Xia Liang-Zheng, Zheng Yan-Ping, Xu Hong-Guang, Liu Ping
Department of Orthopaedics, Qilu Hospital, Shandong University 107#, Wenhua Xi Road, Jinan, Shandong, 250012, P.R. China ; Department of Orthopaedics, Tongling People's Hospital 468#, Bijiashan Road, Tongling, Anhui, 244000, P.R. China.
Department of Orthopaedics, Qilu Hospital, Shandong University 107#, Wenhua Xi Road, Jinan, Shandong, 250012, P.R. China.
Int J Clin Exp Med. 2014 Nov 15;7(11):4291-9. eCollection 2014.
This study is to investigate the effect of anterior cervical discectomy with internal fixation and fusion at different levels on adjacent segments in rabbits. Sixty New Zealand rabbits were randomly divided into four groups, one control group and three model groups, with 15 in each group. Each group underwent anterior cervical internal fixation and fusion at C3-4, C4-5, and C5-6 levels respectively. X-ray film was examined three, six and nine months after fusion to observe the changes in intervertebral space and endplate of adjacent segment. Immunohistochemistry was utilized to evaluate the effects of different fusion methods on adjacent segments of spine. As time went by, in model groups, the majority of cartilage endplates were calcified, as examined by X-ray. Immunohistochemical results of the intervertebral disc showed that the expression levels of collagen type II in nucleus pulposus were decreased significantly, while the expression levels collagen type I in annular fibrosus were increased. And collagen type I tends to replace collagen type II gradually in nucleus pulposus as time goes by. The change in collagen between upper and lower adjacent segments at C3-4 and C4-5 showed no statistical significance after fixation and fusion (p > 0.05). But for C5-6, the change showed statistical significance (p < 0.05). Cervical internal fixation and fusion can induce intervertebral disc degeneration of adjacent segment in rabbits, and cervical internal fixation and fusion operated at different levels may result in different effects on adjacent segments of cervical intervertebral disc.
本研究旨在探讨不同节段颈椎前路椎间盘切除内固定融合术对兔相邻节段的影响。将60只新西兰兔随机分为四组,即1个对照组和3个模型组,每组15只。每组分别在C3-4、C4-5和C5-6节段行颈椎前路内固定融合术。融合后3个月、6个月和9个月进行X线片检查,观察相邻节段椎间隙及终板的变化。采用免疫组化方法评价不同融合方式对脊柱相邻节段的影响。随着时间推移,模型组X线检查显示多数软骨终板钙化。椎间盘免疫组化结果显示,髓核中Ⅱ型胶原表达水平显著降低,而纤维环中Ⅰ型胶原表达水平升高,且随着时间推移,髓核中Ⅰ型胶原逐渐趋于取代Ⅱ型胶原。C3-4和C4-5上下相邻节段固定融合后胶原变化无统计学意义(p>0.05),但C5-6节段变化有统计学意义(p<0.05)。颈椎内固定融合可诱发兔相邻节段椎间盘退变,不同节段的颈椎内固定融合术对颈椎间盘相邻节段的影响可能不同。