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Antidegenerative effects of artificial disc replacement by low water content-poly (vinyl alcohol)

低含水量聚(乙烯醇)人工椎间盘置换术的抗退变作用

基本信息

批准号：
18591630
负责人：
NEO Masashi
金额：
$ 2.52万
依托单位：
Kyoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18591630/
关键词：
intervertebral disc artificial disc polymer Poly (vinyl alcohol)low back pain artificial nucleus pulposus ポリビニルアルコール椎間板変性

项目摘要

Although some authors reported that partial disc replacements (PDR) have beneficial clinical outcomes, there are few controlled animal studies in which the therapeutic effects of this procedure have been demonstrated. The objective of this study was to establish an animal surgery model of PDR and to demonstrate its therapeutic effects. In vivo degenerative changes of rabbit intervertebral discs after PDR were evaluated radiologically and histologically in a controlled trial. The implants were made of poly (vinyl alcohol) hydrogel (35% water content) and rod-shaped. The L2/3 or L3/4 intervertebral discs of Japanese white rabbits were pierced with a 2.0 mm Kirschner wire and implants were inserted into the holes. For comparative purposes, the adjacent discs underwent sham treatments or control treatments in which the dish was pierced but no implant was inserted. Sixty discs from 30 rabbits were analyzed radiologically and histologically for degenerative changes at 1, 3, or 6 months postoperatively. Radiological analysis revealed that significantly less disc height was lost with the replacement treatment than with the control treatment. Change in disc height after the replacement treatment was not significantly different from that after the sham treatment. Histological degeneration of the replaced discs was delayed in comparison with that of the control discs but progressed with time. Even when implants with higher water content were used, no remarkable change was histologically observed in shape. In this study, a safe and reproducible animal model of PDR was established, and its antidegenerative effects were demonstrated by quantitative radiological and histological analyses. Degeneration of the AF after the replacement treatment was delayed by preserving disc height and occupying the NP space. Proper selection of material and design of implants are necessary for long-term success.

尽管一些作者报道了部分椎间盘置换术（PDR）有有益的临床结果，但很少有对照动物研究证明该手术的治疗效果。本研究的目的是建立PDR的动物手术模型，并验证其治疗效果。在一项对照试验中，对兔椎间盘在PDR后的体内退行性改变进行放射学和组织学评价。植入物由聚乙烯醇水凝胶（含水量35%）制成，呈棒状。用2.0 mm克氏针穿刺日本大白兔L2/3或L3/4椎间盘，植入植入物。为了比较，相邻的椎间盘进行了假治疗或对照治疗，其中盘被刺穿但没有插入植入物。在术后1、3、6个月对30只兔的60个椎间盘进行放射学和组织学分析。放射学分析显示，与对照治疗相比，替代治疗的椎间盘高度损失明显减少。假治疗后椎间盘高度变化与假治疗后差异无统计学意义。与对照组相比，更换椎间盘的组织学退变延迟，但随着时间的推移而进展。即使使用含水量较高的植入物，组织学上也没有观察到形状的显著变化。本研究建立了一种安全、可重复的PDR动物模型，并通过定量放射学和组织学分析证实了其抗退行性作用。保留椎间盘高度和占用NP空间延缓了房颤置换术后退行性变。适当的材料选择和植入物的设计是长期成功的必要条件。