindbrain.Materials and methodsIn fresh adult cadavers (n= 12; less than 6 h postmortem) with no CIM, distal tension (75 N) was applied to the conus medullaris with simultaneous observation of the cervical spinal cord, brainstem, and hindbrain and their relationship to the foramen magnum per occipital craniectomy and removal of the posterior arch of C1.ResultsAfter lumbar laminectomy in cadavers, caudal tension on the cord (conus medullaris) demonstrated negligible movement (less than 1 mm) of the caudal brain stem and cervical spinal cord. No movement of the cerebellar tonsils was identified. Moreover, after transection of the lumbar dural cul-de-sac and lumbar spinal dural nerve sleeves, distal traction produced only 2 to 3 mm of caudal descent of the brain stem and cervical spinal cord. Again, no movement of the cerebellar tonsils was visualized.ConclusionsOur findings in a fresh cadaveric model suggest that it is unlikely that caudal fixation of the distal spinal cord results in inferior displacement of the cerebellar tonsils, and a resultant Chiari I malformation or that transection of the filum terminale may reverse tonsillar ectopia. In vivo animal studies are now necessary to verify our findings.