[Show abstract][Hide abstract] ABSTRACT: It is known that selective sacral roots rhizotomy is effective for relieving the neurogenic bladder associated with spinal cord injury. The goal of this study is to review the surgical anatomy of the lumbosacral nerve rootlets and to provide some morphological bases for highly selective sacral roots rhizotomy. Spinal cord dissections were performed on five cadavers under surgical microscope. At each spinal cord segment, we recorded the number, diameter and length of the rootlets, subbundles and bundles from the L1 to S2 spinal segments, and the length of the dorsal/ventral root entry zone. Peripheral nervous system myelin was examined by immunohistochemistry. We found: (1) the ventral or the dorsal root of the lumbosacral segment of the spinal cord was divided into one to three nerve bundles and each bundle was subdivided into one to three subbundles. Each subbundle further gave out two to three rootlets connected with the spinal cord; (2) there were no significant differences in the number of rootlets within the L1 to S2 segments, but the size of rootlets and the length of nerve roots varied (P < 0.05); and (3) the more myelinated fibers a rootlet contained, the larger transection area it had. The area of peripheral nervous system myelin positive cells and the total area of rootlets were correlated (P < 0.001). Thus, during highly selective sacral roots rhizotomy, the ventral and dorsal roots can be divided into several bundles of rootlets, and we could initially distinct the rootlets by their diameters.
Preview · Article · Dec 2010 · The Anatomical Record Advances in Integrative Anatomy and Evolutionary Biology
[Show abstract][Hide abstract] ABSTRACT: To study the highly selective dorsal rhizotomy influence on bladder and penis erection function of SD rats.
Forty mature male SD rats of clean grades, with weight range of 300-350 g were selected. Ten rats were chosen to do electrophysiology study on dorsal rootlets of L6 and S1 segment. Changes in intravesical pressure (IVP) and intracavernous pressure (ICP) were investigated to define main segments which conducted to bladder and corpus cavernosum. Thirty rats were divided into two groups (A and B) on average at random. In group A, we made highly selective dorsal rhizotomy on the fascicle of conduction bladder detrusor muscle. In group B, we made highly selective dorsal rhizotomy on the fascicle of conduction corpus cavernosum. Changes of IVP and ICP after rhizotomy were investigated and recorded.
The changes of IVP during electrostimulation were of no significant variation between L6 and S1 (P=0.972). With the changes of ICP during electrostimulation, S1 segment was of more significant variation than L6 segment, ΔICP of S1 was (13.05±8.41) cmH2O (1 cmH2O=0.098 kPa), while ΔICP of L6 was (6.88±2.76) cmH2O (P<0.01). There was no reasonable variation in IVP and ICP on the left and right dorsal rootlets of S1 segment (P was 0.623 and 0.828 respectively). In group A, there was significant variation in IVP, ΔIVP of before rhizotomy was (14.37±4.89) cmH2O, while after rhizotomy was (3.25±1.29) cmH2O (P<0.001) while no obvious variation in ICP (P=0.153) after highly selective rhizotomy on S1 dorsal rootlets. In group B, there was significant variation in ICP, ΔICP of before rhizotomy was (11.97±4.41) cmH2O, while after rhizotomy was (2.68±1.01) cmH2O (P<0.001), but no obvious variation in IVP (P=0.162) after highly selective rhizotomy on S1 dorsal rootlets.
SD rats' different rootlets of S1 dorsal rootlets can be distinguished by microanatomy and electrostimulation. The IVP and ICP had distinct changes after highly selective dorsal rhizotomy. It could provide an experimental support to treat spastic bladder after spinal cord injury and retain at maximum reflexible erection function in the clinic.
No preview · Article · Oct 2010 · Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences
[Show abstract][Hide abstract] ABSTRACT: To investigate the selective innervation of sacral anterior rootlets to micturition and erection function in SD rats.
Forty male SD rats of clean grade, aged 6 weeks old, were selected. Ten rats received a retrograde nerve tract tracing study. Thirty rats were chosen for an electro-physiological study. The L6, S1 spinal cord segment anterior rootlets of anesthetic rats were electrostimulated respectively. The intravesical pressure, urethral perfusion pressure and intracavernous pressure were recorded simultaneously and innervation effectiveness was analyzed.
CB-HRP labeled neurons were observed mainly in L6 and S1 spinal cords. When some anterior rootlets of L6 and S1 were electrostimulated, the intravesical pressure rose gradually, but the urethral perfusion pressure and the intracavernous pressure curve changed slightly; when other rootlets of the same anterior root were stimulated, the urethral perfusion pressure could reach the peak; while others were stimulated, the intracavernous pressure rose quickly, but there were no great changes in intravesical pressure and urethral perfusion pressure. Some other rootlets might lead to the simultaneous changes of 2 or 3 above-mentioned pressures.
The innervations of L6 and S1 anterior rootlets to rats' bladder detrusor, external urethral sphincter and penile cavernous body are significantly distinct. Different rootlets may be distinguished by microanatomy and electrostimulation.
No preview · Article · Sep 2010 · Zhonghua yi xue za zhi
[Show abstract][Hide abstract] ABSTRACT: Proprioception plays an important role in knee movements. Since there are controversies surrounding the overall recovery time of proprioception following surgery, it is necessary to define the factors affecting proprioceptive recovery after anterior cruciate ligament (ACL) reconstruction and to investigate the relationship between proprioception and muscle strength.
A total of 36 patients who had their ACL reconstructed with a semitendinosus/gracilis graft (reconstructed group: 6 months post-surgery) and 13 healthy adults without any knee injury (control group) were included in the study. Knee proprioception was evaluated with a passive reproduction test. Isokinetic strength was measured using the Biodex System. Statistical analysis was used to compare proprioception of the reconstructed group versus the control group, and to define causal factors, including sex, hamstring/quadriceps ratio, and the course of injury before reconstruction. We also investigated the correlation between the passive reproduction error and quadriceps index.
There was a significant difference in proprioception between the reconstructed and control groups (P < 0.05). When the course of injury before reconstruction was less than 4 months, there was a linear correlation with proprioception 6 months after the operation (r = 0.713, P < 0.05). There was a positive correlation between post-surgery proprioception and the quadriceps index at 6 months post-surgery.
Impaired knee proprioception is observed 6 months after ACL reconstruction. Within 4 months of injury, early undertaking of reconstruction is associated with better proprioception outcome. Patients with enhanced proprioception have a better quadriceps index.
Preview · Article · Nov 2008 · Chinese medical journal
[Show abstract][Hide abstract] ABSTRACT: To study the effects of continuous passive motion on the tendon-bone healing of the semi-tendinous tendon autograft used for anterior cruciate ligament (ACL) reconstruction in rabbits.
In 12 healthy 8-month-old male rabbits, an ACL reconstruction was performed by using double semi-tendinous tendon autograft. Postoperatively these animals were treated by either continuous passive motion (CPM) or cage activity. Specimens of the grafts were collected at 6, 12, 24 weeks postoperatively. Histological change in the tendon-bone healing was studied by haematoxylin-eosin and toluidine blue.
There was more new fiber tissue in the anterior half of the interface. Osteoclasts were most numerous at the tunnel aperture and in the anterior half of the interface. Cartilage in the tendon-bone interface was localized to the posterior aspect of tunnels, the area where compressive stress would be predicted. CPM group developed a denser connective tissue with less vascularity and cellularity. The bone tunnel had more areas with ingrowing denser connective tissue compared with cage activity specimens. With the growth of Sharpery's fibers and fibrocartilage into the interface, a direct ligament insertion was found. In the CPM specimens, the interface tissue was more mature and the direct insertion was broader and more structured.
Compressive stress promotes chondroid formation, and the tension promotes fiber formation. Tendon-bone healing may be optimized by CPM after tendon transplantation into a bone tunnel.
No preview · Article · Aug 2008 · Zhonghua wai ke za zhi [Chinese journal of surgery]