頸肩腕症候群に関する研究 特に頸椎の後側方屈曲の反覆運動による実験的研究
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This papea deals with the results of an experiment performed as a part of the studies of our department on the neck-shoulder-arm syndrome by setting the cervical spine in repeating posterolateral bending movements.<BR>Concerning a group with symptoms called neck-shoulder-arm syndrome, not a few problems still remain unsolved, although deep, many-sided studies have been made both in Japan and abroad. Particularly from the fact that the symptoms manigest themselves only unilaterally in many of the patients, the author attempted to investifate the influence of experimentally induced unilateral cervical intervertebral disk hernia on the spinal cord and nerve roots.<BR>Method:<BR>Fifty-seven mature rabbits were employed for study ; their cervical spinal column was fixed at its right anterolateral portion ; then its sinistropostero-lateral flexion was evoked in a repeating way by electrical stimulation. The effect of the movements of the cervical spine thus induced on the intervertebral disk, spinal cord as well as the nerve roots was studied roentgenologically, macroscopically and histopatholcgically over 1 to 6 weeks.<BR>Results :<BR>1. In group A (the group with the cervical spine fixed in the dextro-antero-lateral portion), displacement of the nuncleus pulposus was successfully provoked in 30 % of the cases sinistropaterally.<BR>2. No such displacement of the nucleus pulpcsus was recognized in group B (non-fixation group) .<BR>3. In correspondence with the fixation of the cervical spine in the dextro-antero-lateral portion, bulging of the annulus fibrosus was noticeable both sinistro-postero-laterally and posteriorly.<BR>4. In either of the groups there was no remarkable rupture of the annulus fibrosus, despite of the displacement of the nucleus pulposus being demonstrable.<BR>5. In group A marked recess of the epiphyseal nucleus was recognized at the 1 st and 6 th week.<BR>6. Failure to demonstrate apparent rupture of the posterior annulus fibrosus may be due presumably to relaxation phenomenon occuring there, because of narrowness of the intervertebral disk.<BR>7. In group A nerve cells of irregular shape appeared in the spinal cord at the 1 st to 2 nd week, and this may be is a result of transient circulatory disturbance due to the unusual stimulation.<BR>8. No appreciable changes were seen histologically in the fibers and the sheath of the nerve roots.<BR>From these results, it is inferable that f orbed, repeated movements of the cervical spine, if limited within the physiological range as in the cases of the present study, are unlikely to produce irreversible changes of the spinal cord and nerve roots histologically, though can actually induce slight bulging of the intervertebral disk.
- 学校法人 昭和大学・昭和医学会の論文