本文關(guān)鍵詞：椎板再生的研究與椎管狹窄動(dòng)物模型的制作　出處：《山東大學(xué)》2007年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： Photoshop 測(cè)量 圖像檔案 椎板切除術(shù) 骨再生 椎管狹窄 椎板切除術(shù) 植骨術(shù) 椎管狹窄 疾病模型 動(dòng)物

【摘要】： 椎板切除術(shù)用于骨科手術(shù)治療已有120多年的歷史，椎板切除引起的繼發(fā)性術(shù)后椎管狹窄也已為骨科醫(yī)師所認(rèn)識(shí)，有關(guān)術(shù)后椎板再生早有文獻(xiàn)報(bào)道。但對(duì)于椎板切除后的再生機(jī)制人們至今尚認(rèn)識(shí)不足，椎板再生引發(fā)后果的實(shí)驗(yàn)研究較少，甚至存在著爭議。而明確椎板再生的機(jī)制和后果可以明確椎板切除后椎管狹窄病理過程，對(duì)臨床治療有重要的指導(dǎo)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(dòng)物模型，以幫助我們對(duì)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(cè)量，本文也對(duì)如何利用Photoshop軟件進(jìn)行諸如面積、角度和距離的測(cè)量進(jìn)行了探討。 一、Photoshop在醫(yī)學(xué)圖像測(cè)量中的應(yīng)用 目的：探索Photoshop軟件用于醫(yī)學(xué)影像資料的距離、角度和面積測(cè)量的方法，并對(duì)其準(zhǔn)確度進(jìn)行驗(yàn)證。 方法：分別用傳統(tǒng)手工、Photoshop CS2、Image-Pro Plus 6.0和對(duì)50例腰椎CT和50例脊柱側(cè)凸患者X光片進(jìn)行測(cè)量。將3種方法測(cè)得的L_(4／5)椎管矢狀徑和脊柱側(cè)凸Cobb角度的結(jié)果以SAS8.02進(jìn)行兩因素方差分析和SNK檢驗(yàn)，以明確各測(cè)量方法的測(cè)量結(jié)果有無顯著統(tǒng)計(jì)差異；用以上兩種軟件對(duì)相同資料的L_(4／5)椎管截面積進(jìn)行測(cè)量并對(duì)測(cè)量結(jié)果進(jìn)行配對(duì)，以SAS8.02進(jìn)行配對(duì)資料的t檢驗(yàn)，以明確測(cè)量結(jié)果有無顯著統(tǒng)計(jì)學(xué)差異。 結(jié)果：在距離和角度的測(cè)量方面PS與手工及IPP測(cè)量均無顯著統(tǒng)計(jì)學(xué)差異(P＞0.05)；在面積的測(cè)量上PS和IPP也無顯著統(tǒng)計(jì)學(xué)差異(P＞0.05)。 結(jié)論：用Photoshop進(jìn)行影像學(xué)測(cè)量簡便準(zhǔn)確，為影像學(xué)測(cè)量提供了一種新的思路和方法。 二、椎板再生的實(shí)驗(yàn)研究 目的：探討大鼠椎板切除后的再生機(jī)制和后果。 方法：以SD大鼠為模型行L_5全椎板切除，與對(duì)照組一同進(jìn)行運(yùn)動(dòng)和感覺功能檢查、影像學(xué)及病理檢查，計(jì)算機(jī)分析結(jié)果數(shù)據(jù)。 結(jié)果：病理學(xué)檢查見椎板缺損處首先形成纖維組織，，繼而椎板邊緣松質(zhì)骨以軟骨內(nèi)成骨的方式向?qū)?cè)再生形成椎板，椎板皮質(zhì)骨則以膜內(nèi)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(shù)后16周L_5椎管截面積測(cè)量結(jié)果顯示，椎板再生引起實(shí)驗(yàn)組椎管狹窄15.6％(P＜0.05)，同時(shí)實(shí)驗(yàn)組出現(xiàn)了明顯間歇性跛行(P＜0.05)。SEP結(jié)果還顯示實(shí)驗(yàn)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(jié)論：椎板再生包括纖維組織軟骨內(nèi)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(dòng)物模型 目的：探索一種制作腰椎管狹窄動(dòng)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(duì)照組(C組)一同進(jìn)行下肢運(yùn)動(dòng)功能(BBB評(píng)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(jìn)行L_5的影像學(xué)及病理學(xué)檢查以觀察和測(cè)量腰椎管狹窄的程度。結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析以檢驗(yàn)?zāi)Ｐ蛯?duì)腰椎管狹窄模擬的效果。 結(jié)果：A、B組術(shù)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(píng)分分別自術(shù)后2周和1周恢復(fù)正常(P＞0.05)。術(shù)后16周時(shí)，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(shù)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(yán)重(P＜0.05)。術(shù)后16周時(shí)病理顯示A組L_5椎管狹窄最為嚴(yán)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(jié)論：椎板切除碎骨�；刂卜ㄖ谱餮倒塥M窄動(dòng)物模型的效果顯著，模擬性良好，是制作該類動(dòng)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(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R-332

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