胶原酶化学髓核溶解术机制的再研究

REEVALUATING THE MECHANISM OF CHEMONUCLEOLYSIS WITH INTRADISCAL IN-JECTION OF COLLAGENASE ON A NOVEL SHEEP MODEL OF INTERVERTEBRAL DISK HERNIATION AND DEGENERATION

摘要:

目的:研究胶原酶盘内注射对山羊腰椎间盘突出模型的化学髓核溶解作用,重新评估化学髓核溶解术的机制。方法:胶原酶注射前10周,通过手术损伤椎间盘前外侧纤维环诱发椎间盘突出和退变,并经MRI证实。胶原酶注射后1天、1周、2周、4周、12周观察X线片上椎间盘高度指数、椎间盘的组织学等变化。结果:胶原酶对正常和退变椎间盘髓核组织具有类似的溶解作用。胶原酶盘内注射后在突出模型椎间盘中央和髓核突出部位均出现溶解空腔,终板破坏轻;而对正常椎间盘溶解部位在椎间盘髓核和内层纤维环,并严重破坏终板。结论:盘内注射胶原酶能有效溶解山羊突出模型椎间盘的中央和突出部位髓核组织。胶原酶注射后12周,退变间盘基质出现再生能力。

Abstract:

Objective:To study the effects of intradiscal injected collagenase on a novel sheep model of intervertebral disk herniation and degeneration and reevaluate the mechanism of chemonucleolisis.Methods:Sheep lumbar intervertebral disks were surgically injured 10 weeks before intradiscal injection of collagenase,inducing disk displacement and degeneration.Disk height index on radiography and histological changes were studied 1 day,1 week,2 weeks,4 weeks,12 weeks after intradiscal injection of collagenase.Results:Chemonucleolysis effects of collagenase on degenerative intervertebral disks tissue were similar to normal disk tissue.Collagenase can dissolve nucleus pulposus in the center of model disks and protrusion sites simultaneously while only central portion and inner annulus fibrosus was dissolved in normal disks.Endplates in normal disks were destroyed more severe than that in model disks after collagenase injection.The staining properties with Safranin-O staining of the nucleus pulposus in model disks was similar to that in normal disks before collagenase injection,but diminished after injection.Conclusions:Collagenase can dissolve nucleus pulposus in the center and protrusion sites of sheep intervetebral disc hernitiation model.Collagenase does not destroy the degenerative disk matrix ability to regenerate after 12 weeks.