椎间盘摘除术后硬膜外瘢痕形成的实验研究  

Experimental Study of the Genesis of Epidural Scar After Discectomy

作　　者：王荣茂[1] 王和鸣[1] 严孟宁[1] 周斌[1] 朱纬[1] 李廷泰[1] 张洪生[1] 

机构地区：[1]福建中医学院附属人民医院,福建福州350004

出　　处：《福建中医学院学报》2004年第4期11-13,共3页Journal of Fujian College of Traditional Chinese Medicine

基　　金：福建省教育厅资助课题 ( JB9810 0 )

摘　　要：探讨椎间盘术后硬膜外瘢痕的确切来源。采用新西兰大白兔 3 0只 ,间隔切除 L1、3、5、7椎板及其下位椎间盘 ,每个间隙随机选择不同处理 :A组硅胶膜覆盖硬膜前方 ;B组硅胶膜覆盖硬膜后方 ;C组空白 ;D组硅胶膜覆盖硬膜前后方。术后 2、4、8周大体和组织学观察硬膜外瘢痕的来源。结果 :改良 Rydell分级评价可见 A、B、C组随着时间的推移均有显著瘢痕粘连 ,而 D组不明显 ,差异显著 ;Nussbaum积分从高到低依次为 C、A、B、D,A、B、C 3组间差异不显著 ,与 D组差异显著。结论 :硬膜外瘢痕不仅来自后方骶棘肌 ,也来自前方破裂的纤维环。Objective:To confirm the right genesis of epidural scar after discectomy.Methods:Laminectomies and discectomies were performed in L-{1,3,5} of 30 rabbits.In each interval one treatment was selected randomly:A-Silicon membrane was put to cover damaged disc anterodurally;B-put postdurally;C-Nothing was put;D-Silicon membrane was put both anteriorly and posteriorly.Every 10 rabbits were sacrificed at 2,4,8 weeks postoperatively.The epidural scar were examined grossly and histologically.Results:Modified Rydell and Nussbaum score showed:adhesion degree turned much serious when time's elapsing in groupA,B,C,But not in groupD.Conclusion:Epidural scar following discectomy derived from not only erector spinae musculature posteriorly,but also ventral damaged annulus fibrosis.

关 键 词：椎间盘摘除术 硬膜外瘢痕 来源 椎间盘移位 

分 类 号：R687.3[医药卫生—骨科学]