摘要
目的:定量分析椎体加压钉(Staple)固定矫正山羊脊柱侧凸后椎体生长板的组织形态学变化,探讨Staple固定对侧凸椎体生长板的影响。方法:用单侧椎弓根螺钉不对称拴系的方法对10只7～10周龄雌性山羊建立脊柱侧凸模型。术前、术后均行脊柱后前位和侧位X线平片检查,术后每4周检查一次,观察山羊脊柱弯曲情况。8～10周后,将成功建立脊柱侧凸模型的山羊随机分为对照组和Staple治疗组,两组山羊均取出后路拴系,Staple治疗组取出拴系后在最大弯曲椎体的凸侧前路置入记忆合金Staple。继续观察8周后完整获取两组山羊的顶椎上生长板、顶椎上一个椎体的下生长板以及两者之间的椎间盘,聚甲基丙烯酸甲酯(PMMA)包埋,不脱钙切片,甲苯胺蓝染色,镜下测量生长板生长方向上增殖层、肥大层高度。结果:10只山羊中有9只术后8～10周内进展为明显的脊柱侧凸,Staple治疗组(n=5)和对照组(n=4)的Cobb角分别为47.2°±11.2°、51.0°±17.7°,两组无显著性差异(P>0.05)。Staple治疗组在Staple置入后即刻Cobb角为34.8°±12.4°,与置入前比较无明显差异(P>0.05);置入后8周为15.6°±11.7°,与置入后即刻比较明显变小(P<0.05);对照组在拴系取出术后即刻和术后8周Cobb角无明显变化(P>0.05)。Staple治疗组生长板凸侧肥大层高度为29.17±4.38μm,凹侧为42.46±8.43μm,两侧有显著性差异(P<0.05);凸侧增殖层高度为75.70±18.36μm,凹侧为81.65±12.49μm,两侧无显著性差异(P>0.05)。对照组生长板肥大层与增殖层高度两侧均无显著性差异(P>0.05)。结论:Staple固定矫正脊柱侧凸重要的细胞学机制可能是逆转了生长板肥大层两侧原有的差异,使凸侧高度低于凹侧。
Objective：To evaluate the role of vertebral growth plates in the correction of scoliosis by quantifying histomorphology of vertebral growth plates in goat scoliosis corrected by Staple.Method：Experimental scoliosis was created in 10 juvenile female goats （7-10 weeks） using unilateral pedicle screws asymmetric tethering.Serial X-ray postoperatively were performed every 4 weeks to investigate the development of the spinal curve.After a period of 8-10 weeks,goats were randomized into Staple treated group and control group. All tethers were removed in both groups while Staple group underwent anterior vertebral stapling using shape- memory-alloy Staples along the convexity of the maximal curvature after posterior tether being removed.After another 8 weeks of observation,the superior growth plate of apical vertebra and the inferior growth plate of proximal vertebra and the intervertebral disc between the two growth plates were completely harvested from all goats.After that,the specimens were embedded in polymethyl methacrylate （PMMA） and sliced undecalcified, stained with toluidine blue.The height of proliferative zonal and the hypertrophic zonal were measured respec- tively.Result：9 of 10 tethered goats had progressive scoliotic curves of significant magnitude during 8- 10weeks of tethering,with Cobb angle of 47.2°±11.2° in Staple group（n=5） and 51.0°±17.7° in control group （n=4） ,however there was no difference in two groups.In Staple group,the Cobb angle immediately after sta-piing was 34.8°±12.4°,there was significant difference between before-stapling and after-stapling （P〈0.05）.The Cobb angle at 8th weeks after the stapling was 15.6°±11.7°,and there was significant difference compare that immediately after the stapling（P〈0.05）,whereas Cobb angles in control group had no change between immediately after removing the tether and 8th weeks after removing the tether （P〉0.05）.In Staple treated group,the hypertrophic zonal height of concave side （42.46±8.43μm） wa
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第11期857-860,I0001,共5页
Chinese Journal of Spine and Spinal Cord
基金
科技部"863"课题(编号:2006AA02Z4D6)
