Discopathy in lumbar spinal stenosis

Background. In a group of patients treated surgically for stenosis in the lumbar spine, we compared the pre-operative nature of the pathology of the intervertebral disc as measured by MRI to the treatment outcome. Material and methods. In 30 persons ranging in age from 39 to 68 who reported at least 60% subjective improvement in quality of life after surgery (wide decompression of the spinal canal in the lumbar segment, spondylodesis, transpedicular fixation) the character of the discopathy was evaluated by MRI. Results. In MRI studies from the study group, feature of dehydratation and protrusion of the nucleus pulposus occurred among all patients, while the most common clinical symptom was neurogenic claudication. Non-removal of intervertebral discs protruding less than 6 mm into the lumen of the spinal canal did not cause worse outcome. Conclusion. In this group of patients treated surgically for lumbar stenosis with wide decompression, the fact that a slight protrusion of the intervertebral disc (prolapse <6mm) persists after surgery, in the absence of conflict between the disc and nerve elements, has no influence on treatment outcome.     

Value of diagnostic methods in diagnosis of the disc disease

Background. Injury of the intravertebral disc after precise clinical evaluation should be confirmed by different radiographic methods. Although diagnostic methods have recently progressed, there are still problems with proper diagnosis concerning the level of pain provocation.
The aim of this study was a comparison of clinical signs of disc prolapse with different radiographic methods and intraoperative findings.
Material and methods. 180 histories of patient treated in the Orthopaedic Clinic of Medical Centre for Postgraduate Education between 1994-2002 were analysed. The most frequent was Lasegue's sign and spine movement limitation. All patients underwent lumbar spine x-ray in order to eliminate bone pathologies of vertebrae. Before making - of operative treatment a decision of magnetic resonance imaging or computer topography were always done. Radiculography was performed only in cases of multilevel disc hernitation and when clinical signs were not obvious.
Conclusions.
1.Clinical examination and first of all different intensity of pain (over 4 degrees in VAS scale) and radiographic imaging were followed by MRI or CT in order to confirm the diagnosis.
2.CT allowed to precise a diagnosis in the case of diagnostic uncertainty among patients with long history of back pain.
3.Compatibility of x-ray (narrowing of vertebral space) with intraoperative findings was 80%. Compatibility of MRI was 96%, and computer tomography 94%.
     

Differential diagnosis of post-surgery scars and recurrent lumbar disc herniation in MRI

Background. Spine MR had a significant progress on disc disease diagnosis, reasons of operative treatment failure, and reccurrence of pain.
The aim of the study was to estimate by the use of MRI the causes of pain among patient after discectomy, and to compare them with intraoperative findings.
Material and methods. Between 1994-1998 in the Orthopaedic Clinic in Otwock 42 patients (18 women and 24 men) who underwent discectomy were examined. They suffered from steady back and leg pain. On the base of standard MRI it was not possible to precisely diagnose the cause of pain. A introduction of paramagnetic
Gd-DTPA allowed more precise diagnosis and to ascertain if pain is caused by recurrence of disc hernitation or postoperative scar.
Conclusions.
1. MR was an examination of choice in postoperative diagnosis in disc disease.
2. An examination with Gd-DTPA contrast enhanced allows to differentiate between postoperative scar and recurrent disc herniatation.
3. If postoperative scar is confirmed, the indication for reoperation should be raised very carefully.
     

兔腰椎间盘髓核穿刺抽吸后的影像及组织病理学变化

背景：髓核摘除后椎间盘会随时间出现什么样的影像学及组织病理学变化,目前尚不明确。目的：观察兔腰椎间盘髓核穿刺抽吸术后影像学及组织病理学的变化。方法：32只日本大耳白兔,用21号针头行L3“椎间盘后外侧穿刺抽吸出部分髓核组织,L2/3椎间盘作为正常对照椎间盘,于抽吸后2,4,8,12周时按照分组取8只兔子行腰椎侧位X射线检查,测量L3/4、L2／3椎间隙高度并计算椎间盘高度指数,行正中矢状位MRI检查及椎间盘组织病理学检查。结果与结论：髓核抽吸后2,4,8,12周椎间盘高度呈逐渐降低趋势,但8-12周变化减小,与正常对照组椎间盘相比,各时间点椎间盘高度指数显著降低（尸〈0．05）。抽吸后2,4,8,12周的髓核信号强度随时间逐渐降低,8周时已达改良Thompson分级标准的4级。抽吸后凝胶状髓核组织随时间逐渐出现裂隙,形态逐渐紊乱,12周时呈现明显的纤维化表现,髓核4周时出现较多的类软骨细胞,呈现活跃状态,髓核细胞明显减少,抽吸后8．12周髓核内纤维样细胞增多,类软骨细胞数量减少,纤维环随时间逐渐出现扭曲,排列紊乱,突起,出现分层、纤维断裂现象。说明后外侧纤维环穿刺髓核抽吸后,兔腰椎间盘X射线高度、MRIT2加权信号强度随时间逐渐降低、减弱,椎间盘组织逐渐出现退变病理改变,但8—12周其变化趋于缓和。     

Indications and range of surgery in the treatment of spine metastatic tumours

Background. Spine is the most common place of metastatic tumors in the skeletal system. Due to diagnostic problems and the risk of quickly increasing neurological defects, the treatment of metastatic spine tumors is a significant clinical problem. The goal of surgical treatment is decreasing pain, neurological improvement and achieving full spinal stability.
Material and methods. Material consists of 31 patients with metastases in spine, who underwent spine surgery. Tumors were placed in thoracic spine at 48% patients, at lumbar spine - 42% patients, and at cervical spine in 10% patients; one level was involved in 56% cases, two or more levels - in 44 % cases. Qualification for surgery contained: the type of primary tumor, the amount of metastases to the spine impairment of spinal biomechanics and overall patient's condition of the. Corporectomy with anterior stabilization (intervertebral cage) was performed at 13 patients, and with additional anterior implants at 2 cases. At 8 patients, with destabilization of posterior spinal column, in spite of corporectomy, posterior stabilization was done. Surgery from posterior approach was performed in 3 cases.
Results. After operation, we noted pain relief at 34% of patients, while in 14% of them transient increase of pain occurred. Neurological status worsened after surgery at 1 patient. We achieved proper spine stabilization, without the need of use of external orthoses at 30 patients. At one patients, reoperation with change of implants and the range of stabilization was necessary. The amount of complications correlated with patient's general condition at the time of surgery.
Conclusions. 1. The main condition of success in operative treatment of spinal metastatic tumors is individual patient's qualification for surgery, including the extent of disease and general patient's condition. 2. Good stabilization with use of implants is a necessary element of surgery of spinal metastases from both anterior and posterior approach.     

MR动态增强成像在腰椎间盘术后再发腰腿痛原因鉴别中的应用

目的：探讨低场MR动态增强扫描对鉴别腰椎间盘术后再发腰腿痛原因的价值。方法：腰椎间盘突出术后再发腰腿痛患者12例作为研究对象，先行CT或MR平扫，选取把硬膜外异常组织层面确定为动态MR扫描层面，然后静脉注射钆-喷替酸葡甲胺（Gd-DTPA 0．1 mmol／kg），每隔4min扫描1次，共扫描8次，并分别测量硬膜外各异常组织的强化程度，将其强化率随时间变化绘成曲线图。并与再手术及病理作对照。结果：12例中再发腰腿痛患者MR动态增强扫描显示硬膜外异常组织主要分为两类，一类硬膜外两种异常强化组织7例，MR表现为周围组织明显强化，且于8min左右强化达到高峰，然后逐渐缓慢减弱．中央组织轻度延时强化，病理为周围新鲜瘢痕组织包绕退变的髓核组织。另一类硬膜外一种异常组织，其中一种强化较为明显．病理证实为瘢痕，硬膜外与椎旁瘢痕强化相似，差异无显著性（P〉0．05），另一种强化弱，手术证实为再突出椎间盘。椎管内硬膜外瘢痕与再突出椎间盘的强化差异有显著性（P〈0．05）。12例中，单纯再突出3例。单纯瘢痕形成2例，再突出合并周围瘢痕组织形成7例。结论：利用MR动态增强扫描对于鉴别腰椎间盘术后再发腰腿痛原因（主要为硬膜外瘢痕与椎间盘疝复发）有重要价值。[著者文摘]     

人工髓核置换腰椎间盘成形术改善患者腰腿痛症状及腰椎活动度33例随访观察

背景人工髓核椎间盘成形术与人工椎间盘置换术相比,其手术创伤小,操作简单,手术风险也较小.目的观察人工髓核假体置换术对腰椎间盘突出症患者症状的恢复及腰椎活动度改善的效果.设计以患者为观察对象的自身前后对照.单位南方医科大学珠江医院骨科.对象2002-01/2003-10南方医科大学珠江医院收治的腰椎间盘突出症患者施行人工髓核置换术33例,男21例,女12例.方法患者均行人工髓核置换椎间盘成形术.术后3个月复查腰椎X射线观察椎间隙高度和形态.随访8个月.根据患者腰椎间盘突出症症状恢复情况(分为优、良、进步、差)进行腰椎功能测评.主要观察指标患者术后腰腿痛症状及腰椎活动度.结果按意向处理分析,33例患者均进入结果分析.随访时患者腰腿痛症状及腰椎活动度优29例,良好3例,差1例,优良率为96.97%(32/33).术后3个月X射线片显示29例保持正常形态和高度,3例未达到正常的高度,但较术前有增高,未发现邻近椎间隙退行性变加重.结论人工髓核置换椎间盘成形术可以有效的缓解患者腰腿痛症状,恢复脊柱节段的运动,减少邻近椎间隙和关节突的退行性变.     

经皮纤维环穿刺法建立兔椎间盘退行性变动物模型

背景:合适的椎间盘退变动物模型是椎间盘组织工程研究的必要条件,但目前尚缺乏公认的模型制备方法。目的:采用C形臂辅助下经皮纤维环穿刺法制备兔椎间盘退变动物模型,并评估其可行性。方法:选定新西兰大白兔L2/3和L3/4椎间盘作为穿刺干预椎间盘,L1/2和L5/6椎间盘作为空白对照组,采用C形臂辅助下经皮穿刺法干预椎间盘。于术后2,4,8,12周各选择2只兔麻醉后拍摄兔腰椎核磁共振影像,处死动物采集椎间盘,进行椎间盘髓核蛋白多糖测定。核磁共振检查观察椎间盘退行性改变,二甲基亚甲蓝染色分光光度法测定髓核中蛋白多糖含量变化。结果与结论:术后4周穿刺干预椎间盘髓核区域核磁共振信号强度及髓核内蛋白多糖含量同空白对照组相比均下降(P<0.05),其后两者呈现逐渐下降趋势。结果证实,C形臂X射线机辅助下经皮纤维环穿刺法可用于椎间盘退变动物模型的制备。     

无症状大学生腰椎间盘MRI信号变化及其临床意义

目的分析无症状大学生腰椎间盘MRI信号变化及临床意义。材料与方法对62名18～27岁的无症状大学生志愿者行MRI检查,由2名医学影像科医师对志愿者MR图像进行指导分析,记录腰椎间盘的表现,包括:变性、膨出、突出、游离以及椎间盘与神经根的关系。结果 62例无症状大学生志愿者中,腰椎间盘正常39名(62.9%),异常23例(37.1%)。椎间盘变性18例(21例次),其中变性伴膨出2例(2例次),变性伴突出7例(7例次);椎间盘膨出7例(8例次);椎间盘突出8例(8例次);未见游离或椎间盘与神经根受压者。结论无症状大学生的腰椎间盘可出现变性、膨出、突出,医师在临床诊治时应慎重,避免漏诊误诊。     

Fabrication of a novel whole tissue-engineered intervertebral disc for intervertebral disc regeneration in the porcine lumbar spine

Tissue-engineered intervertebral discs (IVDs) have been proposed as a useful therapeutic strategy for the treatment of intervertebral disc degeneration (IDD). However, most studies have focused on fabrication and assessment of tissue-engineered IVDs in small animal models and the mechanical properties of the scaffolds are far below those of native human IVDs. The aim of this study was to produce a novel tissue-engineered IVD for IDD regeneration in the porcine lumbar spine. Firstly, a novel whole tissue-engineered IVD scaffold was fabricated using chitosan hydrogel to simulate the central nucleus pulposus (NP) structure, surrounded with a poly(butylene succinate-co-terephthalate) (PBST) fiber film for inner annulus fibrosus (IAF). And, a poly(ether ether ketone) (PEEK) ring was used to stimulate the outer annulus fibrosus (OAF). Then, the scaffolds were seeded with IVD cells and the cell-scaffold hybrids were transplanted into the porcine damaged spine and harvested at 4 and 8 weeks. In vitro cell experiments showed that IVD cells distributed and grew well in the scaffolds including porous hydrogel and PBST fibers. After implantation into pigs, radiographic and MRI images indicated that the tissue-engineered IVD construct could preserve the disc height in the case of discectomy as the normal disc height and maintain a large extracellular matrix and water content in the NP. Combined with the histological and gene expression results, it was concluded that the tissue-engineered IVD had similar morphological and histological structure to the natural IVD. Moreover, after implantation for 8 weeks, the tissue-engineered IVD showed a good compressive stress and elastic moduli, approaching those of natural porcine IVD. Therefore, the prepared tissue-engineered IVD construct had similar morphological and biofunctional properties to the native tissue. Also, the tissue-engineered IVD construct with excellent biocompatibility and mechanical properties provides a promising candidate for human IDD regeneration.

A novel whole tissue-engineered IVD consisting of a triphasic scaffold demonstrated excellent biocompatibility and mechanical properties in the porcine lumbar spine.     

与人工髓核置换相关的国人腰椎间盘结构测量

背景:临床多根据影像资料中腰椎间盘径线尺寸来选择假体型号和预计置入数量。目的:以X射线片和MRI测量分析正常人腰椎间隙高度、腰椎间盘及髓核径线,获取与人工髓核假体相关的椎间盘基础数据。方法:随机抽取157名正常成年人标准腰椎侧位X射线片,测量腰椎间隙前缘、中点和后缘高度。随机抽取106名正常成年人腰椎MRI片,测量椎间盘及髓核的横径和矢状径。结果与结论:①X射线片:椎间隙自上而下逐渐增宽,腰椎间隙后高较低,近50%的L2/3、L3/4、L4/5椎间隙后高和约39.5%的L5/S1椎间隙后高位于7～9mm区间。②MRI片:腰椎间盘横径和矢状径从L2/3至L5/S1依次增大。约46.7%的椎间盘矢状径大于37mm,仅49.0%的髓核矢状径大于24mm;本组髓核平均横径33.5mm,平均矢状径23.4mm。髓核矢状径均大于12mm。约22.9%的髓核矢状径大于24mm。提示多数国内患者需行单枚PDN假体置入,7mm为最适用的PDN假体高度,临床不宜将椎间盘矢状径大于37mm作为国人PDN假体置入数量的术前预评价指标。     

Disc herniation diagnosis in MRI using a CAD framework and a two-level classifier

Purpose

Disc herniation in the lumbar spine is a common condition, so an automated method for diagnosis could be helpful in clinical applications. A computer-aided framework for disk herniation diagnosis was developed for use in magnetic resonance imaging (MRI).

Materials and Method

A computer-aided diagnosis framework for lumbar spine with a two-level classification scheme for disc herniation diagnosis was developed using heterogeneous classifiers: a perceptron classifier, a least mean square classifier, a support vector machine classifier, and a k-Means classifier. Each classifier makes a diagnosis based on a feature set generated from regions of interest that contain vertebrae, a disc, and the spinal cord. Then, an ensemble classifier makes a final decision using score values of each classifier. We used clinical MR image data from 70 subjects in T1-weighted sagittal view and T2-weighted sagittal view for evaluation of the system.

Results

MR images of 70 subjects were processed using the proposed framework resulting in successful detection of disc herniation with 99% accuracy, achieving a speedup factor of 30 in comparison with radiologist??s diagnosis.

Conclusion

The computer-aided framework works well to diagnose herniated discs in MRI scans. We expect the framework can be adapted to effectively diagnose a variety of abnormalities in the lumbar spine.     

经皮纤维环穿刺法建立兔椎间盘退行性变动物模型

背景：合适的椎间盘退变动物模型是椎间盘组织工程研究的必要条件,但目前尚缺乏公认的模型制备方法。目的：采用C形臂辅助下经皮纤维环穿刺法制备兔椎间盘退变动物模型,并评估其可行性。方法：选定新西兰大白兔L2/3和L3/4椎间盘作为穿刺干预椎间盘,L1/2和L5/6椎间盘作为空白对照组,采用C形臂辅助下经皮穿刺法干预椎间盘。于术后2,4,8,12周各选择2只兔麻醉后拍摄兔腰椎核磁共振影像,处死动物采集椎间盘,进行椎间盘髓核蛋白多糖测定。核磁共振检查观察椎间盘退行性改变,二甲基亚甲蓝染色分光光度法测定髓核中蛋白多糖含量变化。结果与结论：术后4周穿刺干预椎间盘髓核区域核磁共振信号强度及髓核内蛋白多糖含量同空白对照组相比均下降（P〈0.05）,其后两者呈现逐渐下降趋势。结果证实,C形臂X射线机辅助下经皮纤维环穿刺法可用于椎间盘退变动物模型的制备。     

综合康复治疗腰椎间盘突出症疗效的MRI观察

目的通过分析患者治疗前、后腰椎间盘突出及其周围结构的形态变化的MRI表现，判断综合康复治疗腰椎间盘突出症的疗效。方法腰椎间盘突出症患者40例，采用物理因子、药物、牵引、推拿、医疗体操进行30d的综合康复治疗。疗程结束后对患者进行腰椎MRI复查，评估治疗效果及治疗前、后突出椎间盘及其周围结构的形态变化。结果综合康复治疗腰椎间盘突出症的有效率为82．5％，治疗前、后的腰椎间盘MRI信号强度、厚度、突出的程度、椎管前后径与横径、侧隐窝宽度等的差异均无统计学意义。结论综合康复疗法不能对腰椎间盘突出症的形态改变产生明显影响，但可有效缓解或消除腰椎间盘突出症患者的临床症状。     

CT检查在牵引治疗腰椎间盘突出症中的评估作用

TherearemanykindsoftherapiestoLumbardiscprotrusion（LDP），inwhichtractionisonekindofeffectivenon－operativemethod；CTiseffectiveandpreferredexaminationmethodtodiag－noseLDP．WeanalyzedclinicalmanifestationsandCTimagesof５８lumbardiscprotrusioncasesthatwerediagnosedbyCTandtreatedwithtractiontherapybeforeandaftertreatmentandassessedfunctionoftractiontherapytoLDP．１Subjectandmethod１．１SubjectWecollected５８LDPcasesthattreatedwithtractiontherapyfromOctober１９９７toJune２００１，inclu…     

犬椎间盘经皮针刺退变模型的建立

背景:普通针头穿刺纤维环是目前较为公认的理想椎间退变模型制作方法,但存在对动物损伤大,操作不简捷等缺点。目的:尝试在C臂机透视下经皮穿刺比格犬腰椎椎间隙建立腰椎间盘退变动物模型。方法:选用8只健康成年犬,行腰椎MRI后在C臂机下经皮穿刺椎间隙,损伤L5/6椎间盘。术后3,6个月行腰椎MRI后,取标本行免疫组织化学观察椎间盘退变情况。结果与结论:经皮椎间盘穿刺后3,6个月,L5/6椎间盘均出现了明显退变,MRI显示T2值均出现明显降低,并且椎间盘大多出现不同程度椎间盘突出征象;L5/6穿刺节段髓核Ⅱ型胶原阳性细胞含量较L4/5髓核均明显减少(P<0.05)。说明经皮穿刺损伤椎间盘建立犬椎间盘退变模型是一种简单有效、重复性好的建模方法。     

Effects of standing on lumbar spine alignment and intervertebral disc geometry in young,healthy individuals determined by positional magnetic resonance imaging

BackgroundMost diagnostic imaging of the spine is performed in supine, a relatively unloaded position. Although the spine is subjected to functional loading that changes the spinal alignment and intervertebral disc geometry, little data exists on how healthy spines adapt to standing. This study seeks to quantify the changes of the lumbar spine from supine to standing in young, back-healthy individuals using a positional magnetic resonance imaging system.MethodsThis is an observational study that examined the changes in the lumbar spine alignment and intervertebral disc geometry between supine and standing of forty participants (19 males/21 females) without a history of low back pain. The regional lumbar spinal alignment was measured by the sagittal Cobb angle. Segmental intervertebral disc measurements included the segmental Cobb angle, anterior-to-posterior height ratio, and intervertebral disc width measured at L1/L2 - L5/S1 levels. Intra-class correlation was performed for intra- and inter-observer measurements.FindingsThe intra-observer intra-class correlation consistency model ranged from 0.76 to 0.98 with the inter-observer correlation ranging from 0.68 to 0.99. The Cobb angle decreased in standing. The L5/S1 segmental Cobb angle decreased in standing. The L2/L3 and L3/L4 anterior-to-posterior height ratios increased and the L5/S1 anterior-to-posterior height ratio decreased in standing. No difference in intervertebral disc widths was observed from supine to standing.InterpretationsWe established normative data for a back-healthy population, using a positional magnetic resonance imaging system, that could inform future investigations that examine the standing-induced adaptations of the lumbar spine in individuals with spinal or intervertebral disc pathologies.     

腰骶椎矢状位形态学改变与椎间盘退变的MRI评价

背景：目前关于椎间盘退变在MRI上的影像学表现及其与下腰痛的关系报道甚多,但腰骶椎矢状位形态学改变与椎间盘退变程度的关系国内尚未见相关报道。目的：观察下腰痛患者腰骶椎矢状位形态学改变与椎间盘退变的关系,并探讨其临床意义。方法：对主诉下腰痛来安徽医科大学第一附属医院门诊就诊并行MRI检查的患者做回顾性分析,选择年龄20～30岁的女性患者167例,在MRI正中矢状面的T2W1图像上观察椎间盘的信号改变及退变程度,评价退变分级,测量每个患者的腰椎前凸角,骶骨平台角及骶椎后凸角度。结果与结论：椎间盘退变组与无椎间退变组腰椎前凸角分别为（24.31±3.48）°和（26.29±3.74）°,差异有显著性意义（P=0.001）;骶骨平台角分别为（102.97±5.58）°和（100.70±3.26）°,差异有显著性意义（P=0.002）;骶骨后凸角分别为（163.45±7.03）°和（167.24±6.71）°,差异有显著性意义（P=0.001）。提示腰椎前凸角、骶骨后凸角、骶骨平台角是评价椎间盘退变程度的形态学参数,腰椎前凸角和骶骨后凸角随椎间盘退变加重而减小,骶骨平台角随椎间盘退变加重而增大。     

Computed tomography diagnostic of the intervertebral disc degeneration and degenerative changes of the lumbo-sacral spine

Background. The aim of the work is problem of computed tomography diagnostic of the intervertebral disc degeneration and degenerative changes of the lumbo-sacral spine.
Authors present result of computed tomography examinations performed in 60 patients at the age from 18 to 69 years, suffering from chronic low back pain for 6 months at least.
Material and methods. Degenerative changes of the vertebra-disc junction on the levels of L3-L4, L4-L5 and L5-S1 were evaluated. The analysis of intervertebral disc changes and osteophytes presence on all of the investigated levels was chose as the assessment criterion.
Results. The pathological changes of the vertebra-disc junction on L5-S1, L4-L5 and L3-L4 levels were stated in 58 (96.6%), 55 (91.6%) and 47 (78.8%) patients, whereas the degeneration of the intervertebral disc was diagnosed in 50, 45 and 15 cases, respectively. Moreover, the vacuum phenomenon was present in connection with the degeneration of the intervertebral disc on L5-S1, L5-L4, L3-L4 levels in 29, 11 and 1 cases, respectively. The osteophytes' presence, as a single proof of the degenerative changes was diagnosed in 8 patients on L5-S1 level, whereas on L4-L5 level in 10 patients. In 32 cases osteophytes were localised on L3-L4 level.
Conclusions. In conclusion, the differences in morphology of the pathological changes are the result of different loading and various mechanisms generating these changes on particular levels.     

兔腰椎间盘退行性病变模型的建立及影像学改变

背景：建立最佳的椎间盘退行性病变动物模型对了解椎间盘退行性病变的发生机制、预防与治疗均具有重要意义。 目的：以针刺损伤制备兔椎间盘退行性病变模型，通过X射线及MRI分析针刺损伤对椎间盘高度及退行性病变的影响。 设计：随机对照观察。 单位：解放军第二军医大学长海医院骨科。 材料：实验于2005—06／2006—04在解放军第二军医大学长海医院动物中心完成，选用6只健康新西兰大白兔，雌雄不拘，平均6月龄，体质量平均为2．5kg，均来自解放军第二军医大学长海医院动物中心，许可证号码为SCXK（hu）2002-0006。实验过程中对动物的处置符合动物伦理学标准。 方法：①采用腹膜后入路对实验兔腰椎进行手术，以L3-4椎间盘为正常对照，不做处置；L4-5椎间盘作为假手术，只进行暴露；L5-6椎间盘暴露后用24G针头从椎间盘的前外侧针刺3次。②分别于术前及术后4周采用Simens公司CR机拍摄腰椎正侧位X射线片，测量L3-4，L4-5及L5-6椎间隙高度，计算与术前椎间隙高度比值；采用Simens Avanto 1．5T医用超导型磁共振扫描仪检测各节段腰椎间盘T2加权信号，根据信号强度记分，4分为正常椎间盘，髓核内信号均匀、明亮：3分为轻微退行性病变椎间盘，T2加权信号部分降低：2分为中度椎间盘退行性病变，T2加权信号明显降低；1分为重度椎间盘退行性病变，其T2加权信号明显降低，而且伴有椎间隙狭窄。 主要观察指标：①腰椎X射线侧位片椎间盘高度变化。②椎间盘退行性病变程度。结果：纳入实验兔6只，均进入结果分析，无脱落。①椎间盘高度变化：L3-4及L4-5术后与术前椎间盘高度比分别为0．9825±0.01708，0．9725±0．01708，均高于L5-6椎间盘高度比（0．5500±0．02582），差异有统计学意义（P〈0．01）。②腰椎MRI的T2加权像上观察椎间盘退行性