椎间融合引起相邻节段退变的动物实验模型  

Experimental animal models of intervertebral fusion-induced adjacent segment degeneration

作　　者：刘英杰 彭俊 刘小康[2] 赵成[3] 杨二柱[4] 徐建广[5] 

机构地区：[1]上海市第六人民医院东院骨科,上海市201306 [2]郑州大学第一附属医院骨科,河南省郑州市450003 [3]中国中医科学院西苑医院骨科,北京市100091 [4]上海交通大学附属第六人民医院骨科,上海市200233 [5]上海交通大学附属第六人民医院脊柱外科,上海市200233

出　　处：《中国组织工程研究》2016年第39期5825-5833,共9页Chinese Journal of Tissue Engineering Research

基　　金：上海市第六人民医院动物实验室及手术室对本实验的大力支持

摘　　要：背景:直立大鼠椎间盘退变模型虽然能证明椎间融合后相邻节段椎间盘退变加重,但无法检验脊椎非融合技术是否更有优势。目的:在已确认的Beagle犬椎间盘退变模型基础上行椎间融合,了解椎间融合后是否加重相邻节段椎间盘退变。方法:将12只Beagle犬随机分为2组,对照组行椎间盘穿刺,损伤L_(5/6)椎间盘;实验组行椎间盘穿刺,损伤L_(5/6)椎间盘,1个月后行L_(4/5)椎间融合。融合后3,6个月行腰椎MRI检查,取L_(5/6)椎间盘标本进行组织学观察与PCR检测。结果与结论:(1)MRI检查:实验组融合后3,6个月出现不同程度的椎间盘突出征象,对照组未出现明显椎间盘突出征;(2)组织学观察:融合后6个月,实验组椎间盘纤维环与髓核组织结构紊乱,褶皱出现空隙,髓核细胞数量减少;对照组椎间盘髓核与纤维环分界清晰,胶原稀疏,排列有序,细胞数量较多,纤维环结构接近正常,胶原纤维排列整齐致密。实验组融合后3,6个月的Ⅱ型胶原阳性细胞少于对照组(P<0.05),且实验组融合后6个月时的Ⅱ型胶原阳性细胞少于融合后3个月时(P<0.05);(3)PCR检测:实验组融合后3,6个月的骨形态发生蛋白15、基质金属蛋白酶组织抑制因子1基因表达量高于对照组(P<0.05),且实验组融合后6个月时的骨形态发生蛋白15、基质金属蛋白酶组织抑制因子1基因表达量高于融合后3个月时(P<0.05);(4)结果表明:椎间融合后能引起相邻节段椎间盘退变的加重。BACKGROUND： Upright rat intervertebral disc degeneration model can prove that intervertebral fusion can aggravate the adjacent-segment intervertebral disc degeneration, but cannot affirm that spinal non-fusion technology has more advantages. OBJECTIVE： Base on the affirmed intervertebral disc degeneration models of Beagle dog, we performed intervertebral fusion to affirm whether or not the intervertebral fusion can aggravate the adjacent-segment intervertebral disc degeneration. METHODS： Twelve Beagle dogs were randomly divided into two groups. The control group animals were stabbed percutaneous to injure L5/6 disc. The experimental group animals were stabbed percutaneous to injur L5/6 disc. One month later, we made L4/5 intervertebral fusion. At 3 and 6 months postoperatively, lumbar MRI was conducted. L5/6 discs were harvested and subjected to histological observation and PCR. RESULTS AND CONCLUSION：（1） MRI： in the experimental group, 3 and 6 months after fusion, different degrees of intervertebral disk herniation appeared. In the control group, no obvious intervertebral disk herniation appeared.（2） Histological observation： 6 months after fusion, in the experimental group, intervertebral disc annulus and nucleus pulposus were disordered; there was a gap in the fold, and the number of nucleus pulposus cells decreased. In the control group, nucleus pulposus and anulus fibrosus boundary was clear; collagen was loose and arranged regularly. Cell number was more. Anulus fibrosus was close to normal. Collagen fibers were regular and dense. In the experimental group, 3 and 6 months after fusion, type II collagen-positive cells were less than the control group（P〈0.05）. Moreover, type II collagen-positive cells were less at 6 months than at 3 months in the experimental group（P〈0.05）.（3） PCR： Bone morphogenetic protein 15 and tissue inhibitor of matrix metalloproteinase 1 gene expression was higher in the experimental group than in the control group at 3 and 6 months after fusion（

关 键 词：脊柱融合术 椎间盘退化 模型 动物 组织工程 骨科植入物 脊柱植入物 椎间融合 椎间盘退变 BEAGLE犬 动物模型 

分 类 号：R318[医药卫生—生物医学工程]