靶点射频消融对兔椎间盘的实验研究  

Rabbit Experimental Study of Radiofrequency Target Ablation in Intervertebral

作　　者：唐郁宽[1] 郭真真[1] 肖承江[2] 李晶[3] 荘高明[1] 壮炜钊[1] 刘德祥[1] 李耀国[1] 孙学文[1] 邓炜[1] 

机构地区：[1]广州市番禺区人民医院放射科,广州511400 [2]广东省第二人民医院介入科,广州510317 [3]广州市番禺区人民医院病理科,广州511400

出　　处：《中国现代医生》2009年第21期42-44,F0003,共4页China Modern Doctor

基　　金：2006年度广州市医药卫生科技一般引导项目(项目编号:2006-YB-249)

摘　　要：目的通过实验及病理学研究,观察靶点射频消融对正常髓核的作用及用于治疗腰椎间盘突出症的安全性。方法14只实验兔分为3组,每只做3～4节椎间盘。A组6只:CT扫描下靶点射频消融椎间盘,分别于术后1h、4周、8周处死兔,取出椎间盘髓核及相应水平的脊髓、神经根,并作大体、光镜下观察。术后4周行MR复查。B组2只:解剖并暴露腰段椎间盘横断面,直视行靶点射频消融,观察椎间盘形态学变化。C组6只:在X线透视引导下穿刺腰椎间盘注入50μg/mL臭氧5mL后行MRI及组织学检查,方法同A组。结果术后A组椎间盘靶区髓核水分较正常明显减少而萎缩,髓核细胞大部分坏死溶解,存活细胞明显减少,相应节段脊髓和神经根均无损伤,4周后此改变仍显著;B组靶点区髓核出现直径8.0mm范围的凝固萎缩区;C组前4周椎间盘髓核变化不明显,8周后才明显出现类似上述病理改变。结论对椎间盘设定一个靶点进行射频消融,术后靶点髓核立即出现萎缩,体积缩小,周围脊髓神经无损伤,具有安全、见效快及可操作性强的特点,为靶点射频消融治疗椎间盘突出症在临床的应用提供了实验依据。Objective To evaluate the influence of radiofrequency target ablation on normal nucleus pulpesus and the safety for treatment of herniated intervertebral disc by animal experiment and pathology. Methods Fiurteen rabbits were divided into 3 groups. 3 - 4 intervertebral discs were experiment on for each rabbits. Six rabbits in group A were treated with radiofrequency target ablation on intervertebral disc guided by CT. Sacrificed for pathology one hour, four weeks and eight weeks later. Nucleus pulpesus,spinal cord and nerve root Specimens were observed maeroscopically and microscopically. MR were rechecked four weeks later. Two rabbits in group B were dissected to expose the lumbar intervertebral discs. They were treated with radiofrequency target ablation directly to observe the morphology change. Six rabbits in group C were subjected medical ozone injection into selected lumbar intervertebral discs under fluoroscopy. The medical ozone concentration was 50 ug/mL. The same MR and microscopic examination were done later as group A. Results There were significant water reduction and analosis of the target area nucleus gelatinosus after radiofrequency target ablation in group A. Majority of the cells appeared necrosis and dissolution,the survival cells were sparsely seen in target district, spinal cord and nerve root around were not damaged. The pathologic changes were still obvious four weeks later. Same changes as group A were observed only eight weeks later in group C. There was clotting and analosis district（the diameter is about 8 millimeter）around target area nucleus gelatinosus in group B. Conclusion Radiofrequeney target ablation is safe,fast effective to intervertebral disc herniation.lt made atrophy and diminution of target area nucleus gelatinosus immediately. There was no damage of nerve root around. This study provided the evidence of the feasibility and value of the procedure of radiofrequency target ablation in clinics.

关 键 词：兔 射频 靶点消融术 椎间盘突出症 实验研究 

分 类 号：R681[医药卫生—骨科学]