SPR治疗脊髓损伤后肢体痉挛及神经根的组织化学研究  

TREATMENT OF SPASTIC LIMBS AFTER SPINAL CORD INJURY AND THE HISTOCHEMISTRY OF NERVE ROOTS

作　　者：王正雷[1] 徐林[2] 姜洪和[1] 高吉昌[1] 张承敏[1] 陈庆贺[1] 袁梅[1] 晁民[1] 王仑[1] 

机构地区：[1]解放军第211医院 [2]北京大学人民医院

出　　处：《解放军医学杂志》2002年第5期445-446,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：探讨选择性脊神经后根切断术 (SPR)治疗脊髓损伤后肢体痉挛的效果并对其腰骶神经根进行组织学和组织化学研究 ,采用L2 ～S1双侧节段开窗式部分椎板切除 ,保留棘突和棘间、棘上韧带 ,显露双侧L2 ～S1神经根出口处 ,将前后根分开、分束 ,测定各后根束阈值 ,阈值较低的后根小束切断。对切取的神经束进行冰冻切片、染色、固定和组织化学处理。结果发现 ,临床应用 2 9例 ,随访 3年疗效满意 ,痉挛解除率为 90 % ,功能改善率为 80 %。切除的神经后根纤维Ache反应阳性 ,后根同感觉支传入纤维相混合。说明采用选择性脊神经后根切断术能有效治疗脊髓损伤后肢体痉挛 。To study the curative effect of selective posterior rhizotomy for spastic limbs after spinal cord injury, and to study the histochemistry of nerve roots. The posterior nerve roots of L 2～S 1 were separated from anterion roots and splited into rootlets. The lower threshold rootlets were sectioned after electrical stimulation. The sectioned rootlets were studied with histochemistry. The resalt showed that the selective posterior rhizotomy was performed on 29 cases who were followed up for 3 years. The treatment was satisfactory. The rate of reducing spasticity was 90% and the rate of functional improvement was 80%. The Ache reaction of sectioned rootlets was positive. The result suggest that it is a successful way to treat spastic limbs after spinal cord injury with selective posterior rhizotomy. Electrical stimulation is necessary in selective posterior rhizotomy.

关 键 词：脊神经根切断术 脊髓损伤 痉挛 神经根 组织化学 

分 类 号：R651.2[医药卫生—外科学]