摘要
目的了解纤维环的愈合能力和三种纤维环切口对椎间盘愈合强度的影响,寻找较为合理的切口方式。方法21只新西兰大白兔经腹膜外入路暴露5个连续腰椎间盘。对实验组的椎间盘施行纤维环切开并髓核部分摘除术,分别采用线性、矩形和弧形三种纤维环切口,每种切口有24个椎间盘。分别于术后2、4和6周三个时段将兔处死后取出脊柱,每个时段有8个椎间盘,分别测定椎间盘最大承受压力,以评价其在不同时段的愈合强度,并行椎间盘组织学观察。结果组织学观察发现无论切口形式,纤维环均于术后4到6周显示出纤维愈合,但线形切口及弧形切口在各时段伤道较矩形切口为窄。各切口组椎间盘的愈合强度在术后2和4周均显著低于对照组。矩形切口组在2周时愈合强度显著地低于线形和弧形切口组,2周以后仍低,但差异没有显著性。结论①纤维环具有一定纤维性愈合的能力。②纤维环切口方式对椎间盘愈合强度存在一定的影响,保留更多的纤维环可能获得更好的愈合。③弧形切口兼具线形切口组和矩形切口组的优势,可能是一种较为合理的纤维环切口方式。
Objective To determine the poteniality of the healing annulus fibrous, To assess whether the type of anular incision made at the time of lumbar discectomy could influence the strength of the healing annulus fibrous, Make an effort to find a logical anular incision. Methods Twenty - one rabbits underwent a retroperitoneal approach to five lumbar disc levels, An anular incision, followed by partial discectomy was done at each lumbar disc level of the trail teams, Anular incision has three styles ： straight , curve and box, Each anular incision type was performed on 24 lumbar discs, The strength of healing annulus fibrous was measured by the rupture intradiscal pressure（RIP） at 2, 4 and 6 weeks after surgery, 8 discs in each time interval, All of the discs were observed histologically, Results Histologic analysis revealed that the healing of annulus fibrous occured on 4 to 6 weeks after surgery regardless of the different anular incision style, Statistical analysis showed that the RIP of the trail team were signifitantly weaker than the RIP of the control team at 2 and 4 weeks after surgery; Between 2 weeks after surgery, The difference of the RIP of the three trail teams was signifitant, Beyond 2 weeks after surgery , The difference tended to become little, Conclusion ①anulus fibrosus has a limited potentiality of healing, ②The type of anular incision did play a role in the strength of healing disc, The incision that left more tissues tend to get more stronger strength of healing, ③The curve incision may be a logical style of anular incision.
出处
《临床和实验医学杂志》
2007年第4期5-7,10,共4页
Journal of Clinical and Experimental Medicine
