Application of shock waves as treatment modality in the vicinity of the brain and skull.

应用冲击波作为大脑和头骨附近的治疗方式。

• 批准号: 15390428
• 负责人: TAKAYAMA Kazuyoshi
• 金额: $ 9.22万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15390428/
• 关键词: shock wave medical care; Ho : YAG laser; neurosurger; distortion; head wound; shock absorber; medical engineering; cavitation; Ho : YAGレーザー; レーザー医学; 頭蓋骨欠損; レーザー誘発衝撃波; 衝撃波工学; 神経内視鏡; 低侵襲治療

Cranial deficits secondary to trauma, surgery, infection, or congenital malformation sometimes require cranioplasty to re-establish rigid protections for the underlying brain and to improve cosmetic appearance. Current methods for cranioplasty are mainly based on the concept of"replacing the skull defect", either with or without the aid of foreign bodies. However, problems arise from use of foreign matter and invasiveness, a novel method for cranioplasty not reliant on the use of foreign body with minimal invasion should be developed.For last two decades, shock waves have been applied, not only for the non-invasive fragmentation of stones at various locations, but also for the fragmentation of artificial bone cement in the hip arthroplasty, and pain management in calcified tendenopathies, attracting attention as a minimally invasive alternative modality. Recently, it has been clinically applied to the treatment of delayed union and non-union of long bones to induce bone formation. This … More has encouraged us to explore the potential of shock waves for closing skull defects less invasively without using foreign material. However, to apply shock waves in the vicinity of brain, there were two major problems to be solved ; one concerning the lack of a suitable shock wave source that can limit shock wave distribution around the target, and the other is the lack of a method for avoiding shock wave propagation beyond the target to ensure safe treatment. In our present study, we have solved both of those problems by developing a compact shock wave generator and brain protection method using Gore-Tex&rreg ; dura substitute. The shock waves were delivered via a holmium yttrium-aluminum-garnet laser-induced cavitational shock wave generator, which was especially designed for use in the vicinity of brain and skull, with an overpressure of 50 bar, at a rate of 3 Hz. We have applied those techniques to see whether they are effective in the closure of a bone defect in the skull of young rats, and present our preliminary results. Present results show the possibility of applying shock wave as an alternative for cranioplasty without using foreign bodies. The result of present study will also be useful for understanding of interaction between neuron and shock waves, and other application, such as shock wave orientated drug delivery system in central nervous system. Less

继发于创伤、手术、感染或先天畸形的颅骨缺损有时需要颅骨成形术来重新建立对底层大脑的刚性保护并改善美容外观。目前的颅骨成形术方法主要基于“替代颅骨缺损”的概念。无论有或没有异物的帮助，但是由于异物的使用和侵入性而产生问题，因此需要一种不依赖于使用异物的微创颅骨成形术的新方法。近二十年来，冲击波不仅应用于不同部位结石的无创破碎，还应用于髋关节置换术中人工骨水泥的破碎以及钙化肌腱病的疼痛管理，引起了人们的关注作为一种微创替代治疗方式，它最近已在临床上应用于治疗长骨延迟愈合和不愈合，以诱导骨形成，这鼓励我们探索冲击波减少颅骨缺损的潜力。然而，要在大脑附近施加冲击波，有两个主要问题需要解决：一是缺乏合适的冲击波源来限制目标周围的冲击波分布。缺乏避免冲击波传播超出目标以确保安全治疗的方法。在我们目前的研究中，我们通过开发紧凑型冲击波发生器和使用 Gore-Tex® 硬脑膜替代品的脑保护方法解决了这两个问题。冲击波是通过钬钇铝石榴石激光诱导空化冲击波发生器，专门设计用于大脑和颅骨附近，超压为 50 巴，频率为 3 Hz。我们已经应用这些技术来看看是否可以。它们可以有效地闭合幼鼠颅骨中的骨缺损，并且我们目前的结果表明，在不使用异物的情况下，应用冲击波作为颅骨成形术的替代方法是可能的。研究还将有助于理解神经波和冲击波之间的相互作用以及其他应用，例如中枢神经系统中的冲击波导向药物输送系统。

项目成果

中川敦寛: "衝撃波による圧依存性脳損傷に関する組織学的検討"平成15年度衝撃波シンポジウム講演論文集. 417-420 (2003)

Atsuhiro Nakakawa：“冲击波引起的压力依赖性脑损伤的组织学研究”2003 年冲击波研讨会论文集 417-420 (2003)。

Osteopromotion for cranioplasty using shock wave. Experiment using skull defect animal model.

使用冲击波进行颅骨成形术的骨质促进。

• 发表时间: 2004
• 期刊: Proceeding of International Symposium on Shock Waves (Beijing)
• 作者: Nakagawa A;Sato J;Hirano T;Ohki T;Saito T;Takayama K;Tominaga T.
• 通讯作者: Tominaga T.

On the efficiency of Gore-Tex layer for brain protection from shock wave damage in cranionlasty.

关于 Gore-Tex 层在颅骨成形术中保护大脑免受冲击波损伤的效率。

• 发表时间: 2004
• 期刊: Review of Scientific Instruments 75
• 作者: Saito T;Voinovich PA;Nakagawa A;Hosseini SHR;Takayama K;Hirano T.
• 通讯作者: Hirano T.

Pulsed liquid jet dissector using holmium : YAG laser - a novel neurosurgical device for brain incision without impairing vessels.

使用钬的脉冲液体射流解剖器：YAG 激光 - 一种新型神经外科设备，用于在不损伤血管的情况下切开大脑。

• 发表时间: 2003
• 期刊: Acta Neurochir (Wien) 145
• 作者: Hirano T;Nakagawa A;Uenohara H;Ohyama H;Jokura H;Takayama K;Shirane R
• 通讯作者: Shirane R

Pulsed holmium : yttrium-aluminum-garnet laser-induced liquid jet as a novel dissection device in neuroendoscopic surgery.

脉冲钬：钇铝石榴石激光诱导液体射流作为神经内窥镜手术中的新型解剖装置。

• 发表时间: 2004
• 期刊: Journal of Neurosurgery 101
• 作者: Nakagawa A;Hirano T;Jokura;H;Uenonara H;Ohki T;Hashimoto T;Menenges V;Sato Y;Kusaka Y;Ohyama H;Saito T;Takayama;K;Shirane A;Tominaga T.
• 通讯作者: Tominaga T.