不同麻醉方式下经皮针刺旋切制备椎间盘退变模型

Preparation of intervertebral disc degeneration models by percutaneous acupuncture rotary-cut under different anesthesia methods

背景:研究发现,不同的麻醉方式对大鼠的平均动脉压、收缩压和舒张压、动脉血p H值以及血液黏度均有明显的影响,但当前针对采用何种麻醉方法进行制备动物模型并未达成一致。目的:比较采用局部麻醉及全身麻醉方式下经皮针刺旋切制备的兔椎间盘退变模型的有效性。方法:将48只新西兰大白兔按随机分为局麻组和全麻组,局麻组采用0.5%利多卡因麻醉,全麻组动物予以腹腔注射体积分数3%戊巴比妥钠(30 mg/kg),2组均采用经皮微创针刺旋切兔L4/5、L5/6椎间盘建立椎间盘退变模型。观察2组动物的造模时间,并于造模后4,8,12,16周通过大体观察及MRI检测、组织病理学检查评价椎间盘退变情况。结果与结论:(1)大体观察:造模后2组髓核组织颜色逐渐暗且弹性降低;(2)MRI显示T2加权像椎间盘信号强度早期均未见明显改变,但信号强度随时间延长呈减弱趋势;(3)根据Pfirrmann分级法评价椎间盘退变程度:2组动物椎间盘退变程度均随时间延长逐渐加重(P<0.05),2组术后各时间点椎间盘退变程度差异无显著性意义(P>0.05);(4)Masson染色显示:造模后8,12周2组纤维环均出现不同程度排列不规整,但结构仍完整,16周后2组纤维环排列紊乱,甚至出现断裂现象,2组间无明显差异;(5)番红O染色示:2组造模后4周髓核细胞均未见明显减少,造模后16周2组髓核细胞均明显减少;(6)造模时间:局麻组平均(15.24±2.67)min明显要短于全麻组(25.64±6.85)min(P<0.05);(7)结果说明,采用局麻和全麻方法经皮微创针刺旋切椎间盘均可成功建立椎间盘退变模型,但是在微创制备兔椎间盘退变模型中采用局麻具有操作时间更短、操作更简单的优点,且其造模效果与采用全身麻醉几乎相同。

BACKGROUND： Different anesthesia methods significantly impact mean arterial pressure, systolic and diastolic blood pressure, arterial blood pH and blood viscosity, but what kind of anesthesia method is more suitable for preparation of animal model does not reach an agreement. OBJECTIVE： To compare the effectiveness of local anesthesia and general anesthesia for preparation of rabbit intervertebral disc degeneration model in procession of percutaneous acupuncture rotary cut. METHODS： A total of 48 New Zealand white rabbits were randomly divided into the local anesthesia group and the general anesthesia group. The local anesthesia group was anesthetized with 0.5% lidocaine. The general anesthesia group was intraperitoneally injected with 3% sodium pentobarbital （30 mg/kg）. In the two groups, models of intervertebral disc degeneration were established by minimally invasive percutaneous acupuncture rotary cut at L4/5, L5/6 levels. Modeling time was observed in both groups. Disc degeneration was evaluated by the gross observation, MRI detection, and histopathological examination at 4, 8, 12, and 16 weeks after modeling. RESULTS AND CONCLUSION： （1） General observation： the nucleus pulposus gradually with darker color and elasticity reduced in two groups after modeling. （2） MRI T2-weighted image results showed no significant changes in disc signal intensity at early stage, but the signal strength showed a decreasing trend with time. （3） Disc degeneration was evaluated according to Pfirrmann grading. Disc degeneration was gradually increased with time in two groups （P 〈 0.05）, but there was no significant difference at postoperative time points in both groups （P 〉 0.05）. （4） Masson staining showed that different degrees of annulus irregular arrangement appear in the two groups 8 and 12 weeks after modeling, but the structure was still intact. 16 weeks later, annulus disorganized, or even breakage in the two groups; no significant difference was detected between the two groups. （5） Safranin O staining showed that nucleus pulposus celts were not significantly reduced in the two groups at 4 weeks, but were significantly reduced at 16 weeks. （6） The average modeling time of local anesthesia group [（15.24＋2.67） minutes] was significantly shorter than that in the general anesthesia group [（25.64±6.85） minutes] （P 〈 0.05）. These results indicate that intervertebral disc degeneration model can be successfully established by minimally invasive percutaneous acupuncture rotary cut by using local anesthesia and general anesthesia however, local anesthesia has a shorter operating time and simple anesthetic procedure. The efficacy was identical between the two methods.