猪腰椎间盘髓核摘除术后疲劳载荷对椎间盘形态的影响

摘要

Objective To investigate The effect of fatigue load on the pig lumbar disc appear-ante after disectomy. Methods 4 samples of pig lumbar spines were selected and divided into two groups randomly:operative group during unilateral vertebral plate disectomy (group A) and control group (group B). Each group was dissected into 8 functional spinal units (FSU) and sub-jected to fatigue loading under the same parameter (the flexion angle was 9° ,the rotation angle was 3°,the peak load was 3500N,the load frequency was 3Hz). Discography was taken on every sample before and after fatigue load experiment to measure the dimension of total dise,annuli fi-brosi area,nucleus area and contrast agent area respectively. Frozen sections were taken on two groups after fatigue load experiment. Results Total disc dimension of two groups increased after load experiment(P<0.05). Group A showed that annuli fibrosi area increased(P<0.05) and nucleus area did not change after load experiment (P>0.05).Group B showed that annuli fibrosi area de-creased(P<0.05) and nucleus area increased after load experiment(P<0.05). Contrast agent area in nucleus area of two groups increased after load experiment (P<0.05) and the proportion of Contrast agent area to nucleus area of group B was greater than that of group A after load experiment (P<0.05). No annuli fibrosi tear was found in two groups either by discography or by frozen section. Conclusion This experiment provid the biomeehanical foundation of animal experiments for explain-ing the clinical effects on young patients generally better than on elderly patients.%目的 探讨腰椎间盘髓核摘除术后疲劳载荷对椎间盘形态的影响.方法 取4具年轻猪新鲜脊柱标本,随机分为手术组(A组)和非手术组(B组),各制成8个脊柱功能单位(FSU),A组行单侧椎板开窗髓核摘除术.两组在相同的设置参数下(前屈9°,旋转3°,轴向载荷最大载荷取3500N,载荷频率为3Hz)行疲劳加载实验,加载前后均行椎间盘造影,分别测量椎间盘总面积、纤维环区面积、髓核区面积及髓核区造影剂所占面积.实验后均行椎间盘美兰染色观察横截面形态.结果 A、B两组疲劳载荷后椎间盘总面积均增大(P<0.05);A组疲劳载荷后纤维环区面积增大(P<0.05),髓核区面积无明显变化(P>0.05);B组疲劳载荷后纤维环区面积缩小(P<0.05).髓核区面积增大(P<0.05);A、B两组疲劳载荷后造影剂所占髓核区面积均增大(P<0.05),B组加载后造影剂所占面积与A组相比较增大(P<0.05);美兰染色显示A、B两组疲劳载荷后均未见有明显的纤维环裂隙,与椎间盘造影图像基本相符.结论 本实验对解释临床上年轻患者术后疗效普遍好于中、老年患者,提供了一定的动物实验生物力学基础.u0000载荷后椎间盘总面积均增大(P<0.05);A组疲劳载荷u0000纤维环区面积增大(P<0.05),髓核区面积无明显变化(P>0.05);B组疲劳载荷后纤维环区面积缩小(P<0.05).髓核区面积增大(P<0.05);A、B两组疲劳载荷后造影剂所占髓核区面积均增大(P<0.05),B组加载后造影剂所占面积与A组相比较增大(P<0.05);美兰染色显示A、B两组疲劳载荷后均未见有明显的纤维环裂隙,与椎间盘造影图像基本相符.结论 本实验对解释临床上年轻患者术后疗效普遍好于中、老年患者,提供了一定的动物实验生物力学基础.u0000载荷后椎间盘总面积均增大(P<0.05);A组疲劳载荷u0000纤维环区面积增大(P<0.05),髓核区面积无明显变化(P>0.05);B组疲劳载荷后纤维环区面积缩小(P<0.05).髓核区面积增大(P<0.05);A、B两