摘要
目的通过在生长期动物模型上植入脊柱半骨骺加压钉（Staple），探讨Staple矫治特发性脊柱侧凸（AIS）的可行性。方法选择14只雌性山羊（年龄：5～8周；体重：6～8kg），分别采用脊柱左侧椎弓根钉内固定，右侧肋骨部分切除的方法建立脊柱侧凸模型，建模时间8周。建模后随机分成两组。对照组：单纯取出后路内固定，不治疗；矫治组：取出内固定同时开胸行前路椎体Staple矫形术。术前术后均摄后前位和侧位X线片，术后定期随访，每4周摄片1次，观察山羊在生长过程中Cobb角的变化及植入物情况。术后观察时间为8周。结果12只山羊建立了脊柱侧凸模型。对照组（n=6）：系列X线片检查发现术后Cobb角变化不明显，术后当时平均Cobb角为40．8°（28°～56°），观察满8周后Cobb角平均为42．5°（30°～58°），差异无统计学意义（P〉0．05）；矫治组（n=6）：观察期内，没有出现Staple断裂、松动或移位，没有血管损伤、神经损伤和胸腔脏器损伤等并发症。术后当时平均Cobb角为44．5°（36°～57°），在术后观察期间，所有Cobb角均有不同程度减少，观察满8周后Cobb角平均为27．7°（12°～39°），差异具有统计学意义（P〈0．05）。结论Staple作为脊柱生长的机械性调节手段，操作简便，安全性高，能够有效地对动物脊柱的生长进行调节，有望成为治疗AIS患者的一种新选择。
Objective To evaluate the feasibility of the correction idiopathic-type scoliosis by implanting the staple in growing animal models. Methods Fourteen female goats were performed unilateral pedicle screws asymmetric tethering in left side in combination with right fib resection （age： 5 to 8 weeks, weight： 6 to 8 kg）. The observing time was about 8 weeks. Goats that had been created scoliosis model successfully were classified in 2 groups randomly. Control group： just removing the posterior tether, no treatment was offered. Correct group： the removing of posterior tether and the stapling of anterior spinal epiphysis were performed simultaneously. Dorsoventral and lateral plain radiographs were taken preoperatively and postoperatively. Serial X-ray postoperatively were performed every 4 weeks to measure the Cobb angle of the spine and to observe the condition of the insert. The observing time is about 8 weeks. Results Radiography showed that 12 goats had created scoliosis model successfully. Control group （ n = 6） ： Series X-ray show that the change of the Cobb angle was not obviously. The initial curves after the procedures measured an average of 40. 8° （28° -56°） , the average Cobb angle was 42. 5° （30°-58°） after 8 weeks, no statistics difference are found （ P 〉 0. 05 ）. Treatment group （ n = 6 ） ： no complication such as pedicel screw break, instrument loosen, dislocation, injury of blood vessel, nerve injury and organ injury of thoracic cavity etc, were found during the observing period. The initial curves after the procedures measured an average of 44. 5° （36° -57°） , to some degree, the Cobb angle decreased and the average was 42. 5° （30° -58°） after 8 weeks. There are statistics difference between the initial and final curves （P 〈 0. 05）. Conclusion As a means of mechanical modulation, stapling can be manipulate conveniently and safely, and can modulate the spinal growth of the animal model successfully, predicted that it may be a new selection
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第2期136-138,共3页
Chinese Journal of Surgery
基金
国家科技部“863”专题课题资助项目（2006AA02Z4D6）
关键词
脊柱侧凸
模型
动物
内固定器
脊柱生长
机械调节
Scoliosis
Model, animal
Internal fixators
Spinal growth
Mechanical modulation
