Staple对侧凸山羊椎体生长板生长率的影响  

EFFECT OF STAPLE ON GROWTH RATE OF VERTEBRAL GROWTH PLATES IN GOAT SCOLIOSIS

作　　者：宋迪煜[1] 孟传龙[1] 郑国权[1] 张巍[1] 张如意[1] 白林[1] 张永刚[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《中国修复重建外科杂志》2009年第1期72-75,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家高技术研究发展计划(863)资助项目(2006AA02Z4D6)~~

摘　　要：目的定量分析Staple对侧凸山羊椎体生长板生长率的影响,进一步探讨Staple矫正脊柱侧凸的可能机制。方法取健康2～3月龄雌性山羊10只,体重6.0～8.5kg,用单侧椎弓根钉不对称栓系的方法建立脊柱侧凸模型,将动物随机分为对照组和Staple治疗组,每组5只。建模8～10周后,两组山羊均取出后路栓系,Staple治疗组在最大弯曲椎体的凸侧前路植入4～5枚Staple,对照组不作处理。继续观察8～13周,X线片记录Cobb角,观察脊柱侧凸矫正情况。处死前第18天和第3天分别给予土霉素和钙黄绿素以标记生长板的骨化前缘;完整获取顶椎上椎间盘以及两相邻的生长板,聚甲基丙烯酸甲酯包埋,不脱钙切片;生物显微镜下测量两荧光标记线之间的距离,分别计算椎体凹凸两侧生长板的生长率。结果有9只山羊建模术后8～10周内进展为明显的脊柱侧凸(Staple治疗组5只,对照组4只)。Staple治疗组术后即刻Cobb角为(34.8±12.4)°,治疗最终时Cobb角减少至(15.6±11.7)°,二者差异有统计学意义(P<0.05);对照组术后即刻与治疗最终时的Cobb角分别为(49.3±18.0)°及(49.0±17.6)°,比较差异无统计学意义(P>0.05)。在低倍生物显微镜下,两组标本凹凸侧的荧光亮度无明显差异;在高倍镜下见生长板骨化前缘有黄绿2条波浪形荧光带,黄色荧光较弱。Staple组凹侧两荧光线间的平均距离明显大于凸侧(Staple侧),凹侧生长板生长率为(3.27±0.96)μm/d,凸侧为(1.84±0.52)μm/d,差异有统计学意义(P<0.05);对照组凹侧生长率为(2.83±0.61)μm/d,凸侧为(2.96±0.77)μm/d,比较差异无统计学意义(P>0.05)。结论Staple可明显改变脊柱侧凸椎体生长板两侧的生长率,使凹侧生长率超过凸侧,以达到有效矫形。Objective To further investigate the possible mechanism of the correction of scoliosis with Staple by quantifying the effect of Staple on growth rate of vertebral growth plates in goat scoliosis. Methods Experimental scoliosis was created in 10 juvenile female goats by using unilateral pedicle screws asymmetric tethering. After 8-10 weeks, goats were divided randomly into Staple treated group （n=5） and control group （n=5）. M1 tethers were removed in both groups and Staple group underwent anterior vertebral stapling with 4-5 shape memory alloy Staples along the convexity of the maximal curvature after posterior tether being removed. All goats were observed for an additional 8-13 weeks, the Cobb angle were measured to observe the correction of scoliosis. The fluorochromes Oxytetracycline and Calcein were administered respectively 18 and 3 days before death to label the ossifying front under the growth plates. Superior intervertebral disc of apical vertebra and two adjacent growth plates were completely harvested in all goats. All specimens were embedded with polymethyl methacrylate and sliced undecalcified. The growth rates of the vertebral growth plates were calculated by measuring the distance between the two fluorescent lines with fluorescence microscope. Results Nine （5 in Staple treated group and 4 in control group） of 10 tethered goats had progressive scoliotic curves of significant magnitude after 8-10 weeks of tethering. In Staple treated group, the Cobb angles were （34.8 ± 12.4）° at the instant after treatment, and （15.6 ± 11.7）° 8-13 weeks after treatment; showing statistically significant difference （P 〈 0.05）. In the control group, the Cobb angles were （49.3 ± 18.0）° at the instant after treatment, and （49.0 ± 17.6）° 8-13 weeks after treatment; showing no statistically significant difference （P 〉 0.05）. In Staple treated group, the growth rate of growth plate in the concavity （3.27 ± 0.96） μm/d was higher than that in convexity （1.84 ± 0.52） μm

关 键 词：STAPLE 脊柱侧凸 生长板 荧光素标记 山羊 

分 类 号：R687[医药卫生—骨科学]