Department of Orthopedics, The First People's Hospital of Yinchuan, Liqun Street, Xingqing District, Yinchuan, 750001, Ningxia, People's Republic of China.
Department of Orthopedics, The Second Affiliated Hospital of Ningxia Medical University, Yinchuan, 750001, China.
Sci Rep. 2022 Jul 27;12(1):12853. doi: 10.1038/s41598-022-16624-2.
The present study aims to establish a method of constructing a New Zealand rabbit spinal tuberculosis model by direct local infusion of M. tuberculosis H37Rv strain into the intervertebral disc space through the posterior lateral approach. Sixty-six New Zealand rabbits were pretreated with complete Freund's adjuvant and randomly divided into 4 group: the posterolateral approach model group (Group A, 25), ventral transverse process approach model group (Group B, 25), control group (Group C, 10), and blank group (Group D, 6). In Groups A and B, the bone holes were filled with gelatin sponge after drilling, and the local area was directly infused with 0.1 ml of M. tuberculosis H37Rv strain suspension. In Group C, the gelatin sponge was filled through the posterolateral approach and the local area was infused with 0.1 ml of normal saline suspension. In Group D, No specific treatment was performed. The general conditions of the experimental rabbits in each group were compared to those of a control group; the degree of vertebral body exposure, incision length, and complications of the two methods were compared; and the tuberculosis models were evaluated by imaging, histopathology, and bacterial culture. In Group A, the lateral side of the vertebral body was well exposed, the damage was mild, and no peritoneal rupture or gastrointestinal complications were observed. In Group B, the ventral side of the vertebral body and the intervertebral disc were exposed, and abdominal complications were more likely to occur. The survival rates of the experimental rabbits at 8 weeks after surgery were 92.0% in Group A, 88.00% in Group B, 90.0% in Group C, and 100% in Group D. MRI examinations showed that in Group A, the positive rate of radiographic bone findings was 86.9% at 4 weeks after surgery and 100% at 8 weeks after surgery; in Group B, the positive rate of radiographic bone findings was 78.2% at 4 weeks after surgery and 95.4% at 8 weeks after surgery. There was no significant difference between Groups A and B in the radiographic bone findings rate detected by the same imaging method at the same time point (P > 0.05). Eight weeks after surgery, bone destruction, paravertebral abscess, and caseous necrosis occurred in the vertebral bodies of surviving rabbits in Groups A and B. The BacT/ALERT 3D rapid culture system was used to culture the pus in the lesion, and the results showed that the positive rate of tuberculosis was 52.17% in Group A and 54.54% in Group B, and the difference was not statistically significant (P > 0.05). After pretreatment with complete Freund's adjuvant, direct infusion of the H37Rv strain of M. tuberculosis into the intervertebral disc space of New Zealand rabbits via the posterolateral approach and the ventral transverse process approach can successfully establish rabbit spinal tuberculosis models.
本研究旨在通过后路外侧入路直接将结核分枝杆菌 H37Rv 株注入椎间盘间隙，建立新西兰兔脊柱结核模型。66 只新西兰兔用完全弗氏佐剂预处理后，随机分为 4 组：后路外侧入路模型组（A 组，25 只）、腹侧横突入路模型组（B 组，25 只）、对照组（C 组，10 只）和空白组（D 组，6 只）。A 组和 B 组在钻孔后用明胶海绵填充骨孔，局部直接注入 0.1ml 结核分枝杆菌 H37Rv 株混悬液。C 组通过后路外侧入路填充明胶海绵，局部注入 0.1ml 生理盐水混悬液。D 组不进行特殊治疗。比较各组实验兔的一般情况；比较两种方法的椎体暴露程度、切口长度和并发症；通过影像学、组织病理学和细菌培养评估结核模型。A 组椎体侧位暴露良好，损伤较轻，无腹膜破裂或胃肠道并发症。B 组椎体腹侧和椎间盘暴露，更容易发生腹部并发症。术后 8 周实验兔的存活率分别为 A 组 92.0%、B 组 88.0%、C 组 90.0%和 D 组 100%。MRI 检查显示，A 组术后 4 周时影像学骨发现阳性率为 86.9%，术后 8 周时为 100%；B 组术后 4 周时影像学骨发现阳性率为 78.2%，术后 8 周时为 95.4%。同一影像学方法在同一时间点检测的影像学骨发现率在 A 组和 B 组之间无统计学差异（P＞0.05）。术后 8 周，A 组和 B 组存活兔的椎体出现骨破坏、椎旁脓肿和干酪样坏死。使用 BacT/ALERT 3D 快速培养系统培养病变处脓液，结果显示 A 组结核阳性率为 52.17%，B 组为 54.54%，差异无统计学意义（P＞0.05）。用完全弗氏佐剂预处理后，通过后路外侧入路和腹侧横突入路将结核分枝杆菌 H37Rv 株直接注入新西兰兔椎间盘间隙，可成功建立兔脊柱结核模型。
