Huang Yong-Can, Xiao Jun, Lu William W, Leung Victor Y L, Hu Yong, Luk Keith D K
Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professor Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China.
Department of Joint Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Eur Spine J. 2017 Mar;26(3):799-805. doi: 10.1007/s00586-016-4535-z. Epub 2016 Mar 23.
Fresh-frozen intervertebral disc (IVD) allograft transplantation has been successfully performed in the human cervical spine. Whether this non-fusion technology could truly decrease adjacent segment disease is still unknown. This study evaluated the long-term mobility of the IVD-transplanted segment and the impact on the adjacent spinal segments in a goat model.
Twelve goats were used. IVD allograft transplantation was performed at lumbar L4/L5 in 5 goats; the other 7 goats were used as the untreated control (5) and for the supply of allografts (2). Post-operation lateral radiographs of the lumbar spine in the neutral, full-flexion and full-extension positions were taken at 1, 3, 6, 9 and 12 months. Disc height (DH) of the allograft and the adjacent levels was calculated and range of motion (ROM) was measured using the Cobb's method. The anatomy of the adjacent discs was observed histologically.
DH of the transplanted segment was decreased significantly after 3 months but no further reduction was recorded until the final follow-up. No obvious alteration was seen in the ROM of the transplanted segment at different time points with the ROM at 12 months being comparable to that of the untreated control. The DH and ROM in the adjacent segments were well maintained during the whole observation period. At post-operative 12 months, the ROM of the adjacent levels was similar to that of the untreated control and the anatomical morphology was well preserved.
Lumbar IVD allograft transplantation in goats could restore the segmental mobility and did not negatively affect the adjacent segments after 12 months.
新鲜冷冻椎间盘（IVD）同种异体移植已成功应用于人体颈椎。这种非融合技术是否真能降低相邻节段疾病尚不清楚。本研究在山羊模型中评估了IVD移植节段的长期活动度以及对相邻脊柱节段的影响。
使用12只山羊。5只山羊在腰椎L4/L5进行IVD同种异体移植；另外7只山羊作为未治疗对照（5只）和异体移植物供体（2只）。在术后1、3、6、9和12个月拍摄腰椎在中立、全屈和全伸位的侧位X线片。计算异体移植椎间盘及相邻节段的椎间盘高度（DH），并采用Cobb法测量活动度（ROM）。对相邻椎间盘的解剖结构进行组织学观察。
移植节段的DH在3个月后显著降低，但直到最后随访时未再进一步降低。移植节段在不同时间点的ROM无明显改变，12个月时的ROM与未治疗对照相当。在整个观察期内，相邻节段的DH和ROM保持良好。术后12个月时，相邻节段的ROM与未治疗对照相似，解剖形态保存良好。
山羊腰椎IVD同种异体移植可恢复节段活动度，且12个月后对相邻节段无负面影响。
