本文選題：經(jīng)皮纖維環(huán)穿刺 + 椎間盤退變��； 參考：《第四軍醫(yī)大學(xué)》2011年碩士論文

【摘要】：理想的椎間盤退變動物模型是椎間盤組織工程研究的必要條件,但目前尚缺乏公認的模型制備方法,探索一種動物創(chuàng)傷性小、造模操作簡單的模型制備方法已成為目前研究的當(dāng)務(wù)之急。 實驗通過生物化學(xué)、影像學(xué)等檢測手段比較C形臂輔助下經(jīng)皮纖維環(huán)穿刺法、右后外側(cè)腹膜外入路纖維環(huán)穿刺法及經(jīng)右后外側(cè)腹膜外入路髓核抽吸法制備兔椎間盤退變動物模型優(yōu)缺點,評估C形臂輔助下經(jīng)皮纖維環(huán)穿刺法制備椎間盤退變動物模型的可行性。 本實驗分為兩部分,第一部分為椎間盤退行性改變動物模型的建立,第二部分為椎間盤退行性改變動物模型的檢測評估。 實驗選用清潔級新西蘭大白兔27只,將實驗動物隨機分入C形臂輔助下經(jīng)皮纖維環(huán)穿刺組、右后外側(cè)腹膜外入路纖維環(huán)穿刺組及右后外側(cè)腹膜外入路髓核抽吸組,每組9只動物。選定每只新西蘭大白兔L2/3和L3/4椎間盤作為實驗干預(yù)椎間盤進行手術(shù)處理,L1/2和L5/6椎間盤為空白對照椎間盤不進行處理。 于術(shù)前隨機選取2只動物進行腰椎核磁共振掃描;術(shù)后2、4、8、12周于每組隨機選取2只動物行腰椎核磁共振掃描后處死并采集椎間盤,進行二甲基亞甲基藍(DMMB)染色分光光度法髓核蛋白多糖含量測定,采用Pfirrmann分級方法對腰椎T2WI核磁共振圖像分別進行退變程度的評估。 實驗結(jié)果顯示: 1.經(jīng)皮纖維環(huán)穿刺組動物無麻醉意外、傷口感染、后肢癱瘓等手術(shù)并發(fā)癥發(fā)生,順利存活至實驗結(jié)束;右后外側(cè)腹膜外入路纖維環(huán)穿刺組一只動物術(shù)中出現(xiàn)麻醉意外,導(dǎo)致死亡;右后外側(cè)腹膜外入路髓核抽吸組一只動物術(shù)后出現(xiàn)切口感染、裂開,經(jīng)換藥、再次縫合和肌注抗生素后切口愈合。 2.空白對照椎間盤術(shù)后各時間點其椎間盤髓核內(nèi)蛋白多糖含量、腰椎矢狀位T2加權(quán)相核磁影像Pfirrmann分級評分基本保持一致。手術(shù)干預(yù)組椎間盤的退變程度均呈現(xiàn)逐漸加重趨勢,髓核抽吸組于術(shù)后2周即出現(xiàn)可觀察到的退變征象,并且在術(shù)后同一時間點其退變程度較纖維環(huán)穿刺方法構(gòu)建的動物模型嚴重,纖維環(huán)穿刺方法構(gòu)建的動物模型于術(shù)后4周才出現(xiàn)退變征象。術(shù)后同一檢測時間點經(jīng)皮纖維環(huán)穿刺法與右后外側(cè)腹膜外入路纖維環(huán)穿刺法構(gòu)建的椎間盤退變動物模型退變表現(xiàn)基本一致。 髓核抽吸法可以快速建立椎間盤退變動物模型,而纖維環(huán)穿刺方法誘發(fā)的椎間盤退行性改變較緩慢。C形臂X射線機輔助下經(jīng)皮纖維環(huán)穿刺方法可以替代傳統(tǒng)的手術(shù)方法模擬椎間盤退變的影像學(xué)和生物化學(xué)改變,且手術(shù)創(chuàng)傷小、術(shù)后并發(fā)癥少,是一種可行的椎間盤退變模型制備方法。
[Abstract]:The ideal animal model of intervertebral disc degeneration is a necessary condition for the research of intervertebral disc tissue engineering. However, there is still a lack of recognized model preparation methods. It has become an urgent task to explore a model preparation method of small animal wound and simple model operation.
The advantages and disadvantages of the C - arm assisted percutaneous fibrous ring puncture, the right posterolateral extraperitoneal approach and the right posterolateral extraperitoneal intramedullary aspiration for the preparation of the rabbit disc degeneration animal model were compared by biochemical and imaging methods. The C - arm assisted percutaneous fibrous ring puncture method was used to prepare the disc degeneration. The feasibility of changing animal models.
The experiment is divided into two parts. The first part is the establishment of the animal model of intervertebral disc degeneration, and the second part is the evaluation of the animal model of intervertebral disc degeneration.
27 New Zealand white rabbits were selected in the experiment. The experimental animals were randomly divided into the C - arm assisted percutaneous fibrous ring puncture group, the right posterolateral extraperitoneal approach group and the right posterolateral extraperitoneal intramedullary aspiration group with 9 animals in each group. Each New Zealand white rabbit was selected as the L2/3 and L3/4 intervertebral disc as an experimental intervertebral disc. The L1/2 and L5/6 intervertebral discs were blank and the intervertebral discs were not treated.
2 animals were randomly selected for lumbar NMR scan before operation. After 2,4,8,12 weeks, 2 animals in each group were randomly selected to die and collect intervertebral disc after lumbar spinal magnetic resonance scanning. Two methylmethylene blue (DMMB) colorimetric method was used to determine the concentration of nucleoprotein polysaccharide, and the T2WI nuclear magnetic resonance (NMR) of the lumbar vertebra was performed by Pfirrmann classification. The vibration images are evaluated for the degree of degeneration respectively.
The experimental results show that:
1. the animals had no anaesthesia, wound infection, posterior limb paralysis and other surgical complications and survived to the end of the experiment. The incision healed after dressing, suture and intramuscular injection of antibiotics.
2. the content of proteoglycan in the nucleus pulposus of the intervertebral disc at each time point after the intervertebral disc operation and the Pfirrmann grading score of the T2 weighted phase of the lumbar vertebral sagittal position were basically consistent. The degeneration degree of the intervertebral disc in the operation intervention group was gradually aggravated, and the degeneration signs of the nucleus pulposus group were observed at the 2 week after the operation, and In the same time point, the degree of degeneration was more serious than that of an animal model constructed by a fibrous ring puncture method. The animal model constructed by the method of fibrous ring puncture only appeared 4 weeks after the operation. The performance of the model is basically the same.
The method of nucleus pulposus aspiration can quickly establish the animal model of intervertebral disc degeneration, and the degeneration of the intervertebral disc induced by the fibrous ring puncture method is better than the slow.C arm X ray machine assisted percutaneous fibrous ring puncture method, which can replace the traditional surgical method to simulate the imaging and chemical changes of intervertebral disc degeneration, and the surgical trauma is small. It is a feasible method for the preparation of intervertebral disc degeneration models.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R-332

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