终丝牵拉脊髓拴系综合征动物模型的建立及评估  

Establishment and evaluation of animal model of filum terminale traction tethered cord syndrome

作　　者：蒋擎玉 尚爱加[2] 史旭东 程浩峰 苏天崎 吴言 JIANG Qing-yu;SHANG Ai-jia;SHI Xu-dong;CHENG Hao-feng;SU Tian-qi;WU Yan(Chinese PLA Medical School,Beijing 100853,China;Department of Neurosurgery Medicine,Chinese PLA General Hospital,Beijing 100853,China;Department of Neurosurgery,School of Medicine,Nankai University,Tianjin 300071,China)

机构地区：[1]中国人民解放军医学院,北京100853 [2]中国人民解放军总医院神经外科医学部,北京100853 [3]南开大学医学院神经外科,天津300071

出　　处：《局解手术学杂志》2024年第11期985-990,共6页Journal of Regional Anatomy and Operative Surgery

基　　金：国家重点研发计划(2022YFC2703304);首都卫生发展科研专项(2022-2-5022)。

摘　　要：目的建立一种新的终丝牵拉脊髓拴系综合征动物模型,以探讨其发病机制。方法将16只新西兰大白兔随机分为牵拉组和假手术组,每组8只。牵拉组用丝线建立终丝牵拉脊髓拴系综合征模型,假手术组仅切断终丝但不作牵引。8周后,完成行为学Talov评分、腰骶部MRI检查、体感诱发电位检测、尿动力学指标检查及病理组织分析。结果术后第8周,牵拉组后肢损伤明显,术后第4周、8周Talov评分低于假手术组(P<0.001)。术后8周腰骶部MRI结果显示,牵拉组矢状位MRI可见末端终丝受丝线牵引、膀胱异常膨大,轴位MRI可见椎管内脊髓受向下及向背侧方向的机械力;假手术组矢状位、轴位MRI显示,脊髓位于椎管正中,膀胱大小正常。术后第8周,牵拉组波幅显著低于假手术组(P<0.001),波幅下降幅度超过50%;牵拉组总体潜伏期比假手术组略有延长(P<0.05)。尿动力学检查结果显示,牵拉组的最大膀胱容量明显高于假手术组(Z=-3.361,P<0.001),膀胱压力明显低于假手术组(Z=-3.361,P<0.001),膀胱顺应性明显高于假手术组(P<0.001)。病理学染色显示,终丝对脊髓的牵拉导致神经组织损伤、膀胱上皮细胞变性。结论本研究成功建立了新西兰大白兔终丝牵拉脊髓拴系综合征模型,可为探究脊髓拴系的发病机制和了解脊髓损伤的病理过程提供参考。Objective To establish a new animal model of filum terminale traction tethered cord syndrome to explore its pathogenesis.Methods Sixteen New Zealand white rabbits were randomly divided into the traction group and the sham group,with 8 rabbits in each group.The traction group used silk thread to establish a model of filum terminale traction tethered cord syndrome,while the sham group only cut the filum terminale without traction.After 8 weeks,the behavioral Talov score,lumbosacral MRI examination,somatosensory evoked potential detection,urodynamic index test and pathological analysis were completed.Results At the 8th week after surgery,the hindlimb injury was obvious in the traction group,and the Talov scores at the 4th and 8th weeks after operation were lower than those in the sham group(P<0.001).The lumbosacral MRI results at 8 weeks after surgery showed that the distal filum terminale was pulled by silk thread,with bladder abnormal enlargement in sagital MRI in the traction group,while axial MRI showed the spinal cord within the spinal canal was subjected to mechanical forces in the downward and dorsal directions;the sagittal and axial MRI of the sham group showed that the spinal cord was located in the middle of the spinal canal and the bladder size was normal.At the 8th week after surgery,the amplitude in the traction group was significantly lower than that in the sham group(P<0.001),and the amplitude decreased by more than 50%.The overall latency period in the traction group was slightly longer than that in the sham group(P<0.05).The results of urodynamic examination showed that the maximum bladder capacity in the traction group was significantly higher than that in the sham group(Z=-3.361,P<0.001),the bladder pressure was significantly lower than that in the sham group(Z=-3.361,P<0.001),and the bladder compliance was significantly higher than that in the sham group(P<0.001).Pathological staining showed that the traction of the filum terminale on the spinal cord led to nerve tissue damage and degeneration of

关 键 词：动物模型 终丝 脊髓拴系综合征 病理染色 尿动力学 核磁共振 体感诱发电位 

分 类 号：R744.9[医药卫生—神经病学与精神病学]