阻断双侧终板营养途径构建山羊椎间盘退变模型

目的通过建立山羊腰椎双侧终板营养途径阻断的动物模型,观察椎间盘退变(IDD)的情况,研究椎间盘营养途径与IDD的相关性。方法选取8只24月龄雌性关中山羊,每只山羊L2~3、L3~4作为实验椎间盘,麻醉后在平行于终板2 mm的椎体骨质处造成骨缺损,并使用骨水泥填塞,阻断椎体和终板之间的营养通路,L1~2、L4~5作为对照椎间盘。分别于术后4、12、24、48周行X线、MRI检查,各时间点随机处死2只山羊,采集椎间盘标本,计算骨水泥有效阻断面积、椎间高度指数(DHI)和Pfirrmann分级,并行HE、Masson三色、蛋白多糖、番红O染色组织学检查。结果术后骨水泥有效阻断面积达49.6%~69.6%(60.7%±5.3%)。术后48周时实验椎间盘DHI百分比为60.5%~81.7%(72.7%±5.6%),椎间高度丢失较对照差异有统计学意义(P<0.01);术后48周时实验椎间盘Pfirrmann分级为3~5(4.0±0.7)分,较对照差异有统计学意义(P<0.01)。组织学检查证实,实验椎间盘术后12周即发生退变,并随时间(24、48周)逐步加重。结论骨水泥填塞阻断双侧终板营养途径可以构建山羊IDD的动物模型,阻断终板营养途径可以导致IDD发生。     

Magnetic resonance imaging of diseased cervical and lumbar intervertebral discs

Magnetic resonance images (MRI) of diseased cervical and lumbar intervertebral discs involving both intrinsic and extrinsic cord lesions were examined using either a 0.15 T resistive or a 0.5 T superconductive magnetic imaging system. High resolution images were obtained by means of a surface coil in most cases. The vertebrae, intervertebral discs, and spinal cord were delineated in greatest detail on spin-echo (SE) images with a long repetition time (TR) and a short echo time (proton density-weighted image), on which the spinal cord was appreciated without overshadowing by the cerebrospinal fluid-filled subarachnoid space. Protrusion of degenerated intervertebral discs into the spinal canal was clearly demonstrated not only on sagittal but also on parasagittal and transverse views. The location of protruded discs and compression of the spinal cord, caudal sac, and nerve roots were well visualized three-dimensionally. Pathological features of intervertebral discs were better appreciated on T2-weighted images with long TR and SE pulse sequences. Degeneration of intervertebral discs resulted in decreased signal intensity in cases involving lumbar disc lesions but not those involving cervical disc lesions. In a case of suspected myelomalacia, the intrinsic cord lesion resulting from traumatic disc protrusion appeared as focal low signal intensity on T1-weighted images and as somewhat high intensity on T2-weighted images. The inversion recovery sequence with median inversion time displayed an inferior image of low contrast and was judged uninformative in comparison to SE images. The authors' observations demonstrate that MRI is an essential diagnostic technique for spinal cord disorders.(ABSTRACT TRUNCATED AT 250 WORDS)     

Correlation of MR images of disc injuries with anatomic sections in experimental thoracolumbar spine fractures

This cadaver study evaluated the value of MR images for detection of acute intervertebral disc damage associated with fractures of the thoracolumbar spine. Damage to the intervertebral disc may be a major contributor to chronic instability in non-operative treatment or failure of fixation and recurrence of deformity in posterior fixation methods. MR imaging can help us to understand the injury patterns and their prognostic significance. However, before we can justify the use of MRI in clinical cases, determination of MRI’s ability to detect acute injury to the disc is necessary. Ten fresh cadaver specimens were used for this study. After obtaining radiograms and MR images, injuries were created with a weight-dropping apparatus using a variety of weights and compression angles. Post-injury radiograms and MR images were taken and the specimens were frozen at –20 °C. Slides of these specimens obtained with cryosection techniques were compared with MR images for evaluation of the damage to different parts of the discs. A total of 20 fractures were observed on cryosections. In 12 of the discs adjacent to fractured vertebral bodies, macroscopic damage was seen on the sections. These were all detected on the corresponding MR images. The study showed that MRI is able to detect acute, macroscopic injury to the intervertebral disc. It is therefore justified to use MR for the study of acute disc damage associated with thoracolumbar fractures. Received: 4 August 1998 Revised: 12 January 1999 Accepted: 27 January 1999     

Disc degeneration in magnetic resonance imaging. A comparative biochemical, histologic, and radiologic study in cadaver spines

Magnetic resonance imaging (MRI) findings of 89 autopsied intervertebral discs from 22 cadaveric lumbar spines were correlated with biochemical composition, conventional radiography, and histologic structure to study the nature of disc intensity changes seen in MRI. Discs with a low signal intensity on T2-weighted MRI were characterized by shortening of relaxation times, dehydration, and decreases in total proteoglycan content and chondroitin-keratan sulfate ratios in the nucleus pulposus. This corresponded well with previously published studies. In histologic structure, no obvious differences between MRI findings were found. In conclusion, a low signal intensity in a lumbar disc on T2-weighted MRI probably reflects a true biochemical disc degeneration, but its relation to structural degenerative changes is uncertain. Therefore, MRI seems to be a sensitive and a specific imaging modality for detecting pathologic biochemical disc changes in the spine of a young adult.     

退变椎间盘聚集蛋白聚糖中硫酸软骨素链变化的实验研究

目的：研究内破裂及突出椎间盘细胞合成的聚集蛋白聚糖中硫酸软骨素链（CS）在长度及数量分布上的变化.方法：将正常椎间盘、内破裂（IDD）及突出椎间盘（LIDP）髓核或纤维环的组织20mg培养于24孔板中,用放射性同位素35S-硫酸盐和3H-丝氨酸标记新合成的蛋白聚糖分子.将聚集蛋白聚糖单体从培养的组织片中提取,用四氢硼酸钠或木瓜蛋白酶消化后,凝胶包谱分析硫酸软骨链的变化特征.结果：IDD椎间盘组织内细胞合成的聚集蛋白聚糖内CS链的数量明显减少,但长度保持相对正常;突出椎间盘组织中CS的数量和长度有明显下降和缩短,CS链数量的减少较IDD组织中更为严重.结论：IDD组织合成CS的减少主要是由于生成的CS链数量减少所致,而数量的进一步减少以及CS链长度的缩短是LIDP组织中CS合成量下降的主要原因.     

Degeneration and the chemical composition of the human lumbar intervertebral disc

Fifteen lumbar spines were collected postmortem. The intervertebral discs were assigned morphological grades and were analyzed for water, collagen, and proteoglycan. In order of increasing degeneration, five grade 0, four grade 1, 45 grade 2, 12 grade 3A, and nine grade 3B discs were identified. The proteoglycan concentration fell progressively with increasing grade, although the concentrations of each component overlapped extensively among the grades. Grade 2 discs showed no consistent differences from adjacent grade 3A or 3B discs in the same spine. All discs in seven of the eight spines with grade 3A or 3B discs and all discs in three spines with no grade 3A or 3B discs had proteoglycan concentrations below 52 mg/g fresh weight. Four of five spines with at least one disc of proteoglycan concentration above this value contained no grade 3A or 3B discs. These observations support the hypothesis that low proteoglycan concentrations in all the discs of a spine precede degeneration.     

Variables affecting disc size in the lumbar spine of rabbits: anesthesia, paralysis, and disc injury

Methods have been developed that permit repetitive radiographic measurement of the lumbar intervertebral disc space in a rostral-caudal direction (width) in the anesthetized laboratory rabbit. Using isolated control discs and injured discs in which narrowing has been induced for chronic and acute periods, the widths of the lumbar intervertebral disc spaces determined ratio-graphically correlate with widths determined histologically (p less than 0.000, r = 0.75). Both an increase (widening) and a decrease (narrowing) in disc width were observed using radiography after different experimental treatments. Anesthesia and lower-body paralysis (an experimentally induced inability to bear weight on and to perceive a pinch stimulus in hind limbs) caused widening of the discs: anesthesia causing a general widening throughout the lumbar spine and lower-body paralysis causing a specific widening low in the lumbar spine. Both disc injection and piercing the disc with needles to recover nucleus pulposus material caused narrowing of the discs. Acridine-orange injection induced a narrowing accompanied by osteophytosis. Experimentally induced narrowing at L4-5 (the result of injury to the disc) resulted in narrowing also at L2-3. These findings are consistent with the hypothesis that in vivo disc-width size in the young rabbit depends on both the quantity of nucleus pulposus material and the force-generating activities of the adjacent spinal muscles, and that disc injury at one level stimulates narrowing at other levels.     

Experimental studies on the effects of recombinant human matrix metalloproteinases on herniated disc tissues--how to facilitate the natural resorption process of herniated discs.

PURPOSE: Recently, MMP-7 and MMP-3 have been found to play a crucial role in the natural resorption process of herniated discs. We therefore examined the role of these recombinant human matrix metalloproteinases (rh MMPs) in the treatment of herniated discs. METHODS: (a) Surgical samples of herniated disc were cultured in the presence or absence of rh MMPs, and wet weight was measured 24h later. (b) The rh MMPs were administered into normal rabbit intervertebral discs, and after 1 week spine samples were stained with Safranin O. (c) The rh MMPs were administered into canine herniated discs in vivo. Myelography and MRI were performed prior to and 1 week after administration. Spine samples were examined histologically. Whole disc tissue was collected, total protein was extracted, and Western blot analysis was performed. RESULTS: (a) Proteoglycan degradation was found in MMP-7, MMP-3, and chymopapain-treated samples. MMP-7 and chymopapain-treated samples displayed a significant loss in wet weight (p<0.01). (b) Normal disc tissues after administration of rh MMP-7, MMP-3, and chymopapain showed an extensive loss of Safranin O staining. (c) The rh MMP-7-treated discs had a marked decrease in protruded herniation by MRI. Herniated discs after administration of MMP-7 and chymopapain showed a significant decrease in protruded mass 7 days after administration compared with saline-treated discs when evaluated by myelography (p<0.01). The rh MMP-7-treated discs displayed a clear loss of Safranin O staining in the nucleus pulposus. Proteoglycan expression was barely detectable in disc tissues after MMP-7 administration, whereas obvious expression was obtained in saline-treated or untreated disc tissues. CONCLUSIONS: Exposure to rh MMP-7 resulted in promising proteoglycan loss in human surgical samples, normal rabbit intervertebral discs, and natural canine herniated discs. Administration of rh MMP-7 may facilitate the resorption process of herniated discs.     

椎间失稳致兔椎间盘退变磁共振影像计量分析

目的 :探讨由于椎间失稳诱发的椎间盘退变在磁共振成像 (magneticresonanceimaging ,MRI)中的表现。方法 :选用新西兰兔 15只 ,随机分为手术组 9只、对照组 6只 ,手术组沿L3～ 6棘突作后正中切口 ,剥离骶棘肌和关节突附丽肌肉 ,切除棘上、棘间韧带和关节突关节外后 1/ 2 ;对照组作相同皮肤切口即缝合。所有动物在标准条件下饲养 ,分别于术后 2、 4、 8个月行腰椎MRI检查及髓核信号值测量。结果 :术后 2～ 8个月 ,对照组腰椎未见异常 ,而手术组L3～ 6椎间盘则相继出现T2 加权像低信号、腰椎后凸畸形、T1加权像低信号、椎间盘后突和硬膜囊受压等改变。对手术组手术节段及其邻近节段椎间盘髓核信号值的定量分析显示 ,T2 加权像信号值减低在术后 2、 4、8个月均具有统计学意义 ,而T1加权像信号值减低在术后 8个月具有统计学意义 ;T2 信号值减低主要发生于术后 2个月 ,T1信号值减低发生于术后 8个月。结论 :脊柱失稳可诱发椎间盘退变。髓核T2 加权像低信号是椎间盘退变的早期和先发征象 ,T1加权像显示形态改变较好 ,但T1信号值在退变早期变化不明显。     

Disc degeneration of cervical spine on MRI in patients with lumbar disc herniation: comparison study with asymptomatic volunteers

An association between progression of cervical disc degeneration and that of lumbar disc degeneration has been considered to exist. To date, however, this association has not yet been adequately studied. Age-related changes in the cervical intervertebral discs were evaluated by magnetic resonance imaging (MRI) in patients with lumbar disc herniation, and compared with the MRI findings of healthy volunteers without lower back pain. The purpose of this study was to clarify whether the prevalence of asymptomatic cervical disc degeneration is higher in patients with lumbar disc herniation than in healthy volunteers. The study was conducted on 51 patients who were diagnosed as having lumbar disc herniation and underwent cervical spine MRI. The patients consisted of 34 males and 17 females ranging in age from 21–83 years (mean 46.9 ± 14.5 years) at the time of the study. The control group was composed of 113 healthy volunteers (70 males and 43 females) aged 24–77 years (mean 48.9 ± 14.7 years), without neck pain or low back pain. The percentage of subjects with degenerative changes in the cervical discs was 98.0% in the lumbar disc herniation group and 88.5% in the control group (p = 0.034). The presence of lumbar disc herniation was associated significantly with decrease in signal intensity of intervertebral disc and posterior disc protrusion in the cervical spine. None of the MRI findings was significantly associated with the gender, smoking, sports activities, or BMI. As compared to healthy volunteers, patients with lumbar disc herniation showed a higher prevalence of decrease in signal intensity of intervertebral disc and posterior disc protrusion on MRI of the cervical spine. The result of this study suggests that disc degeneration appears to be a systemic phenomenon.     

Effects of monopolar radiofrequency heating on intradiscal pressure in sheep.

BACKGROUND CONTEXT: No previous study has assessed the effect of monopolar radiofrequency (RF) heating on intradiscal pressure. PURPOSE: To determine the decrease in lumbar intradiscal pressure after monopolar RF heating. STUDY DESIGN/SETTING: Intradiscal pressure was measured in sheep lumbar discs treated with monopolar RF heating. METHODS: Two monopolar RF heat treatments at 90 degrees C were applied for 2 minutes each to lumbar intervertebral discs of sheep. Intradiscal pressure was measured in live sheep at 0, 7, 14, 21, and 28 days posttreatment. Pressure measurements were taken with a microtip pressure transducer. Electrodes were inserted but not activated in separate discs as a sham control. In vitro sheep spine of different age groups, loading conditions, and electrode orientations were similarly heat treated and intradiscal pressures were measured. RESULTS: Intradiscal pressure was significantly reduced 1 week after monopolar RF heating and remained stable through the 4-week observation period. The RF electrode orientation, the age, and the type of disc loading have significant effects on the amount of initial intradiscal pressure reduction. CONCLUSIONS: Monopolar RF heating can reduce intradiscal pressure in the lumbar spine of sheep.     

颈腰椎间盘病

目的： 探讨颈腰椎间盘病的特点和诊断。方法： 对近４ 年中的颈腰椎间盘突出症、退变性椎管狭窄和颈椎病并施行手术的１９ 例进行了分析。结果： 发现颈腰椎间盘突出症是本病的重要原因。结论： 根据临床症状、体征和影像学检查, 颈椎 Ｍ Ｒ Ｉ和腰椎 Ｃ Ｔ 检查, 是防范混淆和误诊的必要条件。     

Nitric oxide mediates the change of proteoglycan synthesis in the human lumbar intervertebral disc in response to hydrostatic pressure

STUDY DESIGN: This in vitro study clarifies the role of nitric oxide (NO) in human lumbar intervertebral disc metabolism. OBJECTIVE: To investigate the effects of NO on proteoglycan synthesis in human lumbar discs and to test the hypothesis that NO is a mediator of the changes in proteoglycan synthesis in response to hydrostatic pressure. SUMMARY OF BACKGROUND DATA: The authors have clarified that hydrostatic pressure has an apparent effect on proteoglycan synthesis as well as matrix metalloproteinase production in the intervertebral disc. The cellular mechanisms underlying the response of disc cells to hydrostatic pressure remain to be clarified. Herniated lumbar discs produce NO in response to interleukin (IL)-1 beta. In articular cartilage, NO mediates the change of proteoglycan synthesis by IL-1 or shear stress. METHODS: Fifty-eight lumbar intervertebral disc specimens were obtained from patients who had undergone posterior discectomy. The specimens were chopped into 1-2-mm cubes and were incubated in a plastic syringe with 1 mL Dulbecco's modified Eagle's medium (DMEM). The syringes were placed in a water-filled pressure vessel kept at 37 C. Hydrostatic pressures of 1 (control), 3, and 30 atmospheres (atm) were applied. Proteoglycan synthesis was determined from (35)S-sulfate incorporation rates. Nitrite (the stable oxidation product of NO) concentration in DMEM was determined by a spectrophotometric method based on the Griess reaction. As a competitive inhibitor of NO synthases, N(G)-methyl-l-arginine (l-NMA, 10-1000 micromol) and as an organic donor of NO, S-nitroso-N-acetylpenicillamine (SNAP, 1-200 micromol) were used. RESULTS: Addition of l-NMA suppressed NO production and increased proteoglycan synthesis rates in the intervertebral disc specimens in a dose-dependent fashion. Addition of SNAP increased exogenous NO content in the medium significantly and suppressed proteoglycan synthesis rates in a dose-dependent fashion. Three-atmosphere hydrostatic pressure stimulated the proteoglycan synthesis rates. Rates were approximately 1.3-fold greater than at 1 atm, whereas 30-atm pressure inhibited proteoglycan synthesis rates. However, the hydrostaticpressure had inverse effect on NO production. At 3 atm, NO production decreased slightly relative to 1 atm, whereas at a pressure of 30 atm, NO production was increased and was approximately 1.32-fold greater than at 1 atm. L-NMA enhanced the 3-atm pressure-induced increase in proteoglycan synthesis and also relieved the suppression of proteoglycan synthesis at a pressure of 30 atm. CONCLUSION: The current study confirmed the previous finding that human herniated lumbar disc cultures spontaneously produce NO. Endogenously generated and exogenously supplied NO inhibited proteoglycan synthesis in the intervertebral disc. Hydrostatic pressure influenced NO production by disc cells, and NO is one of the mediators that changes proteoglycan synthesis in response to hydrostatic pressure. These results may show that autocrine and paracrine mechanisms of NO play an important role in the regulation of disc cell metabolism under mechanical stress and in the pathophysiology of intervertebral disc degeneration.     

Injection of human umbilical tissue–derived cells into the nucleus pulposus alters the course of intervertebral disc degeneration in vivo

Background contextPatients often present to spine clinic with evidence of intervertebral disc degeneration (IDD). If conservative management fails, a safe and effective injection directly into the disc might be preferable to the risks and morbidity of surgery.PurposeTo determine whether injecting human umbilical tissue–derived cells (hUTC) into the nucleus pulposus (NP) might improve the course of IDD.DesignProspective, randomized, blinded placebo–controlled in vivo study.Patient sampleSkeletally mature New Zealand white rabbits.Outcome measuresDegree of IDD based on magnetic resonance imaging (MRI), biomechanics, and histology.MethodsThirty skeletally mature New Zealand white rabbits were used in a previously validated rabbit annulotomy model for IDD. Discs L2–L3, L3–L4, and L4–L5 were surgically exposed and punctured to induce degeneration and then 3 weeks later the same discs were injected with hUTC with or without a hydrogel carrier. Serial MRIs obtained at 0, 3, 6, and 12 weeks were analyzed for evidence of degeneration qualitatively and quantitatively via NP area and MRI Index. The rabbits were sacrificed at 12 weeks and discs L4–L5 were analyzed histologically. The L3–L4 discs were fixed to a robotic arm and subjected to uniaxial compression, and viscoelastic displacement curves were generated.ResultsQualitatively, the MRIs demonstrated no evidence of degeneration in the control group over the course of 12 weeks. The punctured group yielded MRIs with the evidence of disc height loss and darkening, suggestive of degeneration. The three treatment groups (cells alone, carrier alone, or cells+carrier) generated MRIs with less qualitative evidence of degeneration than the punctured group. MRI Index and area for the cell and the cell+carrier groups were significantly distinct from the punctured group at 12 weeks. The carrier group generated MRI data that fell between control and punctured values but failed to reach a statistically significant difference from the punctured values. There were no statistically significant MRI differences among the three treatment groups. The treated groups also demonstrated viscoelastic properties that were distinct from the control and punctured values, with the cell curve more similar to the punctured curve and the carrier curve and carrier+cells curve more similar to the control curve (although no creep differences achieved statistical significance). There was some histological evidence of improved cellularity and disc architecture in the treated discs compared with the punctured discs.ConclusionsTreatment of degenerating rabbit intervertebral discs with hUTC in a hydrogel carrier solution might help restore the MRI, histological, and biomechanical properties toward those of nondegenerated controls. Treatment with cells in saline or a hydrogel carrier devoid of cells also might help restore some imaging, architectural, and physical properties to the degenerating disc. These data support the potential use of therapeutic cells in the treatment of disc degeneration.     

Does long-term compressive loading on the intervertebral disc cause degeneration?

STUDY DESIGN: Coil springs were stretched and attached to produce a compressive force across the lumbar intervertebral discs of dogs for up to 53 weeks. OBJECTIVE: To test the hypothesis that compressive forces applied to the intervertebral disc for a long period of time cause disc degeneration in vivo in a dog model. SUMMARY OF BACKGROUND DATA: It is a commonly held belief that high forces applied to the intervertebral disc, and to joints in general, play a role in causing degeneration. METHODS: Coil springs were stretched and attached to produce a compressive force across the lumbar intervertebral discs (L3/L4) of 12 dogs. After up to a year, the dogs were killed, and their lumbar spines were removed and radiographed. The L3/L4 disc and the controls (T13/L1 and L4/L5) were excised and examined for visible signs of degeneration. The discs then were assessed using immunohistochemical analysis and enzyme-linked immunosorbent assay. Disc chondrocytes also were assayed for apoptosis. RESULTS: No obvious signs of degeneration in the discs (L3/L4) that had been under compression for up to a year could be observed. There was no disc bulging, anular fissures, or disc space narrowing. Some changes were observed at the microscopic level, although no thickening of the endplate was apparent. The enzyme-linked immunosorbent assay analysis provided significant data for all three regions of the disc (nucleus, inner anulus, and outer anulus). When comparing the compressed disc (L3/L4) with either of the control discs (T13/L1 and L4/L5), in the compressed disc: 1) the nucleus contained less proteoglycan and more collagen I and II; 2) the inner anulus contained less proteoglycan and collagen I; and 3) the outer anulus contained more proteoglycan and less collagen I. The collagen II differences for the inner and outer anulus were not significant. CONCLUSION: Compression applied to the lumbar intervertebral discs of dogs for up to a year does not produce degeneration in any visible form. It does produce microscopic changes and numerical changes, however, in the amounts of proteoglycan and collagen in the nucleus, inner anulus, and outer anulus. The present results add no credence to the commonly held belief that high compressive forces play a causative role in disc degeneration.     

认识颈腰椎间盘病

目的：探讨颈腰椎间盘病的特点和诊断。方法：对近6年中的颈腰椎间盘突出症、迟变性椎管狭窄症和颈椎病并施行手术的56例进行了分析。结果：发现颈腰椎间盘突出症是本病的重要原因。结论：根据临床症状、体征和影像学检查，颈椎MRI和腰椎CT检查，是防范混淆和误诊的必要条件。     

Lumbar epidural brucellar abscess causing nerve root compression.

OBJECTIVES: To evaluate the usefulness of MR sequences for the differential diagnosis of spinal brucellar abscesses which mimic lumbar disc herniation. METHODS: We analyzed six patients with brucellar abscesses who had symptoms mimicking lumbar disc herniation. The study group consisted of three women and three men who were 15-67 (mean = 37) years old. Patients were imaged in the axial and sagittal planes with a I.0-T MR scanner using a spine coil. RESULTS: The level of abscesses were accurate in 100% (six of six) of patients with MR imaging. MRI examinations revealed an extradural soft tissue mass which were iso- to hypointense compared to spinal cord on T1WI and hyperintense on T2-weighted images. By contrast study, diffuse homogeneous or slightly heterogeneous enhancements were seen. CONCLUSION: Lumbar extradural brucellar abscess can have lumbar disc disease symptoms. MRI may non-invasively and rapidly reveal the presence of spinal abscess and degree of extension to the spinal canal. Extradural brucellar abscess should be included in the differential diagnosis of radicular symptoms caused by disc herniation.     

自体富血小板血浆干预兔早期椎间盘退变的初步研究

目的富血小板血浆(platelet-rich plasma,PRP)具有刺激椎间盘细胞增殖、促进细胞外基质合成代谢及抑制纤维环细胞凋亡等作用。通过观察自体PRP干预兔早期椎间盘退变,明确其治疗效果,为临床应用提供理论依据。方法取健康成年新西兰大白兔45只,体重2.5～3.0 kg,雌雄不限;随机分为实验组、对照组、假手术组(n=15)。取实验组兔耳中央动脉血,采用Landesberg等方法制备PRP,同时对全血及PRP行血小板计数。实验组及对照组采用纤维环针刺法建立L4、5及L5、6椎间盘退变模型,造模2周后于L4、5及L5、6椎间隙分别注入100μL自体PRP及100μL PBS液;假手术组仅分离暴露椎间盘,不作处理。观察实验动物造模后一般情况;造模2周及干预1、2周时各组取5只实验动物行腰椎MRI、HE染色及Ⅱ型胶原免疫组织化学染色观察,腰椎MRI退变程度分级及Ⅱ型胶原阳性积分吸光度(IA)值检测。结果兔PRP中血小板计数约为外周血的4.92倍。实验动物均存活至实验完成。造模2周时,与假手术组相比,实验组和对照组椎间盘信号降低,髓核细胞减少,基质退变,Ⅱ型胶原表达降低。腰椎MRI退变程度分级及Ⅱ型胶原阳性IA值结果显示,各时间点实验组、对照组与假手术组相比差异均有统计学意义(P<0.05),干预1、2周时,实验组MRI退变程度分级显著低于对照组(P<0.05),但仍与假手术组有差异(P<0.05);干预1、2周时,实验组髓核细胞及软骨样基质较对照组增多,基质纤维化程度轻,Ⅱ型胶原表达明显强于对照组(P<0.05)。结论椎间盘内注射自体PRP可终止甚至一定程度逆转兔早期椎间盘退变,可能与PRP含有多种生长因子调控细胞功能、改善组织微环境、促进组织再生修复有关。