脊柱截骨术对家兔脊髓功能的影响

Effects of vertebral osteotomy on spinal-cord function in rabbits

目的 研究脊椎截骨术对脊髓功能的影响,为脊椎截骨术的临床应用提供理论依据。方法 将40只家兔以随机数字表法分为对照组、低截骨组(截骨后压缩25%)、中截骨组(截骨后压缩50%)、高截骨组(截骨后压缩100%),每组10只,给予相应的手术处理。测定硬膜皱缩、运动功能(Reuter评分)、脊髓血流量等指标。结果中截骨组、高截骨组的硬膜囊横径、迂曲角为(5.74±0.29) mm、(14.46±0.77)°和(7.65±0.36) mm、(85.62±2.95)°,显著大于低截骨组[(4.85±0.32) mm、0°]和对照组[(4.39±0.11) mm、0°],均P<0.05。中截骨组、高截骨组的脊髓血流量为(27.66±0.85)μL/100μm~3、(10.53±0.24)μL/100μm~3,显著低于低截骨组[(34.28±0.94)μL/100μm~3]和对照组[(33.81±1.06)μL/100μm~3],均P<0.05。低截骨组、中截骨组、高截骨组的Reuters评分为(2.38±0.34)分、(7.25±0.42)分、(9.56±0.73)分,显著大于对照组的(1.39±0.25)分,均P<0.05。结论 脊椎截骨术具有较好的临床效果,较短的脊柱缩短对机体脊髓功能的影响小,临床实践中应注意把握安全截骨的临界值。

Objective To explore the effect of vertebral osteotomy on the function of the spinal cord and to provide a theoretical basis for the clinical application of vertebral osteotomy.Methods By random-number table method,40 rabbits were randomly divided into a control group,a low osteotomy group(compression 25%after osteotomy),a middle osteotomy group(compression 50%after osteotomy),and a high osteotomy group(compression 100%after osteotomy),with 10 animals each.They were given corresponding surgical treatment.Dural shrinkage,motor function(Reuter score),spinal-cord blood flow,and other indicators were determined.Results The dural sac transverse diameter and spinal cord of the middle and high osteotomy groups were(5.74±0.29)mm,(14.46±0.77)°and(7.65±0.36)mm,(85.62±2.95)°,which were higher than those of the low osteotomy[(4.85±0.32)mm,0°]and control group[(4.39±0.11)mm,0°],all P<0.05.The blood flow of the middle and high osteotomy groups were(27.66±0.85)μL/100μm 3 and(10.53±0.24)μL/100μm 3,which were lower than those of the low osteotomy[(34.28±0.94)μL/100μm 3]and control group[(33.81±1.06)μL/100μm 3],all P<0.05.The Reuter score of the low,middle,and high osteotomy groups[(2.38±0.34)points,(7.25±0.42)points,(9.56±0.73)points]were significantly higher than those of the control group[(1.39±0.25)points,all P<0.05].Conclusion Vertebral osteotomy has a good clinical effect.Shorter spine shortening has little effect on spinal-cord function.In clinical practice,attention should be paid to the critical value of safe osteotomy.