前纵韧带损伤加重相应节段损伤椎间盘的退变

发布时间：2018-05-26 09:27

本文选题：前纵韧带 + 椎间盘　；参考：《中国组织工程研究》2017年11期

【摘要】：背景:脊柱失稳可加速正常椎间盘的退变。在外伤导致脊柱失稳时,常同时存在前纵韧带合并椎间盘损伤。目前鲜有关于前纵韧带损伤对损伤后椎间盘退变影响的动物实验研究。目的:通过建立不同程度兔前纵韧带合并椎间盘损伤模型,观察脊柱失稳后损伤椎间盘的退变情况。方法:将24只新西兰大白兔随机分为4组,单纯椎间盘损伤组、椎间盘损伤+前纵韧带部分损伤组、椎间盘损伤+前纵韧带骨附着点断裂伤组和椎间盘损伤+前纵韧带中央横断组。经腹腔暴露L2至L3椎体,按分组分别对L2-L3椎间盘和局部前纵韧带进行相应处理。于术后4周和8周行CT检查,在矢状位二维重建图像上计算受损椎间隙中央高度,并进行统计学分析。摄片后每组随机选取3只兔子,处死后取损伤部位椎间盘组织行苏木精-伊红染色,光镜下镜检。结果与结论:(1)术后4周,椎间盘损伤+前纵韧带中央横断组受损椎间隙高度较单纯椎间盘损伤组明显降低(P0.05),椎间盘损伤+前纵韧带骨附着点断裂伤组和前纵韧带中央横断组分别可见局部骨质增生和钙化;组织学观察发现椎间盘损伤+前纵韧带骨附着点断裂伤组和前纵韧带中央横断组髓核细胞减少,局部炎症反应较单纯椎间盘损伤组明显;(2)术后8周,椎间盘损伤+前纵韧带骨附着点断裂伤组和前纵韧带中央横断组受损椎间隙高度较单纯椎间盘损伤组明显降低(P0.05),椎间盘损伤+前纵韧带骨附着点断裂伤组和前纵韧带中央横断组局部骨质增生和钙化较前明显;苏木精-伊红染色可见髓核细胞形态改变,髓核局部纤维化与纤维环分界模糊,退变程度椎间盘损伤+前纵韧带中央横断组椎间盘损伤+前纵韧带骨附着点断裂伤组椎间盘损伤+前纵韧带部分损伤组单纯椎间盘损伤组;(3)结果表明,兔前纵韧带损伤可加重相应节段损伤椎间盘的退变,且椎间盘退变程度随前纵韧带损伤程度的增加而加重。
[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.
【作者单位】：上海交通大学医学院附属第九人民医院骨科;
【基金】：上海交通大学医学院附属第九人民医院院基金(syz2015-024)~~
【分类号】：R687

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