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KMID : 0378019700130080063
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New Medical Journal
1970 Volume.13 No. 8 p.63 ~ p.69
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The anastomosis of the spinal cord after the experimental transection
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Abstract
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It has long been accepted as fact that there is no regeneration of the spinal cord below a point of transection. In recent years, a limited amount of regeneration of fibers within the central nervous system has been demonstrated, but functional return has not been shown for men, although it has been obtained in some animals.
The transection or excision and suturing of the cord were carried out in nine dogs, which we-re done at the level of T 9 to T 10 vertebrae. Assuming that the principal problem in suturing the sp trial cord might be one of tension on the suture line, the author tried the following techniques.
1. The cord approximated with #00000 chromic cat gut or silk sutures in atraumatic needles, one suture being passed antero-posteriorly through the entire thickness of the cord above and` below which seemed to approximate the central portion of the cord.
2. Sutures were placed on the dentate ligaments at the distance of 0.5 cm. from the cut surface on both sides and above and below, and tightened the sutures on each side, which approximated the cut ends easily and provided easy handling and good stabilization of the cord.
3. Dura mater was opened longitudinally on both ventral and dorsal surfaces and cut transversely, being two dural sleeves on each lateral side of the cord. Mattress sutures were placed on the dural sleeves and tightened which could approximate the distance of 2.0 cm. in maximal occasion between cut surfaces, producing enough slack in the cord.
4. The spinal column was shortened by excising a vertebra in order to produce enough slack in the cord for excision of the scarred portion, which could theoretically shorten tho distance between cut ends of the cord up to 4.0 cm. when the procedure was combined with the maximal tightening and shortening of the dural sleeves.
5. The selection of combination of the procedures depended on the condition of local area operated.
There were no functional recovery in any animals survived but were paraplegic and sacrified at tenth to fourteenth post-operative day except for animals No. 8 and No. 9. Pathological findings in serial cross sections of the cord were studied in or near the cut portion.
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