【摘要】：背景:國內(nèi)外學者對椎間盤退變動物模型的建立做了大量工作,通過改變椎間盤力學特性、纖維環(huán)損傷、酶化學法等多種建模方式模擬椎間盤退變的病理表現(xiàn)。目的:通過髓核抽吸法和纖維環(huán)薄層切除法建立椎間盤退變模型,比較兩種方法的造模效果。方法:取6月齡新西蘭大白兔20只,通過手術暴露L3-4、L4-5及L5-6椎間盤,隨機使用髓核抽吸法和纖維環(huán)薄層切除法對L3-4、L4-5椎間盤進行干預:(1)髓核抽吸組——利用16 G針頭在椎間盤纖維環(huán)穿刺并負壓抽吸10 s;(2)纖維環(huán)薄層切除組——在顯微鏡下輔助下,在兔椎間盤纖維環(huán)上切除1 mm×2 mm范圍的約1/2層纖維環(huán)組織(避免切透全層)。于造模第1,3,5,9,13周進行核磁共振、X射線檢查及椎間盤Masson染色病理學觀察。結果與結論:(1)X射線檢查:纖維環(huán)薄層切除組椎間隙高度自術后第1周起便發(fā)生不同程度降低;髓核抽吸組椎間隙在術后1周及3周輕微降低,自第5周起發(fā)生較明顯降低;纖維環(huán)薄層切除組術后第3,5,9周椎間隙高度指數(shù)百分比高于髓核抽吸組(P0.05);(2)核磁共振檢查:兩種方法均誘導相應椎間盤發(fā)生退變,各組隨時間推移椎間盤退變程度逐漸加重,并于9周后均達到4級退變;髓核抽吸組術后1,3,5周的椎間盤退變程度重于纖維環(huán)薄層切除組(P0.05);(3)病理學觀察:隨時間推移,兩組椎間盤髓核及纖維環(huán)退變程度逐漸加重;(4)結果表明:髓核抽吸法和纖維環(huán)薄層切除法均能誘導椎間盤退變,纖維環(huán)薄層切除法在5周內(nèi)造成的椎間盤退變程度較髓核抽吸法輕,纖維環(huán)薄層切除法在纖維環(huán)上所造成的標示部位可作為纖維環(huán)修補研究的靶點。
[Abstract]:Background: scholars at home and abroad have done a lot of work on the establishment of animal model of intervertebral disc degeneration. By changing the mechanical properties of intervertebral disc, the damage of fibrous ring, enzyme chemical method and other modeling methods to simulate the pathological manifestations of disc degeneration. Objective: to establish the model of disc degeneration by the method of nucleus pulposus aspiration and thin-layer excision of fibrous ring, and compare the effect of the two methods. Methods: twenty New Zealand white rabbits aged 6 months were exposed to L3-4 and L4-5 and L5-6 intervertebral discs by surgery. L3-4 was randomly treated by nucleus pulposus aspiration and thin-layer annular excision. L4-5 intervertebral disc intervention: (1) Nucleus pulposus aspiration group-16G needle in disc fiber ring puncture and suction negative pressure for 10 seconds; (2) Thin-layer excision of the fibrous annulus: with the aid of microscope, about 1 / 2 layer of fibrous annular tissue in the range of 1 mm 脳 2 mm was removed on the rabbit intervertebral disc annulus (avoiding cutting through the whole layer). Nuclear magnetic resonance (MRI), X-ray examination and Masson staining of intervertebral disc were performed at 913 weeks. Results and conclusion: (1) X-ray examination: the height of intervertebral space in thin layer excision group decreased in varying degrees from the first week after operation. The intervertebral space decreased slightly at 1 and 3 weeks postoperatively in the nucleus pulposus aspiration group and decreased significantly at the 5th week, and the percentage of the intervertebral space height index in the thin-layer excision group was higher than that in the nucleus pulposus suction group at the 9th week after operation (P0.05). (2) MRI: the degeneration of the intervertebral disc was induced by both methods, and the degree of degeneration of the intervertebral disc increased gradually with the passage of time, and reached grade 4 after 9 weeks. The degenerative degree of intervertebral disc in the pulposus aspiration group was more serious than that in the thin-layer excision group (P0.05); (3). The degeneration degree of the nucleus pulposus and the fibrous ring of the intervertebral disc increased gradually with the passage of time. (4) the results showed that the disc degeneration could be induced by the pulposus aspiration method and the thin-layer excision method, and the degree of disc degeneration caused by the thin-layer excision of the fibrous ring in 5 weeks was less than that in the nucleus pulposus aspiration method. The marking site caused by thin-layer excision of fiber ring on the fiber ring can be used as a target for the repair of fiber ring.
【作者單位】： 新疆醫(yī)科大學第六附屬醫(yī)院脊柱外科;
【分類號】：R681.53;R-332

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