Effect of anular repair on the healing strength of the intervertebral disc - A sheep model
Effect of anular repair on the healing strength of the intervertebral disc - A sheep model
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DOI：
10.1097/00007632-200009010-00004
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发表时间：
2000-09-01
期刊：
影响因子：
3
通讯作者：
Guiboux, JP
中科院分区：
文献类型：
--
作者：
Ahlgren, BD;Lui, W;Guiboux, JP
研究设计。在绵羊模型中，用间盘来评估直接修复三个不同的环状切口对随后的间盘愈合强度的影响。评估直接修复腰椎间盘摘除时的环状缺损是否会影响纤维环的愈合率和强度。24只绵羊接受了腹膜后入路，达到了5个腰椎间盘水平。在每个暴露的节段均行环状切开，然后行部分腰椎间盘切除术。本研究中使用的环形切口包括1)直的横缝，2)十字形切口，3)窗口或盒子切除。在3个时间间隔测量愈合强度：2周、4周和6周。每种环状切口型30个腰椎间盘，每个时间间隔10个椎间盘。每个时间间隔内有5个椎间盘直接修复，另有5个未修复的椎间盘作为对照。分别于术后2周、4周和6周处死绵羊。整块摘除腰椎，并对椎间盘进行压力-体积测试，以评估修复和未修复的椎间盘损伤在每个时间间隔的环状强度。统计分析不同愈合时间、不同切开方式、不同修复方式对受累椎间盘压力-体积特性的影响。压力-容量测试显示修复的椎间盘有更强的愈合趋势，但修复和未修复的环状强度在时间间隔上没有任何显著差异。在未修复的椎间盘中，箱形切口在早期愈合时的强度仅为裂开或十字切开的40%~50%。腰椎环状切口处的直接修复不会显著改变腰椎间盘摘除术后椎间盘的愈合强度。
Study Design. The intervertebral disc, in a sheep model, was used to assess the effect of directly repairing three different anular incisions on the subsequent healing strength of the intervertebral disc,Objectives. To assess whether directly repairing an anular defect, made at the time of lumbar discectomy, could influence the healing rate and strength of the anulus fibrosus.Methods. Twenty-four sheep underwent a retroperitoneal approach to five lumbar disc levels. An anular incision , followed by partial discectomy was done at each exposed level. Anular incisions used in this study consisted of 1) a straight transverse slit, 2) a cruciate incision, and 3) a window or box excision. Healing strength was measured at three time intervals: 2 weeks, 4 weeks, and 6 weeks. Each anular incision type was performed on 30 lumbar discs, 10 discs in each time interval. Five discs in each time interval underwent direct repair, and five discs were left unrepaired to heal as controls. The sheep were killed at 2, 4, and 6 weeks after surgery. The lumbar Spines were removed en bloc, and the intervertebral discs were subjected to pressure-volume testing to assess the anular strength of repaired versus unrepaired disc injuries at each time interval.Results. Statistical analysis was performed to evaluate the effects of healing time, incision technique, and repair on the pressure-volume characteristics of the involved discs. Pressure-volume testing showed trends of stronger healing for repaired discs, but at no time interval was any significant difference round between repaired and nonrepaired anular strength. Of the nonrepaired discs, the box incision was only 40 to 50% as strong as the slit or cruciate incised discs during early healing.Conclusion. Direct repair of anular incisions in the lumbar spine does not significantly alter the healing strength of the intervertebral disc after lumbar discectomy.