| Project/Area Number |
17K10950
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Osaka Medical College |
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Principal Investigator |
Neo Masashi 大阪医科大学, 医学部, 教授 (80311736)
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| Co-Investigator(Kenkyū-buntansha) |
横田 淳司 大阪医科大学, 医学部, 講師 (10449564)
近藤 洋一 大阪医科大学, 医学部, 教授 (40284062)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2017: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
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| Keywords | C5麻痺 / 頚髄後方移動 / 神経根 / 神経伸長 / ラット / 後縦靭帯 / 血液神経関門 / 脊髄後方移動 / 術後C5麻痺 / 頸部頸髄症 / 頸髄後方除圧 / 発生機序 |
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| Outline of Final Research Achievements |
To elucidate the mechanism of so called C5 palsy, we performed both a cadaveric research for analyzing anatomical features around the cervical roots and an animal research utilizing a novel experimental rodent model of posterior spinal cord shift after decompression surgery. In the former, the superficial layer of posterior longitudinal ligament (PLL) surrounded the posterior aspect which looked like the stabilizing structure of the cervical root. In the latter, the anterior rootlets were gradually elongated as the cord shifted posteriorly after surgery. Above all, the elongation rate of C6 anterior rootlets were significantly higher than the other rootlets. Parallel to these alterations, the MEP latency of the deltoid (C5,6 innervated) was significantly delayed. In C6 anterior root, leakage of the venously-injected fluorescent dye in the endoneurium was observed and gene expression of blood-nerve barrier (BNB)-related membrane proteins decreased, indicating impairment of BNB.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究結果は、頸椎後方除圧術後に生じる脊髄後方移動により、頚神経前根が徐々に伸長され三角筋麻痺を惹起するメカニズムと、伸長された神経根内に生じるBNBの機能不全、浮腫性変化を初めて明らかにした。これらの結果より、今後C5麻痺の予防法を確立していく足掛かりを得た。しかし、諸家のこれまでの研究結果を総合すると、C5麻痺は脊髄後方移動のみならず、手術操作による筋肉の腫脹や脊髄の障害も含め、異なる部位に生じる複数の因子により発症すると考えられるため、その原因究明には今後も多面的アプローチによる研究が必要である。
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