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首页> 外文期刊>Spine >Intra-arterial injection in the rat brain: evaluation of steroids used for transforaminal epidurals.
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Intra-arterial injection in the rat brain: evaluation of steroids used for transforaminal epidurals.

机译：大鼠脑内动脉内注射：用于经椎间孔硬膜外麻醉的类固醇的评估。

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STUDY DESIGN: Prospective in vivo experimental animal model. OBJECTIVES: To determine the effect of intra-arterial injection of the steroids commonly used for transforaminal epidurals on the central nervous system. And to determine if all of the steroids have the same effect. SUMMARY OF BACKGROUND DATA.: Transforaminal epidural steroid injection is commonly employed to treat radicular pain. This approach is associated with complications, including stroke and death. While the mechanism is unknown, the leading hypothesis is that intravascular injection of particulate steroids leads to microembolization. METHODS: To characterize the nature of steroid induced injury, a rodent model was employed. The internal carotid artery was dissected and its branches ligated. The external carotid artery was ligated, mobilized, cannulated, and injectate administered. Five solutions were tested: Depo-Medrol (N = 11), Depo-Medrol carrier (N = 6), Solu-Medrol (N = 6), Decadron (N = 8), and normal saline (N = 7). Drugs, in volume of 50 microL, were injected into the ICA via the ECA cannula at 25 microL/min. The extent of central nervous system injury was evaluated by analysis of coronal sections of the brain. RESULTS: Cerebral hemorrhage occurred in test subjects with the following frequency: 8 of 11 in the Depo-Medrol group, 7 of 8 in the Solu-Medrol group, and 3 of 6 in the Depo-Medrol carrier group; no lesions were identified in the Decadron or saline groups (P < 0.01). Evan's blue dye leakage was detected in the Depo-Medrol and Solu-Medrol groups, but not the Decadron or saline groups. CONCLUSION: This study presents the first in vivo evaluation of intra-arterial steroid injection. Data demonstrate Depo-Medrol, as well as its nonparticulate carrier, and Solu-Medrol can produce significant injury to the blood-brain barrier when injected intra-arterially. These results demonstrate that injury is produced not only by particulate obstruction of the cerebral microvasculature, but also by toxicity of the carrier or steroid (methylprednisolone).
机译：研究设计：前瞻性体内实验动物模型。目的：确定动脉内注射常用于经椎间孔硬膜外麻醉的类固醇对中枢神经系统的影响。并确定所有类固醇是否具有相同的作用。背景数据概述：经椎间孔硬膜外注射类固醇通常用于治疗神经根痛。这种方法与并发症相关，包括中风和死亡。尽管机理尚不清楚，但主要假设是血管内注射类固醇会导致微栓塞。方法：为了表征类固醇诱导的损伤的性质，采用了啮齿动物模型。解剖颈内动脉并结扎其分支。结扎，动员，插管并注射颈外动脉。测试了五种溶液：Depo-Medrol（N = 11），Depo-Medrol载体（N = 6），Solu-Medrol（N = 6），Decadron（N = 8）和生理盐水（N = 7）。将体积为50微升的药物通过ECA套管以25微升/分钟的速度注入ICA。中枢神经系统损伤的程度通过对大脑冠状部分的分析来评估。结果：测试对象发生脑出血的频率如下：Depo-Medrol组为11例中的8例，Solu-Medrol组为8例中的7例，Depo-Medrol载体组为6例中的3例;在十倍体或生理盐水组中未发现病变（P <0.01）。在Depo-Medrol和Solu-Medrol组中检测到Evan的蓝色染料泄漏，但在Decadron或生理盐水组中未检测到。结论：本研究提出了动脉内类固醇注射的首次体内评价。数据表明，Depo-Medrol及其非颗粒载体，当动脉内注射时，Solu-Medrol会对血脑屏障产生重大伤害。这些结果表明，不仅由脑微血管的颗粒阻塞引起损伤，而且由载体或类固醇（甲基泼尼松龙）的毒性引起。

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