摘要
目的建立猪腰椎间盘退变动物模型。方法 6头实验猪全麻下行腰椎腹膜后入路,暴露椎间盘前外侧。18号穿刺针平行于椎间隙刺穿纤维环,深度17 mm,穿刺8个椎间隙。23号手术刀片平行于椎间隙刺穿纤维环,深度17 mm,穿刺25个椎间隙。对照组9个椎间隙只暴露不损伤纤维环。术前及术后2周全部行腰椎MRI检查评估,术后第4、6周对其中特定1头继续进行MRI检查,并于6周时处死取椎间盘组织病理检查。结果刀刺模型组术后2周出现明显的椎间盘退变,MRI T2加权像髓核相对信号强度从0.98±0.13降到0.77±0.17;椎间隙高度从(2.64±0.41)mm降到(1.98±0.32)mm;Pfirrmann分级从术前的Ⅰ级25例,变为术后Ⅱ级18例、Ⅲ级7例。刀刺模型组手术前后对比及术后与另外2组相比,上述指标差异显著(P<0.05或P<0.01)。这种退变现象随着时间的推移有加重趋势。病理切片显示椎间盘髓核细胞减少,为纤维组织取代,纤维环板层裂隙明显,内层有毛细血管长入。针刺组除椎间盘高度有较小的降低外,余与对照组相似。结论刀刺损伤家猪椎间盘纤维环可以建立较理想的椎间盘退变动物模型,使用适当大小的针穿刺纤维环对椎间盘退变的影响不大。
Objective To establish pig model of lumbar disc degeneration. Methods Anterior lateral intervertebral discs of 6 pigs were exposed through lumbar retroperitoneal approach under general anesthesia. Eight disc annuluses were pierced parallel to the endplate by No. 18 needle, at the depth of 17 mm. Twenty-five disc annulus were pierced paral- lel to the endplate by No. 23 blades, depth of 17 mm. Nine discs were exposed without damage to the annulus as controls. All pigs underwent MRI examination before and after 2 weeks of the operation. One of them continued to undergo MRI ex- amination 4 and 6 weeks after operation, and were sacrificed at 6th week to take disc tissue for pathological study. Re- suits Model group stabbed by blades has apparent disc degeneration 2 weeks later. MRI T2-weighted relative signal inten- sity reduced from 0. 98±0. 13 to 0. 77±0. 17; disc height reduced from 2. 64±0. 41 mm to 1.98 ＋0. 32 mm; Pfirrmann grade improved from 25 cases of grade I to 18 cases of grade II and 7 cases of grade !11. The difference of postoperative indexes was significant between model group and the other two. The difference was also significant compared with the indexes before surgery in the model group stabbed by blades. This degeneration phenomenon became severer over time. Biopsy re- vealed reduction of intervertebral disc cells, fibrous tissue disorder, obviously fractured lamellar annulus, capillary ingrowth in the inner annulus. However the acupuncture group was similar to the control group except a smaller decrease of disc height. Conclusions Stabbing pig intervertebral disc with blades can create an ideal animal model of disc degeneration. Stabbing with the puncture needle of appropriate size may not cause disc degeneration.
出处
《实用老年医学》
CAS
2012年第2期141-145,共5页
Practical Geriatrics
基金
江苏省国际科技合作资助项目(BZ2008071)
关键词
纤维环切开
纤维环针刺
椎间盘退变
动物模型
annulus fibrosus incision
annulus fibrosus acupuncture
disc degeneration
animal model
