兔术后椎间盘炎不同治疗方法的比较

Comparison of different therapies for postoperative discitis in rabbits

目的:探讨椎间盘炎的最佳治疗方法。方法:对48只新西兰兔采用直视下向椎间盘内注入细菌方法,制作椎间盘炎模型,并随机分为保守治疗组、早期手术治疗组和延期手术治疗组。比较这3种方法对兔椎间盘炎治疗的效果。结果:早期手术治疗组影像学表现为椎间隙变窄,后期出现椎间融合。组织学检查显示髓核组织被纤维组织取代,未见软骨终板破坏,细菌培养阴性。保守治疗组,椎间隙变窄,椎体骨质破坏及增生,椎间融合少见,细菌培养可见阳性。延期手术组影像学及组织学表现与保守治疗组相似,但细菌培养阴性。早期手术治疗组在C反应蛋白(C-reactiveprotein,CRP)和血沉降至正常时间方面与其他两组比较差异均有显著性意义(F=90.57,87.56,P<0.01),后两者比较差异无显著性意义(F=6.97,P>0.05)。结论:早期手术治疗方法能迅速解除症状,治疗效果优良,是治疗术后椎间盘炎的最佳方法。

AIM:To evaluate the best method for the treatment of postoperative discitis. METHODS:The discitis models of 48 New Zealand rabbits were established by injecting staphylococcus aureus into the intervertebral disc,and were divided randomly into three groups with 16 cases in each group:conservative treatment group,early operation group and delayed operation group.The therapeutic effects of the three therapies on the postoperative discitis in the three groups were compared respectively. RESULTS:In the early operation group,intervertebral space became narrow.Intervertebral fusion was observed by medical image.The fibrous tissue instead of nucleus pulposus tissue changes and nondestructive end plates were also found by histological examination.The bacteria culture was negative.In the conservative treatment group,intervertebral space became narrow.The vertebral destruction of bone and hyperostosis,little intervertebral fusion were found by medical image,and bacteria culture showed positive.The radiographic and pathological evidence of discitis in the delayed operation group was similar to those in the conservative treatment group,but the bacteria culture was negative.Quantitative analyses showed that the time of the C reactive protein and erythrocyte sedimentation rate reduced to normality in the early operation group were better than those in the other groups with a significant difference(F=90.57,87.56,P< 0.01),while there was no significant difference between the delayed operation group and the conservative treatment group(F=6.97,P >0.05). CONCLUSION:The early operation can relieve the symptoms in a short time,and has more advantages over the conservative treatment or the delayed operation,so it is the optimal method for the treatment of postoperative discitis.