Kahanovitz N, Arnoczky S P, Kummer F
Spine (Phila Pa 1976). 1985 Mar;10(2):178-83. doi: 10.1097/00007632-198503000-00015.
Previous experimental studies on the canine intervertebral disc treated with chemonucleolysis have shown encouraging results in preserving normal histologic, biomechanical, and radiographic disc appearance. These observations suggest that chemonucleolysis may have significant advantages over surgical disc excision in preserving normal function of the lumbar vertebral motion segment. An experimental canine study was devised to examine and compare the short and long-term effects of chemonucleolysis and surgical disc excision on the entire lumbar motion segment to determine if one treatment modality is superior to the other in providing better maintenance of motion segment function. Twenty adult beagle dogs underwent anterior laparotomy. In ten dogs, Chymodiactin was injected into the L4-5 disc and in the remaining ten, routine surgical discectomies were performed on the L4-5 disc. Preoperative and presacrifice lateral radiographs were obtained. All dogs were allowed to exercise freely. Five dogs that received Chymodiactin (Group A) and five dogs that had surgical excisions (Group B) were killed six weeks postoperatively. Five months postoperatively, five dogs given Chymodiactin (Group C) and 5 having surgery (Group D) were also killed. Mechanical testing was performed on each treated disc sample with a modified MTS machine (MTS Systems Corp., Minneapolis, MN). Axial compression, bending, shear, and torsion were assessed in ten modes. Stiffness values for each mode were calculated. Following the biomechanical tests, the facet joints and the disc with the adjacent endplate were removed intact and analyzed histologically and with high resolution radiography. Six-week biomechanical testing revealed a 50% loss of torsional stiffness, as well as loss of anterior and medial-lateral shear stiffness in the chemonucleolysis group.(ABSTRACT TRUNCATED AT 250 WORDS)
先前对采用化学髓核溶解术治疗的犬椎间盘进行的实验研究表明,在保持正常的组织学、生物力学和影像学椎间盘外观方面取得了令人鼓舞的结果。这些观察结果表明,在保留腰椎运动节段的正常功能方面,化学髓核溶解术可能比手术椎间盘切除术具有显著优势。设计了一项犬类实验研究,以检查和比较化学髓核溶解术和手术椎间盘切除术对整个腰椎运动节段的短期和长期影响,以确定在提供更好的运动节段功能维持方面,一种治疗方式是否优于另一种。20只成年比格犬接受了前路剖腹术。10只犬,将Chymodiactin注入L4-5椎间盘,其余10只犬,对L4-5椎间盘进行常规手术椎间盘切除术。获得术前和处死前的侧位X线片。所有犬都被允许自由活动。术后6周处死5只接受Chymodiactin治疗的犬(A组)和5只接受手术切除的犬(B组)。术后5个月,处死5只给予Chymodiactin的犬(C组)和5只接受手术的犬(D组)。使用改良的MTS机器(MTS系统公司,明尼阿波利斯,明尼苏达州)对每个处理过的椎间盘样本进行力学测试。在10种模式下评估轴向压缩、弯曲、剪切和扭转。计算每种模式的刚度值。在生物力学测试后,完整切除小关节和带有相邻终板的椎间盘,并进行组织学和高分辨率放射学分析。6周的生物力学测试显示,化学髓核溶解术组的扭转刚度损失了50%,以及前侧和中外侧剪切刚度损失。(摘要截短至250字)