针刺髓核构建退行性变椎间盘模型

Constructing a rabbit model of intervertebral disc degeneration induced by needle puncture in nucleus pulposus

背景:目前对椎间盘退行性变尚无有效治疗方法,实验性椎间盘退行性变模型的建立,是研究椎间盘退行性变病理过程和尝试基因治疗等的基础,建立的动物模型要求与人类的椎间盘退行性变具有相似性和可比拟性。目的:拟建立一种稳定、重复性强的椎间盘退行性变动物模型。设计、时间及地点:随机对照动物实验,于2005-10/2006-03在哈尔滨医科大学附属第一临床医院中心实验室完成。材料:选用健康成年新西兰大白兔30只,按随机数字表法分为2组,手术组15只,对照组15只。方法:手术组以18#腰穿针针刺L1～5节段椎间盘,至少穿刺5次,直至胶冻样髓核组织出现为止;对照组做同样皮肤切口,拨开肌肉,暴露椎间盘后即缝合。主要观察指标:手术8周以后通过MRI和组织病理学检查观察腰椎间盘退行性变情况。结果:①对照组腰椎MRI检查未见异常;手术组L1～2腰椎间盘则相继出现T2加权像低信号、T1加权像信号无明显改变等变化。②组织学切片显示,手术组椎间盘髓核纤维软骨样变性。结论:针刺髓核的方法可以成功构建椎间盘退行性变新西兰大白兔模型。

BACKGROUND： The present studies have not work out an effective method for curing intervertebral disc degeneration. Constructing animal model of intervertebral disc degeneration which more faithfully mimics the pathologic hallmarks of human intervertebral disc degeneration can be a beneficial assistance for futhur intervertebral disc degeneration study and gene therapy. OBJECTIVE： To construct a stable and repeated experiment model for intervertebral disc degeneration. DESIGN, TIME AND SETTING： The randomized controlled trial was performed at the Central Laboratory in the First Clinical College of Harbin Medical University from October 2005 to March 2006. MATERIAL： Thirty New Zealand white rabbits were divided into experimental group and control group by means of random number table with fifteen rabbits in each group. METHODS： The experimental group was punctured on the L1- 5 segments using an 18# needle, puncturing five times at least until nucleus gelatinosus appeared. The identical skin incision and suturing were executed in the control group. MAIN OUTCOME MEASURES： Pathological change of intervertebral disc was checked with MRI and histopathological examination at 8 weeks postoperative. RESULTS： MRI showed that intervertebral disc in the control group had a normal appearance, and low T1 signal in L1- 2 segments and normal T1 signals in the experimental group. The histological sections demonstrated that structural features of fibrous cartilage had appeared in the experimental group. CONCLUSION： The rabbit model of intervertebral disc degeneration can he success produced by the method of puncturing the nucleus pulposus.