颈髓血流障碍与脊髓型颈椎病发病机制的实验研究

An experimental study on the circulatory obstacle and the pathogenesis of cervical spondylotic myelopathy

目的观察脊髓前动脉阻断对颈髓血供、功能的影响及其病理学变化,研究脊髓型颈椎病的发病机制。方法以家兔为实验模型,阻断C2段脊髓前动脉,在术后6h、24h、72h采用改良Tarlov法对动物行为学评级以及检测运动诱发电位的变化,应用激光多普勒血流测定仪测定颈髓血流灌注量,并观察兔颈髓组织细胞形态学、相关免疫组化的变化。结果术后各时相点神经功能减退,血流量下降明显,神经元骨架结构紊乱,细胞器破坏,出现急性缺血性改变。结论脊髓前动脉血流障碍可导致颈髓缺血性病变,引起脊髓的梗死,是脊髓型颈椎病发生不可忽视的重要因素,对其治疗应注意改善局部血液循环。

Objective to study the effect on cord and the histopathological changes after acute the blood supply and function of cervical spinal anterior spinal artery blocked,and to research the pathogenesis of cervical spondylotie myelopathy. Methods Anterior spinal artery of rabbits were blocked at C2 segment, functions of cervical spinal cord were observed by modified Tarlov and Muscle motor evoked potential and blood flow changes of cervical spinal cord were measured by Laser Doppler Flowmetry （LDF）after 6 hours,24 hours and 72 hours while cell morphology and immunohistochemistry transformation of the cervical spinal cord were observed. Results Function of cervical spinal cord was showed blood flow changes of cervical spinal cord being dropped down markedly at every time point. The framework of nerve cell was disorganized,the organellae were destroyed,and acute ischemic changes were showed. Conclusion The blood disturbance of anterior spinal artery can lead to ischemic changes of spinal cord,then result in spinal cord infarct and which is the important factor in the pathogenesis of cervical spondylotic myelopathy.