7.0T Micro MRI 观察丝裂霉素C预防硬膜外粘连的效果研究

目的:应用7.0T Micro MRI探讨预防椎板切除后硬膜外粘连实验研究中丝裂霉素C(MMC)的理想浓度及其使用安全性。方法:30只SD大鼠随机分成5组,每组6只。分别切除L1椎板,术中各组分别以棉片浸透生理盐水(A组)或0.1mg/ml(B组)、0.3mg/ml(C组)、0.5mg/ml(D组)、0.7mg/ml(E组)的MMC,置于裸露的硬脊膜后5min。应用MMC前后分别对大鼠行体感诱发电位测定。术后4周处死大鼠取手术段脊柱,分别做MicroMRI扫描、瘢痕组织面积测定、肉眼观察硬脊膜与后方瘢痕组织粘连情况。结果:A组标本硬膜外瘢痕组织致密,瘢痕面积大,与硬脊膜形成紧密粘连。B组和C组标本硬膜外瘢痕组织不致密,瘢痕面积减小,与硬脊膜部分粘连。D组和E组标本硬膜外瘢痕组织不致密,瘢痕面积更小,与硬脊膜未形成明显粘连。大鼠应用MMC前后体感诱发电位无明显改变。结论:局部应用浓度为0.5mg/ml的MMC能有效减少硬膜外瘢痕组织增生,避免椎板切除术后硬膜外瘢痕粘连,并且安全。0.5mg/ml浓度的MMC可能是椎板切除后预防硬膜外粘连理想的浓度选择。

Experimental study on prevention of peridural adhesion with topical mitomycin C by 7.0T Micro MRI

Objective:To study the suitable concentration and the security of topical mitomycin C(MMC) in preventing postlaminectomy peridural adhesion by 7.0T Micro MRI. Methods:Laminectomies were performed at L1 in 30 rats. Cotton pads soaked either with 0.1 mg/ml(group B),0.3 mg/ml(group C),0.5 mg/ml(group D),0.7 mg/ml(group E) MMC,or saline(group A) were applied to the operative sites for five minutes. To determine the somatosensory evoked potential(SEP), the rats were killed 4 weeks after surgey. The specimens were prepared for determination of the degree of scar adhesion according to Rydell method and the area of the scar with MRI. Results:No obvious adhesion were found in group D and group E. Severe peridural adhesion were formed in the control group(group A). The area of the scar with Micro MRI in group D and E showed significant decrease. The SEP did not alter obviously. Conclusion:0.5 mg/ml MMC may be suitable concentration in preventing postlaminectomy peridural adhesion.