An animal model of lumbar spinal stenosis was developed in which the
pathophysiology of this condition could be examined. Four experimental
groups, each containing six dogs, were studied. One group had a laminectomy
of the sixth and seventh lumbar vertebrae only; these animals served as
controls. In the three other groups, a laminectomy was performed and the
cauda equina was constricted by 25, 50, or 75 per cent to produce chronic
compression. Cortical evoked potentials were recorded preoperatively,
immediately after constriction, and at one, two, and three months
postoperatively. Daily neurological examinations were carried out, and the
neurological deficits were graded using the Tarlov system. After three
months of constriction, the cauda equina of three dogs in each group was
examined histologically, and the vascular circulation was examined by latex
and India-ink injection with a modification of the Spalteholz technique.
The animals in the control group showed no neurological abnormalities, no
changes in cortical evoked potentials, normal microvascularity, and no
histopathological changes in the nerve roots or the spinal cord. The dogs
in which the cauda equina had been constricted 25 per cent had no
neurological deficits, mild changes in cortical evoked potentials, slight
histological changes, and venous congestion of the root and dorsal root
ganglion of the seventh lumbar nerve. The dogs in which the cauda equina
had been constricted 50 per cent had mild initial motor weakness, major
changes in cortical evoked potentials, edema and loss of myelin in the root
of the seventh lumbar nerve, and moderate or severe venous congestion of
the root and dorsal root ganglion of the seventh lumbar nerve. The dogs in
which the cauda equina had been constricted 75 per cent had significant
weakness, paralysis of the tail, and urinary incontinence; two dogs
recovered by the third month, but all had neurogenic claudication for three
months. All six dogs had dramatic changes in cortical evoked potentials and
had complete nerve-root atrophy at the level of the constriction. There was
blockage of axoplasmic flow and wallerian degeneration of the motor nerve
roots distal to the constriction and of the sensory roots proximal to the
constriction, as well as degeneration of the posterior column. Severe
arterial narrowing at the level of the constriction and venous congestion
of the roots and dorsal root ganglia of the seventh lumbar and first sacral
nerves were also present. Cortical evoked potentials revealed neurological
abnormalities before the appearance of neurological signs and
symptoms.(ABSTRACT TRUNCATED AT 400 WORDS)