1988 Fiscal Year Final Research Report Summary
Pathophysiology and pain mechanism of iatrogenic lumbar adhesive arachnoiditis, its prevention and treatment
| Project/Area Number |
61480317
|
|---|
| Research Category |
Grant-in-Aid for General Scientific Research (B)
|
| Allocation Type | Single-year Grants |
|---|
| Research Field |
Orthopaedic surgery
|
|---|
| Research Institution | Faculty of Medicine, Toyama Medical and Pharmaceutical University |
|---|
Principal Investigator |
TSUJI Haruo Faculty of Med., Toyama Med. & Pharmaceut. Univ., Professor, 医学部, 教授 (90009449)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
TAKANO Haruo Faculty of Med., Toyama Med. & Pharmaceut. Univ., Assistant, 医学部, 助手 (40135017)
YAMADA Hitoshi Faculty of Med., Toyama Med. & Pharmaceut. Univ., Lecturer, 附属病院, 講師 (80115196)
ITOH Tatsuo Faculty of Med., Toyama Med. & Pharmaceut. Univ., Associate Professor, 医学部, 助教授 (50111422)
|
|---|
| Project Period (FY) |
1986 – 1988
|
| Keywords | Adhesive arachnoiditis / Myelography / Iatrogenic disorders / Cathecholamine / Serotonin / Cerebrospinal fluid / Tissue culture / 組織培養 |
|---|
| Research Abstract |
This project concerns about clinical and basic studies on iatrogenic lumber abhesive arachnoiditis (ALL), with the causes, symptomatology, pathology, pain mechanism and pathomechanism of the arachnoid cell proliferation.
The result are summarized as follows; 1) LAA was mainly caused by myelography and posterior surgical intervention, and the incidence was approximately 1.2% in low-back pain patients. Iatrogenic LAA was not infrequently observed in patients with degenerative spinal stenosis in the elderly, but it limited in slight adhesive arachnoiditis.
2) Symptoms were mainly corresponded to multiroots irritation, paresthesia and palsies with a bizarre pattern and changing with the time. Patients had a tendency to reveal specific pain behavior and emotional abnormalities.
3) A new stage and myelographic type classifications were drawn from the intraoperative findings, histology and the clinical examinations.
4) Cathecolamine and serotonin metabolites in the CSF were analyzed by HPLC in 191 low-back pain / myelogathy patients including 13 cases with typical LAA. DOPAC and 3-MT were very high irrespective of puncture site in LAA patients, suggesting a combination of disorders of of brain metabolism. No epinephrine abnormality was detected in LAA.
5) Through the arachnoid cell culture system, conditions inducing sbnormal proliferation of the arachnoid cell has been investigated including basic growth curve and DNA synthesis of the cells. The cells showed a phagocytosis and high synthesis capacity of DNA at 6-day culture. This study is further performing on influences of interlenkins, superoxides, various inflammatory products and foreign bodies on the cell pathology in the tissue culture system.
6) A new surgical procedure was developed for patients with lumbar spinal stenosis accompanied by LAA.
|
