颈椎射频消融髓核成形术病理转归的实验研究  

A Pathological Study of Percutaneous Nucleoplasty in Cervical Intervertebral Disc

作　　者：张涛[1] 孙玉福[1] 高中玉[1] 李彦敏[2] 唐玮[1] 冯世庆[3] 

机构地区：[1]天津市第一中心医院骨科,300192 [2]天津市第一中心医院病理科,300192 [3]天津医科大学总医院骨科

出　　处：《天津医药》2010年第9期784-786,834,共4页Tianjin Medical Journal

基　　金：天津市卫生局科技基金资助项目(项目编号:06KZ15)

摘　　要：目的:探讨等离子射频消融髓核成形术后颈椎间盘的病理变化。方法:选用10只成年小尾寒羊,模拟临床对羊的颈椎间盘髓核行等离子射频消融术,术后即刻、2周及4周分别处死羊2只、4只及4只,取颈椎间盘标本,苏木精-伊红染色,光学显微镜下观察消融椎间盘的病理变化。结果:术后即刻标本显示髓核内出现椭圆形空洞,空洞边缘未见热损伤,空洞长轴直径1.5～2.3mm,短轴直径0.4～0.7mm,邻近消融区域的纤维环和终板无热损伤,2周标本显示其髓核内空洞缩小,长轴直径0.6～1.1mm,短轴直径0.1～0.3mm,空洞周围纤维细胞开始增生,4周标本显示空洞被纤维组织填充。结论:颈椎间盘等离子射频消融髓核成形术后髓核组织内无炭化效应,终板、韧带无热损伤反应;消融形成的空洞被髓核和纤维组织修复,手术方式安全。Objective： To determine the histological changes of the cervical intervertebral discs and surrounding tissues after nucleoplasty. Methods：The experimental study was performed in 10 sheep, and each sheep was treated with nucleoplasty in C4-5 and C5-6. Two sheep were killed randomly at 0 week after cervical nucleoplasty and each 4 sheep were killed at 2 and 4 weeks after cervical nucleoplasty. All samples were staining by Hematoxylin and Eosin. The histological changes were observed by light microscopy. Results：The oval-shaped cavities were observed in the nucleus pulposus, and no thermal injury was found around the cavities in the two sheep killed immediately after treatment. The cavities measured between 1.5 mm to 2.3 mm in long axis and between 0.4 mm to 0.7 mm in short axis. The cavities were shortened in 2-week samples of after nucleoplasty. The measured long axis was 0.6 mm to 1.1 mm and the short axis was 0.1 mm to 0.3 mm. The fiber cells could be found around the cavities in the samples of 4 weeks after nucleoplasty. The cavities were replaced by nucleus pulposus and fibrous tissues. Conclusion： Nucleoplasty did not result in thermal damage or other significant damaging effects to the adjacent annulus and end plate. The cavities produced by nucleoplasty were rehabilitated finally. Nucleoplasty is a safe procedure to cervical spine.

关 键 词：椎间盘 颈椎 模型 动物 病理学 绵羊 髓核成形术 

分 类 号：R687.3[医药卫生—骨科学]