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[脊柱牵引与固定对小关节软骨的影响——实验与临床研究]

[The effect of spinal distraction and immobilization on the facet joint cartilage--experimental and clinical studies].

作者信息

Yoshida M

机构信息

Department of Orthopaedic Surgery, Wakayama Medical College, Japan.

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1989 Aug;63(8):789-99.

PMID:2809359
Abstract

The effects of spinal immobilization and distraction on the facet joint cartilage was studied in 49 young Wistar rats which were kept in the specially made lumbar-pelvic distraction apparatus from two to twelve weeks' duration. After two weeks' immobilization and distraction, histologic examinations revealed early regressive degeneration in superficial layers of the facet joint cartilage. Thereafter, the degeneration progressed further and became irreversible between 4 and 8 weeks' immobilization. After release of immobilization, the facet joint cartilage finally resulted in osteoarthrosis. Six clinical cases with thoracolumbar spinal fracture treated by posterior instrumentation without arthrodesis were investigated. Following removal of the instrumentation, the spinal mobility recovered temporarily then decreased gradually afterwards. Histologic examinations on the facet joint in the clinical cases showed pathological changes which were very similar to those of the experimental rats. From these results, we have concluded that the spine without arthrodesis appears to develop into symptomatic arthrosis by internal fixation.

摘要

在49只年轻的Wistar大鼠身上研究了脊柱固定和牵引对小关节软骨的影响,这些大鼠被置于特制的腰骶部牵引装置中,持续时间为2至12周。在固定和牵引两周后,组织学检查显示小关节软骨表层出现早期退行性变。此后,退变进一步发展,在固定4至8周时变得不可逆转。解除固定后,小关节软骨最终导致骨关节炎。对6例经后路内固定但未行关节融合术治疗的胸腰椎骨折临床病例进行了研究。取出内固定后,脊柱活动度暂时恢复,随后逐渐下降。临床病例小关节的组织学检查显示出与实验大鼠非常相似的病理变化。从这些结果中,我们得出结论,未行关节融合术的脊柱似乎会因内固定而发展为有症状的关节炎。

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