椎体终板的解剖与椎间植骨融合的相关性研究

The Correlation between the Anatomical Structure of Vertebral Endplate and Interbody Spinal Fusion

目的 :探讨椎体终板的解剖与椎间植骨融合的相关性。方法 :5具新鲜成人脊柱标本 ,取C3～ 7、L1～ 5椎体各2 5个 ,光镜下观察终板结构。成年犬 15只 ,随机在每只动物的L4～ 5和L6～ 7两个椎间隙构建保留终板和不保留终板的脊柱前路融合模型。术后 4、8、12周分别切取新鲜融合脊柱节段 ,标本切片行光镜和电镜检查 ,观察两组植骨愈合进程。结果 :终板中央区为多孔的松质骨样结构 ,该孔状空腔与终板的通透性有关。动物实验中 ,4周时保留终板组和对照组植骨区均以纤维性骨痂为主 ,保留终板组新生成基质和毛细血管相对较少 ;8周时两组植骨区新生成骨均较为明显 ,骨痂内都有一定量的新生软骨 ,但保留终板组稍多 ;12周时两组均获骨性愈合。结论 :终板有特殊的层状多孔结构 ,具有较大的通透性。保留终板对植骨愈合进程和骨愈合质量无影响。

Objective: To evaluate the correlation between the anatomical structure of endplate and interbody spinal fusion.Methods:25 cervical vertebral body and 25 lumbar vertebral body were harvested from five fresh spine specimens of human cadaver.The endplate sections through specimens were examined under light microscope.In the animal experiment,the anterior lumbar interbody fusion with preserving endplate or without preserving endplate were undergone in L 4～5 and L 6～7 interspace in each dog.The fresh spinal fusion segments were harvested on 4 th week,8 th week and 12 th week.The specimens were examined under light microscope and electrical microscope to observe the procedure of graft healing.Results:The central region of the endplate was porus,as the fused trabeculae.In the animal experiment, the newly born tissue in the two groups were fibrous callus on the 4 th week.But there were less newly born matrix and blood vessels in group with preserving endplate.Both group had newly born bone tissues on the 8 th week postoperatively.There was more catilage tissue in group with preserving endplate.The graft had bony fusion in two groups on the 12 th week after operation.Conclusion:The endplate had a relative great penetration due to its special porous structure.Preserving endplate would not influence the procedure and quality of the graft healing.