Effects of Intradiscal Injection of Local Anesthetics on Intervertebral Disc Degeneration in Rabbit Degenerated Intervertebral Disc
Effects of Intradiscal Injection of Local Anesthetics on Intervertebral Disc Degeneration in Rabbit Degenerated Intervertebral Disc
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DOI：
10.1002/jor.24347
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发表时间：
2019-09
期刊：
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通讯作者：
K. Ura;H. Sudo;Koji Iwasaki;Takeru Tsujimoto;Daisuke Ukeba;N. Iwasaki
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作者：
K. Ura;H. Sudo;Koji Iwasaki;Takeru Tsujimoto;Daisuke Ukeba;N. Iwasaki
椎间盘阻滞是一种通过注射局部麻醉剂来诊断或治疗椎间盘源性腰痛的方法。本研究的目的是使用器官型培养模型和体内长期随访模型研究局部麻醉剂对退行性兔椎间盘（IVD）的有害作用。为了诱导IVD变性，使用兔环形穿刺模型。对于器官型培养模型，在最初的环形穿刺后1个月收获退化的IVD，并在椎间盘内注射局部麻醉剂（1%利多卡因和0.5%布比卡因）后培养3或7天。为了进行体内分析，将局部麻醉剂注射到退化的IVD中，并在6或12个月后制备IVD用于组织学分析。在器官型模型中，布比卡因组的末端脱氧核苷酸转移酶dUTP缺口末端标记阳性髓核（NP）细胞显著高于其他组。在体内研究中，与未处理对照组和仅穿刺组相比，盐水和局部麻醉剂组的NP细胞数量显著减少。然而，在生理盐水、利多卡因和布比卡因组之间没有显著差异。此外，组织学分析显示，仅穿刺组、生理盐水组、利多卡因组和布比卡因组之间的IVD变性没有显着差异。尽管布比卡因在器官型培养模型中诱导了凋亡性NP细胞死亡，但体内观察并未显示任何明确的证据表明局部麻醉剂能够促进退化的IVD的退化，加压注射诱导的损伤除外。© 2019骨科研究学会。由威利期刊公司出版J Orthop Res 37：1963-1971，2019
Analgesic discoblock is widely used for the diagnosis or treatment of discogenic low back pain by injecting local anesthetics. The purpose of this study was to investigate the deleterious effects of local anesthetics on degenerated rabbit intervertebral disks (IVDs) using an organotypic culture model and in vivo long‐term follow‐up model. To induce IVD degeneration, a rabbit annular puncture model was used. For the organotypic culture model, degenerated IVDs were harvested 1 month after the initial annular puncture and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine and 0.5% bupivacaine). To perform in vivo analysis, local anesthetics were injected into degenerated IVDs, and IVDs were prepared for histological analysis after 6 or 12 months. In the organotypic model, terminal deoxynucleotidyl transferase dUTP nick end labeling‐positive nucleus pulposus (NP) cells were significantly increased in the bupivacaine group compared with the other groups. In the in vivo study, the number of NP cells was significantly decreased in the saline and local anesthetics groups compared with the untreated control and puncture‐only groups. However, there was no significant difference among the saline, lidocaine, and bupivacaine groups. In addition, histological analysis showed no significant difference of IVD degeneration among the puncture‐only, saline, lidocaine, and bupivacaine groups. Although bupivacaine induced apoptotic NP cell death in the organotypic culture model, in vivo observations did not show any definitive proof to suggest that local anesthetics were capable of promoting degeneration in the degenerated IVD, except for pressurized injection‐induced damage. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1963–1971, 2019