目的:拟建立一个有效的可重复的椎间盘退变模型。方法:取健康成年新西兰大白兔40只,体质量2.5~3.0 kg,雌雄不限,随机分为纤维环穿刺组和对照组,每组20只。经腹膜外入路暴露L4/5、L5/6两个椎间隙,采用21号针头从椎间隙侧前方刺入L4/5、L5/6椎间盘的纤维环,深度控制在5 mm。对照组仅分离暴露椎间盘,不做任何处理。术后1、2、4、6、8周每组随机选取4只兔子行MRI、HE染色及Ⅱ型胶原免疫组化观察退变椎间盘的变化。结果:MRI观察发现,纤维环穿刺组术后椎间盘T2信号强度呈持续减弱趋势,椎间隙高度也不断下降。从术后2周开始两组差异有统计学意义(P<0.05)。HE染色观察发现,随着时间进展,纤维环穿刺组髓核细胞逐渐减少,8周时组髓核组织几乎完全变性,被纤维软骨组织替代。Ⅱ型胶原免疫组化染色示,纤维环穿刺组Ⅱ型胶原表达随时间呈进行性下降,从术后第2周开始两组差异有统计学意义(P<0.05)。结论:纤维环穿刺法可以诱导兔椎间盘缓慢退变,为深入研究椎间盘退变机制及治疗手段提供可靠的动物模型。 |
[1] ADAMS M A,ROUGHLEY P J.What is intervertebral disc degeneration and what causes it?[J].Spine(Phila Pa 1976),2006,31(18):2151-2161.
[2] 樊守刚,吴小涛,王运涛,等.兔退变椎间盘模型中髓核细胞凋亡的实验研究[J].东南大学学报:医学版,2010,29(1):62-65.
[3] PEARLE A.Directions for future research[J].Bone Joint Surg Am,2009,91(1):159-160.
[4] SINGH K,MASUDA K,AN H.Animal models for human disc degeneration[J].Spine,2005,5(6):267-279.
[5] MASUDA K,AOTA Y,MUEHLEMAN C,et al.A novel rabbit model of mild,reproducible disc degeneration by an anulus needle puncture:correlation between the degree of disc injury and radiological and histological appearances of disc degeneration[J].Spine,2005,30(1):52-41.
[6] MELOSE J,SMITH S,LITTLE C,et al.Recent advances in annular pathobiology provide insights into rim-lesion mediated intervertebral disc degeneration and potential new approaches to annular repair strategies[J].Eur Spine,2008,17(9):1131-1148.
[7] ZHAO C,WANG L,JIANG L,et al.The cell biology of intervertebral disc aging and Degeneration[J].Ageing Res Rev,2007,6(3):247-261.
[8] FREEMONT A.The cellular pathobiology of the degenerate intervertebral disc and discogenic back pain[J].Rheumatology(Oxford),2009,48(1):5-10.
[9] 彭宝淦,贾连顺.椎间盘退变机理的研究进展[J].中国矫形外科杂志,2004,7(4):390-392.
[10] SOBAJIMA S,KOMPEL J F,WALLACH C J,et al.A slowly progressive and reproducible animal model of intervertebral disc degeneration characterized by MRI,X-Ray,and Histology[J].Spine,2005,30(1):15-24.
[11] GRUBER H,INGRAM J,HANLEY E J.An improved staining method for intervertebral disc tissue[J].Biotech Histochem,2002,77(2):81-83.
[12] NERLICH A,ERWIN D,SCHLEICHER,et al.Immunohitologic markers for age-related changes of human lumbar intervertebral discs[J].Spine,1997,22(24):2781-2795.
[13] REVEL M,CLAUDIE A,ROUDIE R,et al.Effects of repetitive strains on vertebral end plates in young rats[J].Clin Orthop,1992,279:303-309.
[14] 吕振华,胡有谷,冯传汉,等.腰椎间盘纤维环主胶原基因表达的观察[J].中华外科杂志,1998,36(2):68-71.
[15] LURIE J,BERVEN S,GIBSON J,et al.Patient preferences and expectations for care: determinants in patients with lumbar intervertebral disc herniation[J].Spine,2008,33(24):2663-2668.
[16] 龙厚清,刘少喻,李佛宝.腰椎间盘退变/突出的分期及其病理学[J].脊柱外科杂志,2004,2(4):234-236.
[17] THOMPSON J,PEARCE R,SCHECHER M,et al.Priliminary eValuation of a scheme for grading the gross morphology of the human intervertebral disc[J].Spine,1990,15:411-415.
[18] ANTONIOU J,STEFKN F,NELSON F,et al.The human intervertebral disc evidence for changes in the biosynthesis and denaturation of the extracelluar matrix wjth groth,maturation,ageing and degeneration[J].Clin Invest,1996,98:996-1003.
[19] PFIRRMANN C,METZDORF A,ZANETTI M,et al.Magnetic resonance classification of lumbar intervertebral disc degeneration[J].Spine,2001,26:1873-1878.
[20] ZHANG Y,CHEE A,THONAR E,et al.Intervertebral disk repair by protein,gene,or cell injection:a framework for rehabilitation-focused biologics in the spine[J].PMR,2011,3(6):88-94. |