| BackgroundThe cerebral palsy is a kind of eternal abnormal movement and posture disease. It based on the unprogressive pathological changes on the brain from the pregnancy to the neonate period. The incidence of the cerebral palsy is 1‰~5‰ and the main cause of disease are cerebral damage and developmental defect. The cerebral palsy makes the patients life so worse and brings a big burden to families and the society. The spastic cerebral palsy is one kind of clinical types. It is about 30%~50% for all patients. About 10 years ago, a new kind of microneursurgery technique, selective posterior rhizotomy (SPR), has been gradually consummated. It was confirmed as a effective measure to remit the spasm and improve the movement function for the spastic cerebral palsy patients. In clinic work we found that SPR could not only remit the spasm of the limbs muscle but also amend some related symptom such as strabismus and salivation. For explaining this phenomenon, some experts brought a "big circle" hypothesis. But this hypothesis has not have the sufficient experimental evidence to prove it. For validating the hypothesis and finding the inside mechanism, we made a SPR rat model. We cut off the left L3-6 spinal nerve posterior roots and observe the c-fos expression in the L3-6 spinal cord and the facilitation/inhibitionsections in the brain stem reticular formation. The result could give us some clew on the relationship between the L3-6 posterior root and the facilitation/inhibition sections in the brain stem. To get more conclusions, we made the cerebral palsy rat model. In this basement we used pseudorabies virus (PRV) to trace the nerve pathway.Methods1. Make a SPR rat model: Separated and cut off the left L3-6 posterior root, a SPR rat model was made. At the same time, the false operation group and control group were made. The result would be compared within three groups.2. Detect c-fos expression: The sections of the L3-6 spinal cord and facilitation/inhibition area in the brain stem were subjected to c-fos immunohistochemical reaction with ABC method. The result was detected and data was recorded and analysed.3. Make a cerebral palsy rat model: This model is based on the man's cerebral palsy pathogenesis. The parietal bone was opened and the right cerebral cortex was damaged. After the operation, rats were fed for 2 months. Then we judge if the model was success. If this rat model were successful, the pseudorabies virus would be injected.4. Inject the pseudorabies virus: The PRV was injected in the left sciatic nerve in both cerebral palsy rat group and control group. The type of PRV was PRV-Su and the concentration was 7x10~7PFU/ml.5. Judge the PRV infection: If the PRV infection was successful was judged by the symptom at 5th day after injection.6. Detect the PRV infection: The successful infected rats were detected by PRV immunohistochemical study. The result was detected and data was recorded and analysed.Results1. The damage of SPR could make the c-fos expression of the posterior horn in L3-6 and the facilitation section of the brain stem reticular formation in SPR model group was significant stronger than that in the false operation groupand control group (p<0.05).2. The damage of SPR could not make the c-fos significantly expressed in the inhibition section of the brain stem reticular formation in three groups.3. PRV infection was detected at 5th day after the PRV-Su injection in the left sciatic nerve. In the cerebral palsy model group, 17 rats were found infection in L3-6 anterior and posterior horn, about 89.47% of the group; 10 rats were found infection in brain stem facilitation section of reticular formation, about 52.63% of the group. In the control group, 9 rats were found infection in L3-6 anterior and posterior horn, about 81.82% of the group; 6 rats were found infection in brain stem facilitation section of reticular formation, about 54.55% of the group. There's no infection was found in brain stem inhibition section of reticular formation in both the cerebral palsy model group and the control group.Conclusion1. The expression of c-fos and infection of PRV-Su indicate that there is a functional and morphologic relationship between the L3-6 spinal nerve posterior roots and the facilitation section of brain stem reticular formation.2. SPR cut off the L3-6 spinal nerve posterior roots and this adjusted the activity of the facilitation section of brain stem reticular formation. The balance between the facilitation and inhibition perhaps would alter the pharynx and larynx muscle state and improve the swallow function. Saliva was swallowed into alimentary canal and the salivation was remitted.
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