UROLOGIC FUNCTION AFTER EXPERIMENTAL CAUDA-EQUINA COMPRESSION - CYSTOMETROGRAMS VERSUS CORTICAL-EVOKED POTENTIALS

被引:27
作者
DELAMARTER, RB
BOHLMAN, HH
BODNER, D
BIRO, C
机构
[1] Division of Orthopaedic Surgery, UCLA School of Medicine, Los Angeles, CA
[2] Department of Orthopaedic Surgery, Case Western Reserve University, School of Medicine, Cleveland, OH
[3] Division of Urology, Case Western Reserve University, School of Medicine, Cleveland, OH
关键词
D O I
10.1097/00007632-199009000-00005
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Twenty female beagle dogs underwent an L6-7 laminec-tomy and six dogs each had 25,50 or 75% constriction of the cauda equina and 2 control dogs had laminectomy only. Cystometrograms were performed pre- and post- operatively and three months after constriction. Cortical evoked potentials were monitored pre- and post-opera- tively and monthly for three months. After three months of constriction, the cauda equina of these dogs in each group was examined histologically and vascular circula-tion was examined by latex and India ink injection (Spal- teholz technique). The control dogs had normal CMGs and CEPs. Twenty-five percent constriction caused no CMG changes and mild CEP changes. Fifty percent constriction caused no statistically significant CMG changes, major CEP changes and venous congestion of the nerve roots and dorsal root ganglia. Seventy-five percent constriction produced severe CMG changes with detrusor areflexia, increased bladder capacity and clinical incontinence. CEPs also had marked deterioration. Vascular analysis revealed severe arterial narrowing at the level of constriction and venous congestion of the nerve roots and dorsal root ganglia. Blockage of axoplas- mic flow and nerve root atrophy was seen in all dogs with 75% constriction. Cortical evoked potentials were the most sensitive predictor of neural compression. CMGs were not sensitive until severe compression was achieved. Bladder dysfunction, i.e., detrusor areflexia, appears to occur with blockage of axoplasmic flow and early sensory changes occur with neurovenous congestion. © Lippincott-Raven Publishers.
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页码:864 / 870
页数:7
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