体外遥控压迫装置构建羊慢性颈脊髓压迫模型  

A sheep model of chronic cervical compressive myelopathy via an in-vitro control compression device

作　　者：李梓赫 张有余 刘杉杉 刘忠军[1] 韦峰[1] LI Zihe;ZHANG Youyu;LIU Shanshan

机构地区：[1]北京大学第三医院骨科

出　　处：《中国脊柱脊髓杂志》2019年第5期449-456,共8页Chinese Journal of Spine and Spinal Cord

基　　金：北京大学生物医学工程联合研究基金

摘　　要：目的:使用一种体外遥控的压迫装置制作羊慢性颈脊髓压迫模型,以实现可数字化精确调控的压迫过程。方法:压迫装置由椎间压迫装置和体内皮下控制模块两部分组成,整个装置由体外安卓手机遥控控制。12只成年小尾寒羊随机分成3组,每组4只,分别为对照组(A组),压迫10周组(B组)和压迫20周组(C组)。将压迫装置置入到C2/3椎间隙并固定,将控制模块置入皮下。A组在手术后推杆不推进,B组和C组动物在清醒状态下遥控推杆每两天推进0.1mm,观察术后1周、5周、10周、15周、20周各组动物Tarlov评分;术后1周、5周、10周、15周、20周行CT扫描并计算椎管内侵占率(ER);术后即刻、1周、10周、20周时进行电生理检查;实验终止时,取C2/3节段脊髓切片,分别进行HE染色、尼氏体染色及TUNEL检测,观察组织学改变。用Pearson相关系数及一般线性回归分析B、C组ER与时间(t)的关系,用Pearson相关系数分析ER与Tarlov评分的关系。结果:实验过程中,B组1只羊的皮下控制模块出现故障,经再次手术更换后故障排除。A组动物术后20周内Tarlov评分未观察到变化,均为5分;实验终止时,B组动物中两只为5分,两只为4分;C组动物中3只为3分,1只为2分;C组在实验终止时的行为学评分与A组终止时存在显著性差异(P<0.05)。实验终止时,B组动物ER为(33.0±1.8)%,C组动物ER为(64.8±1.9)%,B组及C组动物ER与t的Pearson相关系数r=0.998(P<0.001);ER与t的线性回归方程为ER=3.197t。ER与Tarlov评分呈负相关(r=-0.862,P<0.001)。手术过程中及术后即刻,全部动物潜伏期和波幅都未发生明显改变;术后即刻、术后1周时,B组和C组动物的SEP潜伏期及波幅与A组比较无显著性差异,但10周及20周时较A组潜伏期明显延长(P<0.001),波幅明显下降(P<0.001)。实验终止时,A组观察到形态正常的前角运动神经元和皮质脊髓束神经纤维结构;B组切片中观察到前角运动神经元细胞萎�Objectives: This study applied an in-vitro control compression device to sheep model of chronic cervical compressive myelopathy to make the compression digitalized and precisely controllable. Methods: The compression device consisted of two parts, intervertebral compression part and percutaneous control part, and was controlled by an Android phone in vitro. 12 male small tailed han sheep were divided into 3 groups randomly on average, control group (A), 10 weeks group (B) and 20 weeks group (C). The compression device was implanted into intervertebral space of C2/C3 and fixed. Control part was implanted subcutaneously. The control group (A) ran no compression after surgery. Group B and group C were pushed 0.1mm every two days while awake. Tarlov score was assessed in each group before and after push. The Tarlov score was recorded at 1 week, 5, 10, 15 and 20 weeks after surgery. CT scan was performed immediately, 1, 5, 10, 15 and 20 weeks after surgery and the spinal canal encroachment rate was calculated at the same time. Electrophysiology examination (SEP) was performed immediately, 1, 10 and 20 weeks after surgery. The spinal cord specimens at C2/3 level were collected, and HE, Nissl and TUNEL test were performed to observe the histology results at the end of experiment. Pearson correlation coefficien t(r) and general linear regression was used for the analysis of the encroachment rate(ER) of group B and C and time (t, week). The relationship between ER and Tarlov score was analysed with Pearson correlation coefficient(r). All results were analyzed via SPSS software. Results: One control part of sheep in group B broke down and was repaired after reoperation. No behavioral changes were noted in group A and all Tarlov scores were 5. The final Tarlov score was 5 in 2 sheep and 4 in 2 sheep of group B, 3 in 3 sheep and 2 in 1 sheep of group C. The results of Tarlov score showed significant difference(P<0.05). The final radiological findings showed that the average spinal canal encroachment rate was (33.0±1.8)% in

关 键 词：颈脊髓压迫 慢性 动物模型 数字化调控 

分 类 号：R681.5[医药卫生—骨科学] R332[医药卫生—外科学]