椎板再生的研究与椎管狭窄动物模型的制作

发布时间：2018-01-01 16:43

本文关键词：椎板再生的研究与椎管狭窄动物模型的制作　出处：《山东大学》2007年硕士论文　论文类型：学位论文

【摘要】： 椎板切除术用于骨科手术治疗已有120多年的历史，椎板切除引起的继发性术后椎管狭窄也已为骨科医师所认识，有关术后椎板再生早有文献报道。但对于椎板切除后的再生机制人们至今尚认识不足，椎板再生引发后果的实验研究较少，甚至存在着争议。而明确椎板再生的机制和后果可以明确椎板切除后椎管狭窄病理过程，对临床治疗有重要的指导意义。此外还可以利用椎板再生引发椎管狭窄的现象来制作退变性腰椎管狭窄的动物模型，以帮助我们对该类疾病的研究。另外，要定量研究椎管狭窄的程度就离不开椎管截面积的测量，本文也对如何利用Photoshop软件进行诸如面积、角度和距离的测量进行了探讨。一、Photoshop在医学图像测量中的应用目的：探索Photoshop软件用于医学影像资料的距离、角度和面积测量的方法，并对其准确度进行验证。方法：分别用传统手工、Photoshop CS2、Image-Pro Plus 6.0和对50例腰椎CT和50例脊柱侧凸患者X光片进行测量。将3种方法测得的L_(4／5)椎管矢状径和脊柱侧凸Cobb角度的结果以SAS8.02进行两因素方差分析和SNK检验，以明确各测量方法的测量结果有无显著统计差异；用以上两种软件对相同资料的L_(4／5)椎管截面积进行测量并对测量结果进行配对，以SAS8.02进行配对资料的t检验，以明确测量结果有无显著统计学差异。结果：在距离和角度的测量方面PS与手工及IPP测量均无显著统计学差异(P＞0.05)；在面积的测量上PS和IPP也无显著统计学差异(P＞0.05)。结论：用Photoshop进行影像学测量简便准确，为影像学测量提供了一种新的思路和方法。二、椎板再生的实验研究目的：探讨大鼠椎板切除后的再生机制和后果。方法：以SD大鼠为模型行L_5全椎板切除，与对照组一同进行运动和感觉功能检查、影像学及病理检查，计算机分析结果数据。结果：病理学检查见椎板缺损处首先形成纤维组织，，继而椎板边缘松质骨以软骨内成骨的方式向对侧再生形成椎板，椎板皮质骨则以膜内成骨的方式再生，此外纤维组织中出现软骨岛并骨化成椎板。术后16周L_5椎管截面积测量结果显示，椎板再生引起实验组椎管狭窄15.6％(P＜0.05)，同时实验组出现了明显间歇性跛行(P＜0.05)。SEP结果还显示实验组出现了下肢感觉障碍—潜伏期延长(P＜0.05)，波幅下降(P＜0.05)。结论：椎板再生包括纤维组织软骨内成骨和椎板切缘的骨再生，再生造成椎管狭窄。三、椎板切除碎骨粒回植法制作腰椎管狭窄动物模型目的：探索一种制作腰椎管狭窄动物模型的简便有效的方法。方法：以SD大鼠为模型，分别行L_5全椎板切除(B组)及切除后自体碎骨粒回植(A组)，与空白对照组(C组)一同进行下肢运动功能(BBB评分及出现间歇性跛行前的行走距离)和体表诱发电位(SEP)检查以观察腰椎管狭窄的表现，并进行L_5的影像学及病理学检查以观察和测量腰椎管狭窄的程度。结果进行统计学分析以检验模型对腰椎管狭窄模拟的效果。结果：A、B组术后均出现了明显的椎板再生和腰椎管狭窄的表现，且以A组更为明显。A、B组BBB评分分别自术后2周和1周恢复正常(P＞0.05)。术后16周时，在3组大鼠中A组出现间歇性跛行前的行走距离最短(P＜0.05)，其均数较C组减少42.9％，B组较C组减少17.1％(P＜0.05)。A、B组术后SEP明显受损(P＜0.05)，出现下肢感觉功能障碍，且以A组最严重(P＜0.05)。术后16周时病理显示A组L_5椎管狭窄最为严重(P＜0.05)，截面积较C组减少34.1％，B组较C组减少18.2％(P＜0.05)，L_5的X线、CT和MRI检查亦显示A、B组椎板再生，椎管狭窄。结论：椎板切除碎骨粒回植法制作腰椎管狭窄动物模型的效果显著，模拟性良好，是制作该类动物模型的简便有效的方法。
[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.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R-332

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