Nakashima Shojiro, Matsuyama Yukihiro, Takahashi Katsuya, Satoh Tomoya, Koie Hiroshi, Kanayama Kiichi, Tsuji Taichi, Maruyama Koji, Imagama Shiro, Sakai Yoshihito, Ishiguro Naoki
Department of Orthopaedic Surgery, Nagoya University School of Medicine, Showa-ku, Nagoya, Japan.
Biomed Mater Eng. 2009;19(6):421-9. doi: 10.3233/BME-2009-0608.
The degeneration of intervertebral disc (IVD) is a major cause of low back pain. However, there is no satisfactory preventive treatment for degenerative disc disease (DDD). In this study, we examined the effects of a novel cross-linked hyaluronate hydrogel and cross-linked chondroitin sulfate (CS) hydrogel on a rabbit model of IVD injury. We injected 300 microl of phosphate buffer saline, 1% sodium hyaluronate, cross-linked hyaluronate hydrogel, or cross-linked CS hydrogel into the injured IVDs. One, three or six months after treatment, the whole spinal columns were dissected and magnetic resonance (MR) images of the IVDs were examined. It was noted that the IVD, which was injected with cross-linked hyaluronate hydrogel or cross-linked CS hydrogel mostly retained the normal signal intensity of the MR images. These IVDs exhibited a higher degree of staining with safranin-O than the control discs or 1% sodium hyaluronate-injected discs, suggesting that the intradiscal application of cross-linked hyaluronate hydrogel or cross-linked CS hydrogel probably inhibits the degenerative cascade of the DDD. The intradiscal administration of these drugs is safe, easy and costs less. In the near future, these intradiscal injections may become the standard therapy for the treatment of DDD instead of the spine surgeries.
椎间盘退变是腰痛的主要原因。然而,对于椎间盘退变疾病(DDD)尚无令人满意的预防性治疗方法。在本研究中,我们研究了一种新型交联透明质酸水凝胶和交联硫酸软骨素(CS)水凝胶对兔椎间盘损伤模型的影响。我们将300微升磷酸盐缓冲盐水、1%透明质酸钠、交联透明质酸水凝胶或交联CS水凝胶注入受损的椎间盘。治疗后1、3或6个月,解剖整个脊柱并检查椎间盘的磁共振(MR)图像。值得注意的是,注入交联透明质酸水凝胶或交联CS水凝胶的椎间盘在MR图像上大多保留了正常信号强度。与对照椎间盘或注入1%透明质酸钠的椎间盘相比,这些椎间盘用番红O染色的程度更高,这表明椎间盘内应用交联透明质酸水凝胶或交联CS水凝胶可能抑制了DDD的退变级联反应。这些药物的椎间盘内给药安全、简便且成本较低。在不久的将来,这些椎间盘内注射可能会取代脊柱手术成为治疗DDD的标准疗法。