单、双侧椎板开窗髓核摘除术髓核取出量比较的实验研究

目的测量单、双侧椎板开窗髓核摘除术分别取出的髓核量,并通过椎间盘造影术探讨术后椎间盘的形态学表现。方法取4具猪的腰椎节段标本,随机编号为A、B、C、D。标本A用于称量完整髓核的重量;标本B用于观察术前椎间盘造影后的形态学表现;标本C、D分别用于评估单、双侧开窗取出的髓核量与术后椎间盘造影的形态学表现。结果标本A、C、D取出的髓核量分别为（0.80±0.05）g、（0.26±0.29）g、（0.31±0.38）g。标本A的髓核取出量多于标本C、D,P〈0.01。标本D的髓核取出量多于标本C,P〈0.01。标本B、C、D造影剂充盈面积分别为（141.9±12.0）mm^2、（59.7±21.4）mm^2、（75.1±19.5）mm^2。标本B的造影剂充盈面积大于标本C、D,P〈0.01。标本D的造影剂充盈面积大于标本C,P〈0.01。髓核摘除量与造影剂充盈面积之间具有正相关性,r=0.649,P〈0.05。样本回归方程为Y=-22.341＋318.107X。结论单侧或双侧椎板开窗均不能取出全部髓核组织,双侧开窗取出的髓核明显多于单侧开窗,残存髓核成为腰椎间盘突出症复发的可能原因。

Experimental study on nucleus removed during uni-or-bilateral vertebral plate disectomy

Objective To weigh nucleus removed during uni-or-bilateral vertebral plate disectomy and to explore the CT after discography after operation. Methods 4 samples of pig lumbar spines were selected and numbered A,B,C,D randomly. A was used to weigh the total nucles. B was used to observe the CT after discography before operation. C and D were respectively used to evaluate the nucleus removed and the CT after discography after operation during uni-or-bilateral vertebral plate disectomy. Results The weight of nucleus removed of A,C,D was （0.80±0.05）g, （0.26±0.29）g,（0.31±0.38）g respectively. The weight of nucleus removed of A exceeded that of C and D,P〈0.01. The weight of nucleus removed of D exceeded that of C,P〈0.01. The area of contrast agent of B,C,D was （141.9±12.0）mm^2,（59.7±21.4）mm^2,（75.1±19.5）mm^2. The area of contrast agent of B exceeded that of C and D,P〈0.01. The area of contrast agent of D exceeded that of C,P〈0.01. The weight of nucleus removed was correlated with the area of contrast agent,r=0.649, P〈0.05. The linear regression equation was Y=-22.341＋318.107X. Conclusion The total nucleus can not be removed during uni-or-bilateral vertebral plate discectomy. The weight of nucleus removed during bilateral vertebral plate disectomy exceeds that during unilateral vertebral plate disectomy significantly. Remaining nucleus could be one cause for recurrence of lumbar disc herniation.