本文選題：前縱韌帶 + 椎間盤��； 參考：《中國組織工程研究》2017年11期

【摘要】：背景:脊柱失穩(wěn)可加速正常椎間盤的退變。在外傷導致脊柱失穩(wěn)時,常同時存在前縱韌帶合并椎間盤損傷。目前鮮有關于前縱韌帶損傷對損傷后椎間盤退變影響的動物實驗研究。目的:通過建立不同程度兔前縱韌帶合并椎間盤損傷模型,觀察脊柱失穩(wěn)后損傷椎間盤的退變情況。方法:將24只新西蘭大白兔隨機分為4組,單純椎間盤損傷組、椎間盤損傷+前縱韌帶部分損傷組、椎間盤損傷+前縱韌帶骨附著點斷裂傷組和椎間盤損傷+前縱韌帶中央橫斷組。經(jīng)腹腔暴露L2至L3椎體,按分組分別對L2-L3椎間盤和局部前縱韌帶進行相應處理。于術后4周和8周行CT檢查,在矢狀位二維重建圖像上計算受損椎間隙中央高度,并進行統(tǒng)計學分析。攝片后每組隨機選取3只兔子,處死后取損傷部位椎間盤組織行蘇木精-伊紅染色,光鏡下鏡檢。結果與結論:(1)術后4周,椎間盤損傷+前縱韌帶中央橫斷組受損椎間隙高度較單純椎間盤損傷組明顯降低(P0.05),椎間盤損傷+前縱韌帶骨附著點斷裂傷組和前縱韌帶中央橫斷組分別可見局部骨質(zhì)增生和鈣化;組織學觀察發(fā)現(xiàn)椎間盤損傷+前縱韌帶骨附著點斷裂傷組和前縱韌帶中央橫斷組髓核細胞減少,局部炎癥反應較單純椎間盤損傷組明顯;(2)術后8周,椎間盤損傷+前縱韌帶骨附著點斷裂傷組和前縱韌帶中央橫斷組受損椎間隙高度較單純椎間盤損傷組明顯降低(P0.05),椎間盤損傷+前縱韌帶骨附著點斷裂傷組和前縱韌帶中央橫斷組局部骨質(zhì)增生和鈣化較前明顯;蘇木精-伊紅染色可見髓核細胞形態(tài)改變,髓核局部纖維化與纖維環(huán)分界模糊,退變程度椎間盤損傷+前縱韌帶中央橫斷組椎間盤損傷+前縱韌帶骨附著點斷裂傷組椎間盤損傷+前縱韌帶部分損傷組單純椎間盤損傷組;(3)結果表明,兔前縱韌帶損傷可加重相應節(jié)段損傷椎間盤的退變,且椎間盤退變程度隨前縱韌帶損傷程度的增加而加重。
[Abstract]:Background: spinal instability can accelerate normal disc degeneration. The anterior longitudinal ligament associated with disc injury is often present at the same time when the spine is unstable due to trauma. There are few experimental studies on the effects of anterior longitudinal ligament injury on disc degeneration after injury. Aim: to establish a rabbit model of anterior longitudinal ligament combined with disc injury to observe the degeneration of injured intervertebral disc after spinal instability. Methods: Twenty-four New Zealand white rabbits were randomly divided into 4 groups: the disc injury group and the anterior longitudinal ligament injury group. Intervertebral disc injury anterior longitudinal ligament bone attachment injury group and intervertebral disc injury anterior longitudinal ligament central transection group. L2 to L3 vertebrae were exposed intraperitoneally and L2-L3 intervertebral disc and local anterior longitudinal ligament were treated accordingly. Ct was performed at 4 and 8 weeks after operation. The height of the damaged intervertebral space was calculated on the sagittal 2D reconstruction images and analyzed statistically. After the film, 3 rabbits were randomly selected from each group. The injured intervertebral disc tissue was stained with hematoxylin-eosin and examined under light microscope. Results and conclusion 4 weeks after operation, The height of the injured intervertebral space in the central transverse section of anterior longitudinal ligament was significantly lower than that in the simple disc injury group (P 0.05). The local area was found in the fracture of anterior longitudinal ligament bone attachment point and the central transverse section of anterior longitudinal ligament in disc injury group. Hyperosteogenesis and calcification; Histological observation showed that the number of nucleus pulposus cells decreased and the local inflammatory reaction was significantly lower in the anterior longitudinal ligament attachment injury group and the central transverse anterior longitudinal ligament injury group than in the simple disc injury group at 8 weeks after operation. Intervertebral disc injury anterior longitudinal ligament bone attachment injury group and anterior longitudinal ligament central transverse section group were significantly lower than the simple disc injury group (P 0.05), disc injury anterior longitudinal ligament bone attachment injury group and anterior longitudinal ligament fracture group and anterior longitudinal ligament injury group, anterior longitudinal ligament injury group and anterior longitudinal ligament injury group, anterior longitudinal ligament fracture group and anterior longitudinal ligament injury group. The local hyperosteogenesis and calcification in the central transection group were more obvious than those in the former group. Hematoxylin-eosin staining showed that the morphological changes of nucleus pulposus cells, local fibrosis of nucleus pulposus and the boundary of fibrous ring were blurred. Degenerative degree of intervertebral disc injury anterior longitudinal ligament central transection group intervertebral disc injury anterior longitudinal ligament bone attachment injury group anterior longitudinal ligament injury partial injury group anterior longitudinal ligament injury group simple disc injury group, the results showed that The anterior longitudinal ligament injury can aggravate the degeneration of the corresponding segments of the disc, and the degree of disc degeneration increases with the increase of the injury degree of the anterior longitudinal ligament.
【作者單位】： 上海交通大學醫(yī)學院附屬第九人民醫(yī)院骨科;
【基金】：上海交通大學醫(yī)學院附屬第九人民醫(yī)院院基金(syz2015-024)~~
【分類號】：R687

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