摘要
目的目前对脊柱侧凸伴发的脊柱前凸研究较少。通过观察镍钛记忆合金加压钉(Staple钉)所致的脊柱前凸骨骺组织学变化,探讨Staple钉对胸椎前凸生长的影响。方法 2~3月龄雌性山羊18只,体重8~12kg,随机分为长钉组、短钉组、空白对照组,每组6只。长钉组和短钉组分别于山羊T6~11节段植入Staple长钉(7mm齿深)、Staple短钉(4mm齿深),空白对照组不进行干预。术前及术后3个月行X线片观察Cobb角变化,然后处死山羊取脊柱顶椎生长板和下关节突组织进行HE染色观察骨骺软骨细胞,并行免疫组织化学聚腺苷酸二磷酸核糖聚合酶-p85片段和细胞核增殖抗原双重染色法对软骨细胞进行计数,并计算各组软骨细胞增殖活跃度。结果术后3个月,长钉组和短钉组Cobb角均显著高于术前,且显著高于空白对照组,差异均有统计学意义(P<0.05);长钉组及短钉组间比较差异无统计学意义(P>0.05)。HE染色和免疫组织化学双重染色显示:与空白对照组相比,长钉组和短钉组生长板及下关节突软骨骨骺的增殖层和肥大层的软骨细胞数均明显减少,软骨细胞柱状排列更不规则,细胞外基质所占体积比增高;长钉组的这种趋势较短钉组更为明显。长钉组和短钉组HE染色组织学分级与空白对照组比较差异均有统计学意义(P<0.05),长钉组与短钉组间差异无统计学意义(P>0.05)。长钉组和短钉组椎体生长板及下关节突软骨增殖活跃度与空白对照组比较差异均有统计学意义(P<0.01),长钉组和短钉组间比较差异无统计学意义(P>0.05)。结论 Staple钉通过影响山羊胸椎的远端生长板及其下关节突的骨骺软骨细胞增殖活跃度,从而影响骨生长,导致脊柱后凸增加。
Objective Currently,there are few researches on lordosis associated with scoliosis.To explore the effects of nickel-titanium memory alloy staple(Staple) on the growth of thoracic lordosis by observing the histological changes of cartilage cells in the osteoepiphysis of the thoracic vertebrates in goats.Methods Eighteen 2-3 months old female goats,weighing 8-12 kg,were randomly divided into long staple group(n=6),short staple group(n=6),and blank control group(n=6).Long staple(7 mm) and short staple(4 mm) were implanted into T6-11 segments of goats in long and short staple groups by anterior approach,respectively.The blank control group was not treated.The X-ray examination was performed pre-operatively and at 3 months post-operatively to observe the changes of Cobb angle.Then the growth plates and inferior facet processes of the apex vertebral body were harvested to observe the histological grades of cartilage by HE staining,and to observe proliferation and apoptosis of chondrocytes through immunohistochemistry double labeling staining with poly-ADPribose-polymerase-p85 and proliferating cell nuclear antigen.Results At 3 months after operation,the T6-11 Cobb angles were significantly higher than those of pre-operation in short staple group and long staple group,which were significantly higher than those in blank control group(P 0.05),but there was no significant difference between short staple group and long staple group(P 0.05).The results of HE staining and immunohistochemistry double staining showed that the number of chondrocytes were reduced obviously with irregular columnar arrangement and increased volume ratio of surrounding extracellular matrix in proliferative zone and hypertrophic zone of growth plate and inferior articular process in both long and short staple groups,and this tendency was more noticeable in long staple group.There were significant differences in the grades of proliferation viability of chondrocytes between 2 staple groups and blank control group(P 0.05),but there was no significant difference tewteen long staple group and short staple group(P 0.05).The proliferation viabilities of chondrocytes in growth plate and inferior articular process were significantly higher in blank control group than in 2 staple groups(P 0.01),but there was no significant difference between long staple group and short staple group(P 0.05).Conclusion The histological evidences prove that the Staple implantation by anterior approach can reduce proliferation viability of chondrocytes in growth plate and inferior articular process of the thoracic vertebrates in goats,which conduces the growth direction of thoracic vertebrates to kyphosis.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第4期456-461,共6页
Chinese Journal of Reparative and Reconstructive Surgery