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1.
Objective: To evaluate the effects and mechanism of radiation-sterilized allogeneic bone sheets in inducing vertebral plate regeneration after laminectomy in sheep. Methods: Twelve adult male sheep (aged 1.5 years and weighing 27 kg on average) provided by China Institute for Radiation Protection underwent L3-4 and L4-5 laminectomy. Then they were randomly divided into two groups: Group A ( n = 6 ) and Group B ( n = 6 ). The operated sites of L4-5 in Group A and L3-4 in Group B were covered by " H-shaped" freeze-drying and radiation-sterilized allogeneic bone sheets ( the experimental segments), while the operated sites of L3-4 in Group A and L4-5 in Group B were uncovered as the self controls (the control segments ). The regeneration process of the vertebral plate and the adhesion degree of the dura were observed at 4,8,12,16,20 and 24 weeks after operation. X-ray and CT scan were performed in both segments of L3-4 and L4-5 at 4 and 24 weeks after operation. Results: In the experimental segments, the bone sheets were located in the anatomical site of vertebral plate, and no lumbar spinal stenosis or compression of the dura was observed. The bone sheets were absorbed gradually and fused well with the regenerated vertebral plate. While in the control segments, the regeneration of vertebral plate was not completed yet, the scar was inserted into the spinal canal, compressing the dura and the spinal cord, and the epidural area almost disappeared. Compared with the control segments, the dura adhesion degree in the experimental regenerated segments was much milder (P<0.01), the internal volume of the vertebral canal had no obvious change and the shape of the dura sack remained well without obvious compression. Conclusions: Freeze-drying and radiation-sterilized allogeneic bone sheets are ideal materials for extradural laminoplasty due to their good biocompatibility, biomechanical characteristics and osteogenic ability. They can effectively reduce formation of post-laminectomy scars, prevent recurrence of post-laminectomy spinal stenosis, and induce regeneration of vertebral plates.  相似文献   

2.
Objective: To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods: Twenty-four Japanese white rabbits underwent laminectomy (including the attached ligaments) at Lz and Ls. After laminectomy at Ls, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at Lz, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intraceHular structure of fibroblasts. Results: The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group,which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions: Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.  相似文献   

3.
Objective: To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods: Twenty-four Japanese white rabbits underwent laminectomy (including the attached ligaments) at L2 and L5. After laminectomy at L5, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at L2, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intracellular structure of fibroblasts. Results: The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group, which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions: Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.  相似文献   

4.
Objective: To determine whether an adenoviral construct containing bone morphogenetic protein-4(BMP-4) gene can be used for lumbar spinal fusion. Methods: Twelve New Zealand white rabbits were randomly divided into two groups, 8 in the experimental group and 4 in the control group. Recombinant, replication-defective type 5 adenovirus with the cytomegalovirus (CMV) promoter and BMP-4 gene (Ad-BMP-4) was used. Another adenovirus constructed with the CMV promoter andβ-galactosidase gene (Ad-β-gal) was used as control. Using collagen sponge as a carrier, Ad-BMP-4 (2.9×108 pfu/ml) was directly implanted on the surface of L5-L6 lamina in the experimental group, while Ad-β-gal was implanted simultaneously in the control group. X-ray was obtained at 3, 6, and 12 weeks postoperatively to observe new bone formation. When new bone formation was identified, CT scans and three-dimensional reconstruction were obtained. After that, the animals were killed and underwent histological inspection. Results: In 12 weeks after operation, new bone formation and fusion were observed on CT scans in the experimental group, without the evidence of ectopic calcification in the canal. Negative results were found in the control group. Histological analysis demonstrated endochondral bone formation at the operative site and fusion at early stage was testified. Conclusions: In vivo gene therapy using Ad-BMP-4 for lumbar posterolateral spinal fusion is practicable and effective.  相似文献   

5.
Objective: To observe the dynamic changes of free iron contents and its relationship to the changes of lipid peroxidation after experimental spinal cord injury (SCI). Methods: Sprague Dawley rats were randomly divided into three groups: Group A (n=6) received no operation; Group B (n=48) received only laminectomy (sham) ; and Group C (n=48) received both laminectomy and traumatic injury ( SCI model). The SCI animal models were made by using an modified Alien‘s weight-drop device (50 g. cm) on T12. Rats were sacrificed at 0.5, 1, 3, 6, 12, 24 hours after injury. The levels of free iron involved in spinal cord segments at different time points were measured by blcomycin assay. The malondialdehyde (MDA) was also measured by the thiobarbituric acid (TBA). Results: After SCI in Group C, the level of free iron showed a significant increase at 0.5 hour compared to Groups B and A, restored to the control level at 6 h; the level of MDA was increased at 0.5 hour, peaked at 3 hours, returned to the control level at 12 hours; the concentrations of free iron and lipid peroxidation in injured rats were significantly and positively correlated at 0.5-3 hours. Conclusions: After SCI the levels of free iron are increased quickly and might be a major contributor to lipid peroxidation in injured spinal cord.  相似文献   

6.
Antioxidation of quercetin against spinal cord injury in rats   总被引:2,自引:0,他引:2  
Objective : To observe the effect of quercetin on experimental spinal cord injury (SCI) in rats. Methods: Sixty Sprague-Dawley rats were randomly divided into four groups : Group A only for laminectomy, Group B for laminectomy with SCI, Group C for SCI and intraperitoneal injection with a bolus of 200 mg/kg quercetin and Group D for SCI and intraperitoneal injection of saline. SCI model was made by using modified Aliens method on T12. Six rats of each group were killed at 4 h after injury and the levels of free iron and malondialdehyde ( MDA) of the involved spinal cord segments were measured by bleomycin and thiobarbituric acid (TBA) assays separately. The recovery of hind limb function was assessed by Modified Tarlov 's scale and inclined plane method at 7 d,14 d and 21 d after SCI. The histological changes of the damaged spinal cord were also examined at 7 d after SCI. Results: After SCI, the levels of free iron and MDA were significantly increased in Groups B and D, while not in Group C. The Modified Tarlov 's score and the inclined plane angles were significantly decreased in Groups B, C and D. The histological findings were not improved. Conclusions: After SCI, quercetin can reduce the level of lipid peroxidation, but not improve recovery of function.  相似文献   

7.
Objective: To evaluate the effect of autologous bone marrow mesenchymal stem cells (BMSCs) seeded bio-derived bone materials (BBM) combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) in repairing defect of osteonecrosis of femoral head (ONFH).
Methods: Early-stage osteonecrosis in the left hip was induced in 36 adult New Zealand white rabbits (provided by the Animal Center of Guangxi Medical University, Nanning, China) after core decompression and delivery of liquid nitrogen into the femoral head. Then the animals were divided into three groups according to the type of implants for bone repair: 12 rabbits with nothing (Group Ⅰ, the blank control group), 12 with BBM combined with rhBMP-2 (Group Ⅱ), and 12 with BMSCs-seeded BBM combined with rhBMP-2 (Group Ⅲ). At 4, 8, and 12 weeks after surgery, X-ray of the femoral head of every 4 rabbits in each group was taken, and then they were killed and the femoral heads were collected at each time point, respectively. Gross observation was made on the femoral heads. After hematoxylin and eosin staining, Lane-sandhu scores of X-ray and bone densitometry were calculated and the histomorphometric measurements were made for the new bone trabeculae.
Results: At 12 weeks after surgery, two femoral heads collapsed in Group Ⅰ, but none in Group Ⅱ or Group Ⅲ. X-ray examination showed that the femoral heads in Group I had defect shadow or collapsed while those in Group II had a low density and those in Group III presented with a normal density. Histologically, the defects of femoral heads were primarily filled with no new bone but fibrous tissues in Group Ⅰ. In contrast, new bone regeneration and fibrous tissues occurred in Group II and only new bone regeneration occurrd in Group Ⅲ. Lane-sandhu scores of X-ray, bone mineral density and rate of new bone in trabecular area in Group Ⅲ were higher significantly than those of the other two groups. Conclusions: Our findings indicate a superior choice of  相似文献   

8.
Objective: To study the regularity of migration and distribution of bone marrow stromal cells (BMSCs) in injured spinal cord with intradural space transplantation. Methods: Forty Wistar rats were randomly assigned into 4 groups. The spinal cord injury model was prepared according to the modified Allen method. BMSCs were labeled by CM-Dil. And 5.0x 10^6 cells were transplanted by different channels including intraventricular injection (Group A),injured spinal cord intrathecally injection (Group B), remote intrathecally injection at the L3-L4 level (Group C), and intravenous injection (Group D). Spinal cord was dissected at 24 hours, 1, 2, 3 and 4 weeks after transplantation. Sections of 4 μm were cut on a cryostat and observed under fluorescence microscopy. Results: No fluorescence was observed 24 hours aftertransplantation in spinal cord injury parenchyma except Group B. One week later, BMSCs in Groups A and C began to migrate to the injured parenchyma; 2-4 weeks later, BMSCs penetrated into the injured parenchyma except Group D. The number of BMSCs decreased at 3-4 weeks after transplantation. The number of cells in Group B decreased faster than that of Groups A and C. Conclusions: BMSCs transplanted through intraventricular injection, injured spinal cord intrathecally injection and remote intrathecal injection could migrate to the injured parenchyma of spinal cord effectively. The number of BMSCs migrated into injured spinal cord parenchyma is rare by intravenous injection.  相似文献   

9.
Objective : To study the effect of allograft compound vertebra on vertebral reconstruction in rabbits so as to provide biomechanical direction for manufacturing and selecting vertebral reconstruction materials. Methods: Twenty-five healthy New Zealand white rabbits were divided randomly into three groups: normal group ( Group A, n = 5 ) ,iliac bone graft group ( Group B, n = 10) and allograft compound vertebra group ( Group C, n = 10). After C4 was resected, iliac bone implantation and allograft bone cage transplantation were fulfilled in Group B and Group C, respectively. Every 5 rabbits from Group B and Group C were selected to test the biomechanical strength and biological activity one and two months postoperatively. Results: No significant statistical difference was found between Group A and Group C one and two monthspostoperatively ( P 〉 0.05 ). The biomechanical strength of Group B was much weaker than that of Group A and Group C one month postoperatively (P 〈 0.05 ), but at two months postoperatively, no statistical difference was found among the three groups. The biological activity and vertebral moulding ability of Group C were better than those of Group B at one and two months postoperatively. Conclusions: Compound vertebra, which is made up of allograft cortical bone cage and autogenous cancellous bone, shows instantaneous and permanent biomechanical stability and biological activity, therefore, it is an ideal material for vertebral reconstruction.  相似文献   

10.
Objective: To observe whether offactory ensheathing cells could be used to promote axonal regeneration in a slmntaneously nonregenerating system. Methods: After laminectomy at the lower thoracic level, the spinal cords of adult rats were exposed and completely transected at T10. A suspension of ensheathing cells was injected into the lesion site in 12 adult rats, and control D/F-12 (1:1 mixture of DMEM and Ham‘s F-12) was injected in 12 adult rats. Six weeks and ten weeks after cell transplantation, the rats were evaluated by climbing test and motor evoked potentials (MEPs) monitoring. The samples were procured and studied with histologiel and immounohistochemical methods. Results: At the 6th week after cell transplantation,d the rats in both the transplanted and control groups were paraplegic and the MEPs could not be recorded. At the 10th week after cell transplantation, of 7 rats in the control group, 2 rats had muscles‘ contraction of the lower extremities, 2 rats had hips and/or knees‘ active movement; and 5 rats‘ MEPs could be recorded in the hind limbs in the transplanted group ( n = 7). None of the rats in the control group had functional improvement and no MEPs recorded ( n = 7 ). Numerous regenerating axons were observed through the transplantation and continued to regenerate into the denervated host tract. Cell labelling using anti-Myelin Basic Protein (MBP) and anti-Nerve Growth Factor Receptor (anti-NGFR) indicated that the regenerated axons were derived from the appropriate neuronal source and that donor cells migrated into the denervated host tract. But axonal degeneration existed and regenerating axons were not observed within the spinalcords of the adult rats with only D/F-12 injection. Conclusions: The axonal regeneration in the transected adult rat spinal cord is possible after eusheathing cells transplantation.  相似文献   

11.
同种异体骨板覆盖预防硬膜外瘢痕粘连的实验研究   总被引:8,自引:0,他引:8  
目的 探讨经冻干辐照处理后的同种异体骨板预防椎板切除术后硬膜外瘢痕粘连的作用。方法 12只成年雄性绵羊,随机分成A、B两组,每组6只。两组均作L3,4和L4,5椎板切除,A组的L4,5和B组的L3,4椎板缺损用“H”形同种冻干辐照骨板覆盖,为实验节段;A组的L3,4和B组的L4,5不覆盖骨板作为对照节段。于术后4、8、12、16、20和24周取材,行大体、X线平片和组织切片观察;并对4、24周取材行CT扫描。结果 术后4周,实验节段可见同种骨板形态、位置保持完好,椎管内无狭窄,硬膜囊无压迫,镜下椎板咬除缘有多量新生骨小梁生成,周边有大量软骨细胞及其分泌黏多糖和坏死后所留下的空腔,骨板内侧有增生纤维组织及少量炎性细胞浸润;对照节段可见大范围致密的纤维组织夹杂变性坏死肌肉嵌入椎板缺损处,硬膜广泛粘连,硬膜囊受压。术后24周,实验节段椎管重建基本完成,覆盖骨板吸收完全,并与再生椎板融合,椎管形态完好,硬膜外未见瘢痕组织;对照节段椎板再生未完成,瘢痕组织自椎管外嵌入椎管内,压迫硬膜囊及脊髓,硬膜外间隙几乎消失。统计学分析表明手术后期(16~24周),实验节段与对照节段相比硬膜粘连程度明显减轻,椎管矢状径均较对照节段大,硬膜囊形状保持良好,无明显压迫。结论 同种异体冻干辐照骨板在实验羊椎板切除后的硬膜外能有效减少瘢痕形成和粘连。  相似文献   

12.
目的:探讨纳米羟基磷灰百/聚酰胺(nano-hydmxyapatite/polyamide-66,n-HA/PA66)复合人工椎板在防止脊柱后路术后椎管内瘢痕粘连,重建脊柱后部结构完整性的价值。方法:22只1岁龄雄性家犬行L5椎板切除,实验组13只行复合人丁椎板植入,另9只作空白对照。术后4、8、16、24周各时相点摄X线片,行组织学、扫描电镜观察;术后24周行MRI检查.结果:实验组术后16~24周复合人工椎板界面观察到软骨细胞及板层骨,硬膜粘连程度比对照组明瞳减轻(P〈0.01)。术后24周时MRi显示实验组椎管完整性恢复。结论:n-HA/PA66复合材料具有良好的生物相容性,能有效阻止硬膜外粘连。  相似文献   

13.
钛网椎管成形在脊柱融合术中的应用   总被引:2,自引:0,他引:2  
目的 介绍一种治疗椎体爆裂性骨折椎板减压后脊柱融合的方法。方法 椎体爆裂性骨折病人 3 4例 ,均有不同程度的脊柱不稳及硬膜囊或神经根压迫。在进行后路椎板减压、经椎弓根内固定后 ,采用钛网椎管成形脊柱后路融合重建脊柱的稳定性。结果 全部病例经 1 2~ 1 8个月随访 ,内固定物无断裂 ,钛网在位 ,椎管成形良好 ,硬膜囊及神经根无压迫。 3 1例神经功能有不同程度的恢复。结论 钛网椎管成形脊柱融合术治疗椎体爆裂性骨折效果良好。此方法操作简单 ,安全 ,能够在恢复椎管形状、免除硬膜囊及神经根压迫的同时 ,进行植骨融合 ,增加脊柱的稳定性 ,易于推广应用。  相似文献   

14.
Severe local tissue lesions after chemonucleolysis with collagenase   总被引:9,自引:0,他引:9  
The authors report the case of a young female patient submitted to chemonucleolysis at L4-5 with collagenase, in whom severe tissue lesions affecting the cartilaginous end-plate, the vertebral bone, the posterior intervertebral ligament, the epidural fat, and the dura mater were verified at laminectomy, which had become necessary due to functional motor deterioration.  相似文献   

15.
同种异体骨板覆盖预防椎板切除术后硬膜外粘连临床应用   总被引:1,自引:0,他引:1  
目的探讨同种异体骨板覆盖在预防椎板切除术后硬膜外粘连方面的疗效。方法对58例腰椎间盘突出或腰椎管狭窄患者,行全椎板切除,“H”形同种异体冻干辐照骨板覆盖。观察临床症状及CT、MR I表现。结果术后随访6个月~2.5年,CT、MR I椎管扩大,骨板无倾斜、移位,脊髓无压迫,无排异反应;术后椎管内容物形态良好,骨板两侧已与相邻接触骨组织融合,密度相等。结论同种异体冻干辐照骨板具有良好的生物相容性、生物力学性能和诱导成骨作用,是一种良好的硬膜外覆盖材料,能有效阻止硬膜外粘连,防止椎管术后再狭窄,可用于节段性椎管覆盖成型术。  相似文献   

16.
目的观察前后路一期减压、植骨、内固定治疗脊髓前后方均受压的下颈椎损伤的疗效。方法对本组自2004年1月至2005年12月5例下颈椎骨折脱位并脊髓损伤接受手术治疗的患者,进行回顾性分析。其中后路椎板切除、前路椎间盘切除、植骨颈椎前路钢板内固定术2例;后路椎板切除、前路病椎次全切除、钛网植骨融合钢板内固定术1例;后路椎板切除小关节复位、小关节间植骨侧块钢板内固定术、前路椎间盘切除、植骨术内固定2例。结果脱位均获完全复位,脊髓获得有效减压,椎间植骨6个月后均获骨性融合。4例脊髓功能有不同程度恢复,术中无重要神经、血管、气管及食道损伤,未发生术后消化道应激性溃疡。结论早期前后联合入路治疗下颈椎骨折脱位并脊髓损伤安全、有效。  相似文献   

17.
Recombinant osteoinductive proteins have been used successfully in canine and rabbit models of posterolateral intertransverse process arthrodesis, but little is known about the ability of these compounds to achieve fusion in nonhuman primates. The goals of this investigation were to compare different combinations of recombinant human bone morphogenetic protein-2 (rhBMP-2) dosages and carriers in a nonhuman primate model of posterolateral intertransverse process spinal fusion and to determine the feasibility of using rhBMP-2 in the presence of exposed dura in a laminectomy model. Posterolateral intertransverse process arthrodeses were performed at L4-5 in 29 rhesus monkeys. The most striking findings were as follows: rhBMP-2 could induce bone in a nonhuman primate spine; the presence of a laminectomy defect with exposed dura did not preclude the safe use of rhBMP-2 for posterolateral fusion; soft tissue compression of the collagen sponge carrier prevented bone induction at standard BMP doses, presumably due to squeezing of the protein out of the sponge; and longer rhBMP-2 loading time into the collagen carrier and mechanical protection from the soft tissue compression both allowed more bone induction at a lower dose of rhBMP-2.  相似文献   

18.
几丁糖膜预防椎板切除术后硬膜周围粘连的实验研究   总被引:10,自引:0,他引:10  
目的:观察几丁糖膜对预防椎板切除术后硬膜周围粘连的作用。方法:24只成年新西兰白兔L3、L5水平切除椎板10×05cm,L3硬膜外放置几丁糖膜(A点),L5作为空白对照(B点)。分别于术后3周、6周、12周进行大体形态、组织学观察。结果:A点硬膜与瘢痕无明显粘连,硬膜外有空隙,未见明显异物、炎症反应;B点硬膜与瘢痕紧密粘连,瘢痕侵入椎管内,对硬膜有压迫。结论:几丁糖膜具有明显的预防硬膜周围粘连的作用。  相似文献   

19.
目的探讨后路脊柱固定联合双侧经腹膜外病灶清除术治疗腰骶椎结核的临床疗效。方法2000年3月-2005年2月,采用后路脊柱固定、双侧经腹膜外病灶清除术治疗16例椎体结核患者。男11例,女5例;年龄21~56岁。结核部位:L3 4例,L4 6例,L5 4例,S1 2例。其中累及3个椎体1例,跳跃病变1例。病程6个月~6年,平均13个月。16例血沉平均40mm/h;14例WBC正常,2例稍高。X线片检查示5例椎间隙破坏变窄,7例出现病椎压缩,1例相邻2个椎体破坏严重,残余骨质嵌插重叠;16例均可见双侧腰大肌脓肿。16例CT扫描可见椎体骨质破坏、脓肿形成及数量不等的死骨。11例MRI显示椎体破坏、脓肿形成并流注到腰大肌内。患者术后进行常规抗痨治疗。结果1例术后1个月切口裂开,经对症处理后愈合;余患者切口均Ⅰ期愈合。患者获随访2~5年,平均29个月。术后即出现双大腿麻木3例,足背伸无力1例,大小便失禁1例,未作特殊处理,2周后均恢复正常;1例出现腹股沟斜疝,未作处理:6例出现视物模糊、眼睛干涩等:2例出现听力障碍,调整用药后恢复;1例再次出现低热、腰痛,卧床3个月并调整延长应用抗痨药物后痊愈。余患者均无复发。血沉均恢复正常,随访末期X线片示腰椎、腰骶椎获骨性融合13例,后凸畸形1例,椎体间形成骨桥2例。结论一次手术完成后路脊柱固定、双侧经腹膜外病灶清除术治疗腰骶椎结核有较高的安全性、可行性,可减少手术次数、缩短治疗周期、降低治疗费用、提高治疗效果。  相似文献   

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