Department of Orthopaedic Surgery, University of Utah School of Medicine, Los Angeles, CA, USA.
Spine (Phila Pa 1976). 2010 Feb 15;35(4):371-7. doi: 10.1097/BRS.0b013e3181b962a4.
Immature goat spines were instrumented at 5 levels with 2 different fusionless scoliosis implants. Instrumented and subadjacent spinal segments were analyzed to determine the effect on the disc and endplate.
Analyze the regional biochemistry and histology of spinal motion segments in healthy goat spines treated with 2 clinically relevant, fusionless scoliosis implants.
Fusionless scoliosis surgery is thought to be more physiologic than fusion as it preserves the growth, motion, and function of the spine. There are presently little data supporting this belief.
Scoliosis was created in twelve 8-week-old female goats (n = 6 per group) using 1 of 2 fusionless scoliosis implant strategies: 2 SMA staples per level or a bone anchor/ligament tether. A third group served as controls (n = 6). Goats were analyzed after 6 months. Qualitative and quantitative analyses were performed on spinal motion segments using H&E, TUNEL, and caspase-3 staining.
Neither implant strategy produced degenerative changes in the disc. However, discs at instrumented levels in both groups demonstrated decreased cell density (P < 0.01) and increased cellular apoptosis (P < 0.001) compared to controls. Subadjacent discs demonstrated preservation of viable cells and endplate vascularity compared to instrumented discs.
Fusionless scoliosis implants result in alterations in viable cell density within the disc and reduced vascularity in the vertebral endplates of instrumented but not subadjacent discs. Though obvious disc degeneration was not observed, the implications of the cellular and histologic changes are not known. Additional study will be necessary to better understand various fusionless scoliosis surgery strategies and their effect on surrounding tissues.
对 5 个不同节段的未成熟山羊脊柱使用 2 种不同的无融合脊柱侧凸植入物进行仪器操作。对仪器操作和邻近的脊柱节段进行分析，以确定其对椎间盘和终板的影响。
分析用 2 种临床相关的无融合脊柱侧凸植入物治疗的健康山羊脊柱运动节段的区域生物化学和组织学。
无融合脊柱侧凸手术被认为比融合手术更符合生理，因为它可以保留脊柱的生长、运动和功能。目前几乎没有数据支持这种观点。
使用 2 种无融合脊柱侧凸植入策略（每节段 2 个 SMA 钉或骨锚/韧带系绳）在 12 只 8 周龄雌性山羊（每组 6 只）中创建脊柱侧凸。第 3 组作为对照组（n = 6）。山羊在 6 个月后进行分析。使用 H&E、TUNEL 和 caspase-3 染色对脊柱运动节段进行定性和定量分析。
这两种植入策略都没有导致椎间盘发生退行性变化。然而，与对照组相比，两组仪器操作节段的椎间盘细胞密度降低（P < 0.01），细胞凋亡增加（P < 0.001）。与仪器操作节段相比，邻近节段的椎间盘保留了更多的活细胞和终板血管。
无融合脊柱侧凸植入物导致椎间盘内活细胞密度改变，以及仪器操作节段的椎体终板血管减少，但未观察到明显的椎间盘退变。细胞和组织学变化的影响尚不清楚。需要进一步研究以更好地了解各种无融合脊柱侧凸手术策略及其对周围组织的影响。
