2002 Fiscal Year Final Research Report Summary
RESEACH OF MICROHEMODYNAMICS IN PATIENTS WITH LUMBAR SPINAL CANAL STENOSIS USING THE HIGH MAGNIFICATION CONTACT ENDOSCOPE
| Project/Area Number |
13671541
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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 |
Orthopaedic surgery
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| Research Institution | TEIKYO UNIVERSITY |
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Principal Investigator |
DEZAWA Akira medical science assistant professor, 医学部, 助教授 (90237024)
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| Co-Investigator(Kenkyū-buntansha) |
MIKI Hiroshi medical science professor, 医学部, 教授 (70082154)
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| Project Period (FY) |
2001 – 2002
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| Keywords | Microcirculation / Microrheology / Contact endoscopy / Intermittent Claudication / Lumbar spinal canal stenosis / Microhemodynamics |
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| Research Abstract |
Contact endoscope provides the 80-150-fold magnification and gains the same magnitude of illumination and resolution as the microscope. It is useful tool of measuring blood flow on the surface of spinal nerve root in surgery for neurogenic intermittent claudication due to spinal canal stenosis.A@ The recorded data in DVD (especially the change of the speed of erythrocyte and the change of blood vessel) was analyzed by the original computer software (IPlabo)
The pathogenesis of intermittent claudication has gained increasing attention in the study of ischemia of spinal nerve root.
We were evaluated to support the increased changes of blood flow after an infusion of prostaglandine and the electrical stimulation of the peripheral nerve (tibial posterior and peroneal nerve). Two conclusions can be drawn from this study. A contact endoscopic procedure affords excellent visualization for obtaining the blood flow on spinal nerve root easily and safely. This newly developed endoscope will allow
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the application of other orthopaedic research in case of the synovial disease.
Assessment of qualitative and quantitative changes in the microcirculation of nerve roots, such as the diameter of blood vessels and the low rate of erythrocytes, was observed during lumbar interbody fusion. To ascertain changes in the microcirculation of nerve roots before and after retraction during lumbar interbody fusion surgery.
The changes in microhemodynamics caused by nerve root retraction have not yet been elucidated.
Subjects were patients with lumbar spinal canal stenosis who underwent lumbar interbody fusion. Changes in the microcirculation of nerve roots were examined in the L5 nerve root in 26 patients and SI nerve root in 3 patients. Through the use of video images captured by contact endoscope and stored in a computer,erythrocytes were automatically followed to measure flow rate and the diameter of blood vessels.
Plasma skimming, where blood cells and plasma flow separately, was seen in 3 of the 29 patients (10.3%) prior to retraction of the nerve root and in 8 of the 29 patients (27.6%) following retraction. Intravascular erythrocyte agglutination (IEA), where erythrocytes flow in clumps due to changes in the charge state of erythrocytes, was seen in blood vessels larger than 100 μm in three patients (10.3%) after retraction.
Following nerve root retraction, the flow rate of erythrocytes through blood vessels decreased an average of 23.9% (p<0.005).
A contact endoscope was used to observe the microhemodynamics of nerve roots before and after retraction of the nerve root during lumbar interbody fusion surgery, and a decrease in the flow rate of erythrocytes was observed. Less
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