骨水泥材料加压灌注对椎间盘退变影响的实验研究  

Experimental study on effect of bone cement on intervertebral disc degeneration

作　　者：吴维勇 王业林 哈斯 邢鹏 王晓岚 刘聪 WU Wei-yong;WANG Ye-lin;HA Si;XING Peng;WANG Xiao-lan;LIU Cong(Tianjin University of Traditional Chinese Medicine,Tianjin301617,China;Department of Traditional Chinese Medical Orthopedics,Inner Mongolia Traditional Chinese Medicine Hospital,Hohhot010000,China)

机构地区：[1]天津中医药大学,天津301617 [2]内蒙古自治区中医医院骨伤科,内蒙古呼和浩特010000

出　　处：《颈腰痛杂志》2023年第4期503-507,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：内蒙古自治区自然科学基金项目(编号:2015MS0870)。

摘　　要：目的通过建立兔骨质疏松模型,探讨椎体灌注骨水泥(polymethyl methacrylic,PMMA)影响相邻椎间盘代谢的生物学机制。方法选用成年雌性新西兰大白兔45只,其中15只作为正常对照组(A);剩余的30只以去势法建立兔骨质疏松模型,确定骨质疏松动物建模成功后,随机分为实验组(B)和实验组(C)各15只,手术部位选择第6、7腰椎,模拟经皮椎体成形术式。其中,B组椎体穿刺成功并放置通道后,不注入任何物质;C组分别向第6、7腰椎椎体注入约0.5 mL的PMMA;对照组(A)不做任何处理。术后8周进行标本取材,并作如下研究:①观察实验对象椎间盘髓核、纤维环等组织的病理变化,对其病理变化进行评分;②测定实验对象的髓核组织水含量、葡萄糖胺聚糖GAG含量以及Ⅱ型胶原与蛋白聚糖的表达量;③应用DICOM软件分别测试实验对象的椎间盘灰度值。结果PMMA灌注8周后,组织学观察发现实验组(C)的髓核和纤维环结构较实验组(B)以及对照组(A)发生显著的退变(P<0.01);实验组(C)动物髓核含水量、GAG、Ⅱ型胶原和蛋白聚糖的表达均较实验组(B)以及对照组(A)有较明显下降(P<0.01);影像学检查分析结果显示:实验组(C)的灰度值明显高于对照组(A)和实验组(B),且随时间推移,实验组(C)的增长量明显高于对照组(A)和实验组(B),均有显著性差异(P<0.01)。结论PMMA加压灌注椎体会影响相邻椎间盘的正常代谢并引发或加速组织结构的退变。Objective To establish a rabbit osteoporosis model and explore the biological mechanism of vertebral body perfusion cement(polymethyl methacrylic,PMMA)affecting the metabolism of adjacent intervertebral disc.Methods Forty-five healthy New Zealand white rabbits were selected and 15 were selected as the normal control group(A).The remaining 30 rabbitswere established as castor-induced osteoporosis model.Then they were randomly divided into experimental groups(B)and(C)after successful modelling ofosteoporosis,with 15 rats in each group.The surgical procedure of percutaneous vertebroplasty was used to set the 6/7 lumbar vertebrae as the surgical vertebral body,and theexperimental group B wasonly performedvertebral puncture without injecting any substance;experimental group C was injected approximately 0.5 ml PMMA into vertebrae 6 and 7 respectively,and the control group A received no treatment.Specimens were taken 8 weeks after surgery and the following studies were conducted:①The pathological changes of the intervertebral disc nucleus pulposus,annulus fibrosus,and other tissues of the experimental subjectswere observed and their pathological changeswere scored;②The content of water,glucosamine glycan GAG and the expression of type II collagen and Proteoglycan in the nucleus pulposus of the experimental subjects were measured.③DICOM software was appliedto test the grayscale values of the intervertebral discs of the experimental subjects.Results After 8 weeks of PMMA perfusion,the structure of nucleus pulposus and annulus fibrosus in theexperimental group(C)showed significant degeneration compared with theexperimental group(B)and control group(A)(P<0.01);the water content of nucleus pulposus and the expression of gag,type II collagen and proteoglycan in the experimental group(C)were significantly lower than those in the experimental group(B)and control group(A)(P<0.01);the results of imaging examination showed that the gray value of the control group(A)and experimental group(B)was significantly lowerthan that of

关 键 词：骨质疏松 骨水泥 椎间盘 

分 类 号：R681.5[医药卫生—骨科学]