本文關鍵詞：椎板再生的研究與椎管狹窄動物模型的制作　出處：《山東大學》2007年碩士論文　論文類型：學位論文

  更多相關文章： Photoshop 測量 圖像檔案 椎板切除術 骨再生 椎管狹窄 椎板切除術 植骨術 椎管狹窄 疾病模型 動物

【摘要】： 椎板切除術用于骨科手術治療已有120多年的歷史，椎板切除引起的繼發(fā)性術后椎管狹窄也已為骨科醫(yī)師所認識，有關術后椎板再生早有文獻報道。但對于椎板切除后的再生機制人們至今尚認識不足，椎板再生引發(fā)后果的實驗研究較少，甚至存在著爭議。而明確椎板再生的機制和后果可以明確椎板切除后椎管狹窄病理過程，對臨床治療有重要的指導意義。此外還可以利用椎板再生引發(fā)椎管狹窄的現(xiàn)象來制作退變性腰椎管狹窄的動物模型，以幫助我們對該類疾病的研究。另外，要定量研究椎管狹窄的程度就離不開椎管截面積的測量，本文也對如何利用Photoshop軟件進行諸如面積、角度和距離的測量進行了探討。 一、Photoshop在醫(yī)學圖像測量中的應用 目的：探索Photoshop軟件用于醫(yī)學影像資料的距離、角度和面積測量的方法，并對其準確度進行驗證。 方法：分別用傳統(tǒng)手工、Photoshop CS2、Image-Pro Plus 6.0和對50例腰椎CT和50例脊柱側凸患者X光片進行測量。將3種方法測得的L_(4／5)椎管矢狀徑和脊柱側凸Cobb角度的結果以SAS8.02進行兩因素方差分析和SNK檢驗，以明確各測量方法的測量結果有無顯著統(tǒng)計差異；用以上兩種軟件對相同資料的L_(4／5)椎管截面積進行測量并對測量結果進行配對，以SAS8.02進行配對資料的t檢驗，以明確測量結果有無顯著統(tǒng)計學差異。 結果：在距離和角度的測量方面PS與手工及IPP測量均無顯著統(tǒng)計學差異(P＞0.05)；在面積的測量上PS和IPP也無顯著統(tǒng)計學差異(P＞0.05)。 結論：用Photoshop進行影像學測量簡便準確，為影像學測量提供了一種新的思路和方法。 二、椎板再生的實驗研究 目的：探討大鼠椎板切除后的再生機制和后果。 方法：以SD大鼠為模型行L_5全椎板切除，與對照組一同進行運動和感覺功能檢查、影像學及病理檢查，計算機分析結果數(shù)據(jù)。 結果：病理學檢查見椎板缺損處首先形成纖維組織，，繼而椎板邊緣松質骨以軟骨內成骨的方式向對側再生形成椎板，椎板皮質骨則以膜內成骨的方式再生，此外纖維組織中出現(xiàn)軟骨島并骨化成椎板。術后16周L_5椎管截面積測量結果顯示，椎板再生引起實驗組椎管狹窄15.6％(P＜0.05)，同時實驗組出現(xiàn)了明顯間歇性跛行(P＜0.05)。SEP結果還顯示實驗組出現(xiàn)了下肢感覺障礙—潛伏期延長(P＜0.05)，波幅下降(P＜0.05)。 結論：椎板再生包括纖維組織軟骨內成骨和椎板切緣的骨再生，再生造成椎管狹窄。 三、椎板切除碎骨�；刂卜ㄖ谱餮倒塥M窄動物模型 目的：探索一種制作腰椎管狹窄動物模型的簡便有效的方法。 方法：以SD大鼠為模型，分別行L_5全椎板切除(B組)及切除后自體碎骨粒回植(A組)，與空白對照組(C組)一同進行下肢運動功能(BBB評分及出現(xiàn)間歇性跛行前的行走距離)和體表誘發(fā)電位(SEP)檢查以觀察腰椎管狹窄的表現(xiàn)，并進行L_5的影像學及病理學檢查以觀察和測量腰椎管狹窄的程度。結果進行統(tǒng)計學分析以檢驗模型對腰椎管狹窄模擬的效果。 結果：A、B組術后均出現(xiàn)了明顯的椎板再生和腰椎管狹窄的表現(xiàn)，且以A組更為明顯。A、B組BBB評分分別自術后2周和1周恢復正常(P＞0.05)。術后16周時，在3組大鼠中A組出現(xiàn)間歇性跛行前的行走距離最短(P＜0.05)，其均數(shù)較C組減少42.9％，B組較C組減少17.1％(P＜0.05)。A、B組術后SEP明顯受損(P＜0.05)，出現(xiàn)下肢感覺功能障礙，且以A組最嚴重(P＜0.05)。術后16周時病理顯示A組L_5椎管狹窄最為嚴重(P＜0.05)，截面積較C組減少34.1％，B組較C組減少18.2％(P＜0.05)，L_5的X線、CT和MRI檢查亦顯示A、B組椎板再生，椎管狹窄。 結論：椎板切除碎骨粒回植法制作腰椎管狹窄動物模型的效果顯著，模擬性良好，是制作該類動物模型的簡便有效的方法。
[Abstract]:Department of orthopedics surgery laminectomy for more than 120 years of history, laminectomy and secondary operation induced after spinal stenosis has also been recognized by the Department of orthopedics physicians, postoperative bone regeneration as reported in the literature. But for the mechanism of regeneration after laminectomy is still not enough understanding, experimental study of bone regeneration and consequences even less. There is a dispute. And clear the mechanism and consequences of bone regeneration after laminectomy and spinal stenosis can be clearly pathological process, has an important guiding significance for clinical treatment. In addition to the regeneration of spinal stenosis caused to make the phenomenon of degenerative lumbar spinal stenosis animal model using lamina, to help us to this kind of disease research. In addition, to measure the quantitative research on the extent of spinal stenosis is cannot do without spinal canal cross-sectional area, this paper such as the area of how to use Photoshop software, and angle The measurement of distance is discussed.
The application of Photoshop in medical image measurement
Objective: To explore the method of measuring distance, angle and area of medical image data by Photoshop software, and to verify its accuracy.
Methods: using the traditional manual, Photoshop CS2, Image-Pro 6 and Plus in 50 cases of CT and 50 cases of lumbar scoliosis X optical films were measured. The 3 measured L_ (4 / 5) of sagittal diameter of spinal canal and scoliosis Cobb angle results of two factor analysis of variance and SNK test to SAS8.02, in order to clear the measurement measurement results are significantly statistical difference; with the above two kinds of software on the same data L_ (4 / 5) cross-sectional area of spinal canal were measured and the measurement results of paired t test, paired with SAS8.02, in order to clear the measurement results have no significant difference.
Results: there was no significant difference in the distance and angle measurement between PS and manual and IPP measurements (P > 0.05). There was no significant difference in the area measurement between PS and IPP (P > 0.05).
Conclusion: the imaging measurement of Photoshop is simple and accurate, which provides a new idea and method for imaging measurement.
Two, experimental study of laminectomy
Objective: To investigate the regenerative mechanism and consequences of lamina excision in rats.
Methods: SD rats were taken as a model to perform L_5 laminectomy. The motor and sensory functions were examined together with the control group, including imaging and pathological examination, and computer analysis results.
Results: the pathological examination showed lamina defect at first fibrous tissue formation, and lamina edge of cancellous bone to the contralateral lamina regeneration formed by endochondral ossification, cortical bone in lamina intramembranous bone regeneration way, in addition to fibrous tissue appeared in cartilage and bone into vertebral plate. The island of 16 weeks L_5 the spinal canal cross-sectional area measurements after operation, bone regeneration caused by spinal stenosis 15.6% experimental group (P < 0.05), while the experimental group appeared obvious intermittent claudication (P < 0.05).SEP results also showed that the experimental group had lower extremity sensory disturbance latency prolonged (P < 0.05), the amplitude decreased (P < 0.05).
Conclusion: the regeneration of the vertebral lamina includes the bone regeneration of the endochondral osteogenesis and the lamina cutting edge of the fibrous tissue, and the regeneration of the vertebral canal leads to the stenosis of the spinal canal.
Three, the animal model of lumbar spinal canal stenosis made by laminectomy and broken bone grafts
Objective: To explore a simple and effective method for making the animal model of lumbar spinal canal stenosis.
Methods: SD rat models, respectively L_5 laminectomy (group B) and autogenous bone particles after resection replantation (A group), and control group (C group) with lower extremity motor function (BBB score and intermittent claudication walking distance before the evoked potential (SEP) and body surface) were examined by lumbar stenosis performance, and L_5 imaging and pathological examination to observe and measure the lumbar canal stenosis. The results were statistically analyzed to simulate lumbar canal stenosis in order to test the model.
Results: A, B group after all appeared obvious bone regeneration and lumbar stenosis performance, and was more pronounced in the A group.A, B group BBB score respectively after 2 weeks and 1 weeks of recovery (P > 0.05). 16 weeks after the operation, the 3 groups of rats the A group had intermittent claudication walking distance before the shortest (P < 0.05), the mean number of reduced 42.9% compared with C group, B group and C group decreased 17.1% (P < 0.05).A, B group after SEP was significantly impaired (P < 0.05), lower extremity sensory dysfunction, and group A is the most serious (P < 0.05). After 16 weeks when pathological group A showed the most serious L_5 spinal stenosis (P < 0.05), the cross-sectional area is the reduction of C 34.1% group, B group than in C group decreased 18.2% (P < 0.05), L_5 CT and X-ray, MRI examination also showed that A, B group of bone regeneration and spinal canal stenosis.
Conclusion: laminectomy and bone grafting is a good and simple method for making animal models of lumbar spinal stenosis.

【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2007
【分類號】：R-332

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