Department of Orthopaedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2017 Nov 5;130(21):2579-2584. doi: 10.4103/0366-6999.213910.
Current treatments for scoliosis have some defects and complications. To study spinal deformities and test novel scoliosis treatments, many animal models of scoliosis have been developed. These models applied a single load to the spine and could not precisely modulate the spinal growth in different dimensions. In this study, we applied posterior tethering in various directions with the application of nickel-titanium (NT) coil springs in dog's spine to modulate spinal growth in the coronal, sagittal, and transverse planes and create a scoliosis model possess curves that mimic adolescent idiopathic scoliosis (AIS) three dimensionally.
Scoliosis was surgically induced in eight 8-week-old female dogs (weight: 1.95-2.30 kg) using bone screws and NT coil springs. The deformity was induced through the placement of posterior NT coil springs that tethered the spine by bone screw fixation. All dogs were monitored with serial radiographs to document changes in deformities.
All experimental animals developed scoliotic curves convex to the left in the lumbar segment. The mean coronal Cobb angle was 18.0° immediately postoperatively and 54.5° at 22 weeks. The mean lordosis increased from 6.2° postoperatively to 35.0° at final follow-up. Apical axial rotation increased from 4.5° postoperatively to 31.2° at 22 weeks.
With the application of NT springs in dogs that allowed posterior tethering in various directions, lumbar spinal deformity was achieved in three planes: coronal, sagittal, and transverse planes. Notably, the lumbar spine in surgically treated dogs developed lordoscoliosis with obvious rotation and the curves mimic AIS three dimensionally well. This method allows lumbar scoliosis to develop without deep dissection of muscle and maintains the essential anatomical elements along the spinal curve. Moreover, the spinal growth modulation technique could yield information that would provide a basis for developing novel early-stage treatments for children with scoliosis.
目前的脊柱侧弯治疗方法存在一些缺陷和并发症。为了研究脊柱畸形并测试新的脊柱侧弯治疗方法,许多动物脊柱侧弯模型已经建立。这些模型对脊柱施加单一负荷,无法精确调节脊柱在不同维度上的生长。在这项研究中,我们通过应用镍钛(NT)螺旋弹簧在狗的脊柱上以各种方向施加后路牵引,来调节冠状面、矢状面和横断面的脊柱生长,并创建一个具有三维模拟青少年特发性脊柱侧凸(AIS)曲线的脊柱侧弯模型。
通过骨螺钉和 NT 螺旋弹簧在 8 只 8 周龄雌性犬(体重:1.95-2.30kg)中进行手术诱导脊柱侧弯。通过后路 NT 螺旋弹簧的放置来诱导畸形,通过骨螺钉固定来固定脊柱。所有狗均通过连续 X 线片监测来记录畸形的变化。
所有实验动物的腰椎段均出现向左凸的脊柱侧凸曲线。术后即刻的平均冠状 Cobb 角为 18.0°,22 周时为 54.5°。术后的平均腰椎前凸角从 6.2°增加到最终随访时的 35.0°。术后的顶椎轴向旋转从 4.5°增加到 22 周时的 31.2°。
通过在狗身上应用 NT 弹簧来实现各种方向的后路牵引,可以在冠状面、矢状面和横断面三个平面上实现腰椎脊柱畸形。值得注意的是,手术治疗的狗的腰椎会发生脊柱后凸侧凸,且明显旋转,曲线很好地模拟了 AIS 的三维特征。这种方法可以在不进行深层肌肉解剖的情况下使腰椎侧弯发展,并保持脊柱曲线上的基本解剖结构。此外,脊柱生长调节技术可以提供有关信息,为儿童脊柱侧弯的早期治疗方法提供基础。