Postlaminectomy Adhesion of the Cauda Equina in Rats : A Pathophysiological Study for its Prevention

目的.椎板切除术诱导马尾粘连已被大鼠实验和术后系列磁共振成像证实。对大鼠马尾粘连与临床症状的相关性进行分析。此外，还对腰椎粘连性蛛网膜炎的预防措施进行了评价。Wistar大鼠从L5至L6椎板切除连续评估的感觉，运动和排尿功能。为预防马尾粘连，将大鼠分为3组：对照组仅接受溶剂溶液，吲哚美辛组口服吲哚美辛7天，类固醇组腹腔内给予甲基强的松龙3天。分别于术后24 h、3周、6周对3组马尾粘连及营养血管蛋白示踪剂渗漏情况进行组织学比较。甩尾试验评估的热刺激阈值显示马尾粘连大鼠延长。其他症状显示无显着变化后椎板切除术与或不高岭土的实施。在椎板切除术后24小时，吲哚美辛和甲基强的松龙均显著抑制马尾粘连和营养血管的蛋白渗漏。术后3周和6周给予抗炎药的大鼠马尾神经粘连明显减轻，神经元变性明显减轻。椎板切除术后马尾粘连可引起大鼠热感觉减退。椎板切除术前后给予抗炎药物抑制马尾粘连，促进马尾粘连的恢复。

Purpose. Laminectomy-induced cauda equina adhesion has been proved by rat experiments and postoperative serial magnetic resonance imagings in men. In rats, correlation between cauda equina adhesion and clinical symptoms were analyzed. In addition, the preventive measures for lumbar adhesive arachnoiditis were evaluated.Methods. Wistar rats laminectomized from L5 to L6 were serially assessed for sensory, motor and urinary functions. For the prevention of cauda equina adhesion, rats were divided into 3 groups : Rats in the control group received only vehicle solutions, those in the indomethacin group orally received indomethacin for 7 days, and those in the steroid group were intraperitoneally administered methylprednisolone for 3 days. At 24 hours, 3 and 6 weeks after laminectomy, the cauda equina adhesion and leakage of a protein tracer from the nutrient vessels were histologically compared in the 3 groups.Results. Threshold for thermal stimulation assessed by tail flick test showed elongation in rats with cauda equina adhesion. Other symptoms revealed no significant changes after laminectomy with or without kaolin implementation. Both indomethacin and methylprednisolone significantly suppressed cauda equina adhesion and protein leakage from the nutrient vessels at 24 hours after laminectomy. Rats treated with the anti-inflammatory drugs showed diminution of cauda equina adhesion and the neural degeneration at 3 and 6 weeks after laminectomy.Conclusion. Cauda equina adhesion after laminectomy brought about thermal hypesthesia in rats. Anti-inflammatory drug administration before and after laminectomy suppressed cauda equina adhesion, and facilitated the recovery of cauda equina adhesion.