纤维环针刺法建立兔椎间盘退变模型的实验研究

目的建立一种稳定可靠、可重复性好、成功率高，且与人类退变相似的椎间盘退变模型。方法38只普通级新西兰大白兔，雌雄不计，随机选取2只动物用于研究兔腰椎的解剖学特点，另外36只动物用随机数字表法均分为模型组和对照组。模型组手术取右侧腹膜后入路，暴露至L5/L6、L4/L5椎间盘纤维环，予16G穿刺针针刺纤维环；对照组同法暴露不进行针刺。分别于术前及术后4周对实验动物行X线和MRI检查，术后4周处死实验动物，取椎间盘标本行病理学检查。结果术后4周，X线和MRI检查显示模型组椎间盘高度明显降低、部分骨赘形成、终板硬化，T2加权像信号较术前明显降低、椎间盘颜色变黑变暗，髓核缩小或消失，纤维环变厚；而对照组椎间盘未见明显变化，T2加权像呈均匀高信号；取椎间盘标本经HE染色，电镜下见模型组髓核组织明显缩小，结构紊乱，细胞密度较小，纤维向内塌陷，纤维环板层出现明显断裂，排列不整齐，纤维环内层见少量毛细血管长入；对照组腰椎间盘病理学检查无明显退变表现；免疫组化见模型组椎间盘内TNF-a数量较对照组明显增多。结论该方法具有操作简单、可行、高效等优点，是建立椎间盘退变模型的一种可靠方法。

Construction of rabbit model of intervertebral disc degeneration induced by needle acupuncture in annulus fibrosu.

Objective To establish a reliable, reproducible rabbit model of intervertebral disc degeneration with high success rate. Methods Thirty-eight new Zealand white rabbits of general level, excluding male and female, were enrolled in the study. Two rabbits were randomly selected for the study of the anatomy of the lumbar spine, and the remaining 36 rabbits were randomly divided into model group and control group. The model group after surgery took the right retroperitoneal approach, exposure to L5/L6, L4/L5 intervertebral disc, 16 G needle acupuncture the annulus. The control group was not exposed to the same method puncture. Preoperative and postoperative four weeks, X-ray and MRI examination were performed. Animals were sacrificed after 4 weeks, and the disc specimens were taken for pathological examination. Results After 4 weeks, X-ray and MRI examination showed that the disc height in the model group significantly reduced, with partial osteophyte formation and endplate sclerosis, T2-weighted images before the signal was significantly lower than the preoperative, with darkening disc, shrinking or disappeared nucleus, thickening annulus, and decreased disc height. The disc showed no significant change in the control group, T2-weighted images showed homogeneous high signal. The disc specimens were taken for HE staining and electron microscopy, which showed significantly reduced nucleus pulposus, structural disorder, smaller cell density, fiber collapse inward, anular lamellar apparent fracture, irregular arrangement, a small amount of the annulus inner capillary in growth in the model group. Rabbits in the control group had no significant performance of lumbar intervertebral disc degeneration. Immunohistochemistry showed the number of TNF-a of the model group increased significantly compared with the control group. Conclusion This method is simple, practical and efficient, which is a reliable method to establish the model of disc degeneration.