犬同种异体腰椎间盘移植的手术技术

Surgical technique for allograft lumbar intervertebral disc transplantation in a dog model

[目的]研究并描述一种在无内固定辅助条件下建立犬同种异体椎间盘移植模型的手术技术。[方法]选取1岁龄健康杂种犬25只,处死其中的5只,在无菌条件下取L1～6椎间盘共25个液氮保存,剩余20只犬用于建立L5、6椎间盘移植模型的研究。术中,术后1、4、6、8、12周进行X线检查,观察移植椎间盘的位置、高度变化以及相邻椎体的愈合情况。[结果]椎间盘移植术前选取合适大小的供体椎间盘,术中注意保留前、后纵韧带及对侧纤维环,可以实现在无内固定条件下成功建立同种异体椎间盘移植模型。本研究椎间盘移植成功17例,其余2例出现椎间盘脱出,1例出现椎间盘感染。术后3个月影像学检查示移植椎间盘的上下终板与相邻椎体形成骨性愈合。与术前相比,术后3个月随访椎间盘高度无明显变化（P〉0.05）。[结论]采用恰当的手术技术,有助于在无内固定辅助下成功实施同种异体椎间盘移植手术。本研究提供了一种建立犬同种异体椎间盘移植模型的可行的手术方案。

[Objective] To investigate and describe the surgical technique for allograft intervertebral disc transplantation in a dog model. [Methods] Twenty- five adult dogs were used in this study. A total of 5 dogs were sacrificed as donors and the L1 ～ 6intervertebral discs were collected and frozen in liquid nitrogen. The remaining twenty dogs were used to investigate allograft intervertebral disc transplantation in L5、6segment. X- rays was performed intra- operatively and 1,4,6,8,12 weeks after surgery to investigate the position,the height,and the healing of the allograft disc. [Results] By choosing the suitable size of allograft and preserving the anterior and posterior longitudinal ligament,contralateral annular fibrosus and appropriate portion of the anterior annulus fibrosus were essential to successfully transplantation without internal fixation. A total of 2 cases of dislocation and 1 case of infection were found in this study,the remaining 17 cases were successful. There was no significant difference in the height of allograft disc between intra- operation and any follow- up（ P〈0. 05）. [Conclusion] Using appropriate surgical technique may help to the success of the allograft disc transplantation. This study provides a practicable procedure for allograft disc transplantation.