椎板切除术后早期进行直腿抬高运动对硬膜外纤维化影响的实验研究  

Influence of straight-leg-raising movement on epidural fibrosis in early time after laminectomy in a rabbit model

作　　者：赵继军[1] 李正维[2] 杨述华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院骨科,武汉430022 [2]大连医科大学附属第一医院骨科,116023

出　　处：《中国矫形外科杂志》2006年第19期1494-1496,i0002,共4页Orthopedic Journal of China

摘　　要：[目的]探讨腰椎术后早期进行直腿抬高运动对于硬膜外纤维化的影响。成年新西兰大白兔40只,随机分为2组,全部行S1椎板切除术,实验组于术后模拟人进行直腿抬高运动,而对照组不予任何处理。术后1、2、4、8周每组随机处死5只兔子取材。大体观察1、2周时实验组瘢痕的形成要晚于对照组;4、8周时黏连分级两组存在显著性差异(P<0.05),实验组重于对照组。2、4、8周时实验组的瘢痕指数高于对照组(P<0.05)。瘢痕组织学评分1周时两组无差异(P>0.05),2、4、8周时对照组要优于实验组(P<0.05)。成纤维细胞及炎性细胞计数,早期实验组细胞数多于对照组(P<0.05),但晚期两组无显著性差异(P>0.05)。[结论]腰椎术后直腿抬高运动可增加硬膜外瘢痕的形成,延缓瘢痕的成熟,加重瘢痕对硬膜及神经根的黏连和固定。[ Objective] To determine the influence of Straight-Leg-Raising movement on epidurai fibrosis after lamioectomy. [ Method ] Fourty adult New Zealand rabbits were selected as laminectomy models in the study. They were divided into 2 groups-Straight-Leg-Raising group （SLR） and Control group （C） randomly. All rabbits were performed the operation of total laminectomy in S1. Five rabbits of each group selected randomly were killed in the 1 ^st , 2^nd , 4^th and 8^th week after laminectomy. [ Result] The formation of scar in SLR group was retarded contrast to that of group C in the first two weeks, but there was no statistical difference in adhesion degree; in the 4th and 8th week, the epidural fibrosis of SLR group was more serious than that of group C. The sear area in SLR group was larger than that of group C in the 2^nd, 4^th and 8^th week. The number of fibroblasts and inflammatory cells in SLR group was larger than that of group C in early stage ; however, there was no statistical significance between the two groups in later stage. [ Conclusion] Straight-Leg-Raising movement after laminectomy may aggravate the formation of epidural scar and retard the maturity of scar. SLR movement may also aggravate the adhesion of scar.

关 键 词：椎板切除术 神经根 瘢痕 直腿抬高运动 

分 类 号：R687[医药卫生—骨科学]