硬膜外阻滞后对突出椎间盘组织及黄韧结构的观察

OBSERVATION OF THE TISSUE STRUCTURE OF THE PROLAPSED INTERVERTEBRAL DISC AND LIGAMENT FLAVUM AFTER EPIDURAL BLOCK

摘要:

目的：了解硬膜外阻滞（ＥＢ）治疗腰间盘突出症是否对椎管内局部组织有影响。方法：通过ＥＢ组、非ＥＢ组２０例腰椎间盘突出症手术切除的黄韧带及椎间盘组织的组织学观察，以及前者１２例、后者１０例电镜超微结构观察的结果进行比较。结果：光镜下黄韧带及椎间盘组织的腔面光滑程度和炎症反应情况，ＥＢ组与非ＥＢ组比较无显著性差异；电镜下观察上述两种组织的纤维成份和排列以及细胞的超微结构，两组比较亦无显著性差异。结论：

Abstract:

Aim: Investigation of the influence of the corticoid injected into the epidural cavity for the treatment of prolapsed lumbar intervertebral disc on the local tissues in the spinal cavity. Method: Comparison of the histologic findings of the ligament flavum and the disc tissues removed during discectomy between the epidural block (EB) group (40 cases) and the non EB control group (20 cases), and the electron microscopic (EM) findings of the same tissues between the former (12 cases) and the later (10 cases). Results: No significant difference was found between the 2 groups either on light microscopy or electron microscopy in (1) smooth and integral degrees and the inflammatory reaction of the cavosurface of the ligamenta flavua and the disc tissues and (2) their cellular ultrastructures and fibrous arrangement. Conclusions: There is no direct relationship between the lumbar EB and the epidural scar adhesion formation. The EB does not affect the ultrastructures of the local tissues in the spinal cavity. However, strict care must be taken on sterilization of the surgical procedure, since there is some chronic inflammatory reaction in the ligament flavum and disc tissues in some patients in the two groups.