2002 Fiscal Year Final Research Report Summary
Clinical Study for chronic compressive disorders of the spinal cord-Elucidation of the pathogenesis and Selection of the therapy-
| Project/Area Number |
13671419
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | AKITA UNIVERSITY |
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Principal Investigator |
ITOH Yasunobu Akita Univ. Sch. of Med., Associate Professor, 医学部, 助教授 (00184698)
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| Project Period (FY) |
2001 – 2002
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| Keywords | Cervical canal stenosis / Cervical OPLL / Cervical spondylotic myelopathy / MEG / Dipole / MRI / NCSS |
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| Research Abstract |
Objective evaluation of sensory dysfunction derived from chronic compressive disorders of the spinal cord is difficult. In the present study, the authors investigated the possibility of assessing cervical myelopathy-induced sensory disorders by using magnetoencephalography to measure somatosensory evoked magnetic fields.
In 7 patients with cervical myelopaty including cervical spondylotic myeloradiculopathy (n=4), cervical ossification of posterior longitudal ligament (n=2), and spinal dural arteriovenous fistula (n=1), somatosensory evoked magnetic fields were measured before and on the 7th day after surgery by using a 204-channel magnetoencephalography system (Neuromag) to stimulate the bilateral median nerve and the bilateral posterior tibial nerve, and the intensity and latency of N20m (first response occurring 20msec after stimulation) and P38m were then determined. The extensive laminoplasty at the level of C3-C6(C7) were performed, and the cord decompression was demonstrated with
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the postperative MRI study in all patients. Additionally, the severity of the sensory disorder was assessed before and after surgery by obtaining sensory scores determined using the Neurosurgical Cervical Spine Scale. Analysis of the results showed that the postoperative intensity of N20m in the 4 patients with cervical myelopathy was higher than that demonstrated preoperatively, and the postoperative latency in the same patients shortened compared with the preoperative study. In addition, of four patients in whom sensory scores improved remarkably after surgery, there were a correlation between sensory scores and dipole intensity. The period of symptoms in 3 patients with no change of the latency and intensity of N20m postoperatively was characteristically long, over 3 years.
Somatosensory evoked magnetic field measurements determined by magnetoencephalography are useful in objectively and noninvasively assessing sensory disorders caused by chronic compressed disorders of the spinal cord. Less
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