Hutton William C, Murakami Hideki, Li Jun, Elmer William A, Yoon S Tim, Minamide Akihito, Akamaru Tomoyuki, Tomita Katsuro
Atlanta Veterans Medical Center, Department of Biology, Emory University, Emory University School of Medicine Atlanta, GA 30033, USA.
J Spinal Disord Tech. 2004 Feb;17(1):53-63. doi: 10.1097/00024720-200402000-00011.
The hypothesis that injecting bone cement adjacent to one or both endplates would bring about degeneration in the intervening disc was tested.
In 11 dogs, bone cement was injected just below the superior endplates of L1, L2, and L3 to block the nutritional supply through these endplates to the three intervertebral discs T13-L1, L1-L2, and L2-L3. In one other dog, both the superior and the inferior endplates of the same discs (T13-L1, L1-L2, and L2-L3) were blocked with bone cement. All 12 dogs were euthanized between 31 and 70 weeks after the surgery. The three experimental discs (T13-L1, L1-L2, and L2-L3) and two control discs (T12-T13 and L4-L5) were excised and assessed using enzyme-linked immunosorbent assay (ELISA) and histology.
Radiographs of the lumbar spine at the time of death did not show any signs of disc bulging, disc space narrowing, or peripheral osteophyte formation in any of the 12 dogs. The experimental discs as well as the control discs appeared normal in every dog. After the discs were bisected, they were carefully inspected for any visible signs of degeneration. The experimental discs showed no clear signs of disc degeneration and were not distinguishable from the control discs on a gross level. The numerical results from the ELISA showed that in the experimental discs as opposed to the control discs, there were significant increases in proteoglycan content in both the nucleus (P = 0.033) and annulus (P = 0.01) and clear histologic changes in some of the discs.
The results show that injecting bone cement adjacent to one or both endplates for up to 70 weeks does not produce degeneration in any visible form in the intervening disc. There were no disc bulging, no apparent annular fissures, and no disc spacing narrowing. There were, however, increases in protoglycan content in both the nucleus and the annulus and clear histologic changes in some of the discs.
对在一个或两个终板附近注射骨水泥是否会导致其间椎间盘退变的假说进行了验证。
在11只犬中，将骨水泥注射到L1、L2和L3上终板下方，以阻断通过这些终板向三个椎间盘（T13-L1、L1-L2和L2-L3）的营养供应。在另一只犬中，用骨水泥阻断相同椎间盘（T13-L1、L1-L2和L2-L3）的上、下终板。所有12只犬在手术后31至70周实施安乐死。切除三个实验性椎间盘（T13-L1、L1-L2和L2-L3）和两个对照椎间盘（T12-T13和L4-L5），并采用酶联免疫吸附测定（ELISA）和组织学方法进行评估。
死亡时腰椎X线片未显示12只犬中任何一只出现椎间盘膨出、椎间隙变窄或周边骨赘形成的迹象。每只犬的实验性椎间盘和对照椎间盘看起来均正常。将椎间盘对半切开后，仔细检查是否有任何可见的退变迹象。实验性椎间盘未显示明显的椎间盘退变迹象，在大体水平上与对照椎间盘无法区分。ELISA的数值结果显示，与对照椎间盘相比，实验性椎间盘的髓核（P = 0.033）和纤维环（P = 0.01）中蛋白聚糖含量均显著增加，并且部分椎间盘出现明显的组织学变化。
结果表明，在一个或两个终板附近注射骨水泥长达70周不会使其间的椎间盘出现任何可见形式的退变。没有椎间盘膨出，没有明显的纤维环裂隙，也没有椎间隙变窄。然而，髓核和纤维环中的蛋白聚糖含量增加，并且部分椎间盘出现明显的组织学变化。
