Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model
Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model
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DOI：
10.1016/j.spinee.2013.07.489
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发表时间：
2014-07-01
期刊：
影响因子：
4.5
通讯作者：
Masuda, Koichi
中科院分区：
文献类型：
--
作者：
Gregory, Diane E.;Bae, Won C.;Masuda, Koichi
背景：退行性椎间盘疾病是一种常见的病理性疾病，伴有结构和生化变化。椎间盘应力分布的变化可能导致纤维环 (AF) 损伤，从而影响椎间盘的强度和完整性。鉴于目前的一些退变疗法结合了髓核 (NP) 的生物再生，因此 AF 仍然能够容纳这种新生长的材料至关重要。目的：在实验性退变兔椎间盘中使用粘合剥离试验来检查 AF 的抗分层能力。研究设计：实验诱导椎间盘退变；方法：采用环形穿刺法在八只新西兰白兔中诱导椎间盘退变。另外四只兔子作为对照。在实验兔中，将 18 号针插入 L2-L3 和 L4-L5 水平的前外侧 AF 区域，并通过 X 射线监测椎间盘高度。术后4周和12周处死动物并拍摄磁共振图像和X射线。从实验动物身上切下四个椎间盘；两个穿刺（L2-L3 和 L4-L5）和两个对照（L3-L4 和 L6-L7）。还从年龄匹配的对照动物身上切除了相同的四个椎间盘，并用作未刺穿的对照椎间盘。为了确定抗分层性，从每个椎间盘上切下 AF 样本，并以 0.5 毫米/秒的速度进行机械剥离测试。结果：磁共振成像和 X 射线图像证实了 NP 脱水和椎间盘高度降低，类似于临床退变中发现的情况。与同一动物的未穿刺椎间盘（低 27%）和未穿刺对照椎间盘（低 30%）相比，穿刺/退变椎间盘的抗分层能力显着降低（p=.024）。 结论：本研究的结果表明，退变增加了 AF 层之间分层的可能性。鉴于变性后 AF 完整性发生巨大变化，临床治疗不仅应以 NP 的补液或再生为目标，还应以修复和强化 AF 来限制 NP 为目标。 (C) 2014 Elsevier Inc. 保留所有权利。
BACKGROUND CONTEXT: Degenerative disc disease is a common pathologic disorder accompanied by both structural and biochemical changes. Changes in stress distribution across the disc can lead to annulus fibrosus (AF) damage that can affect the strength and integrity of the disc. Given that some present degeneration therapies incorporate biological regrowth of the nucleus pulposus (NP), it is crucial that the AF remains capable of containing this newly grown material.PURPOSE: To examine the resistance of AF to delamination using an adhesive peel test in experimentally degenerated rabbit discs.STUDY DESIGN: Experimentally induced disc degeneration; excised AF tissue study.METHODS: Disc degeneration was induced in eight New Zealand white rabbits by annular puncture; four additional rabbits served as controls. In experimental rabbits, an 18-gauge needle was inserted into the anterolateral AF region of levels L2-L3 and L4-L5, and disc height was monitored by X-ray. Animals were sacrificed at 4 and 12 weeks postsurgery and magnetic resonance images and X-rays were taken. Four discs were excised from the experimental animals; two punctured (L2-L3 and L4-L5) and two controls (L3-L4 and L6-L7). The same four discs were also excised from the age-matched control animals and served as nonpunctured control discs. To determine resistance to delamination, AF samples were dissected from each disc and subjected to a mechanical peel test at 0.5 mm/s.RESULTS: Magnetic resonance imaging and X-ray images confirmed dehydration of the NP and reduced disc height, similar to that found in clinical degeneration. Resistance to delamination was significantly lower in punctured/degenerated discs compared with both the nonpunctured discs from the same animal (27% lower) and the nonpunctured control discs (30% lower) (p=.024).CONCLUSIONS: The findings of this study suggest that degeneration increases the potential for delamination between AF layers. Given this substantial change to the integrity of the AF after degeneration, clinical treatments should not only target rehydration or regrowth of the NP, but should also target repair and strengthening of the AF to confine the NP. (C) 2014 Elsevier Inc. All rights reserved.