CAJ | 학술논문

目的建立一种科学性、可重复性及可操作性较高的大型哺乳动物的急性脊髓压迫损伤模型,为脊柱、脊髓损伤的发生及修复重建等相关研究提供技术和实验平台.方法选用成年雄性山羊,体重质量35～45 kg,经静脉麻醉后采用椎体后凸成形术时使用的球囊系统,经椎板间有限开窗入路制备活体山羊的急性脊髓压迫模型,然后按步骤将球囊置于欲研究的靶脊髓节段并加以扩张.共将动物数字表法随机分为4组:假手术组A(3只)(仅行靶节段的椎板切除,并不置入球囊)；假手术组B(4只)(行靶节段的椎板切除,并置入球囊但不予扩张)；靶脊髓节段部分受压组C(4只)(扩张球囊占椎管前后径约30％)；靶脊髓节段完全受压组D(4只)(扩张球囊占椎管前后径约90％).术中和术后采用X线和CT重建技术记录球囊所处的脊柱节段位置、球囊扩张后椎管的占位程度；记录球囊扩张时达到椎管占位程度目的时的球囊压强值、容量值及所需时间；采用改良Tarlov运动功能评分记录术前及术后第7天动物的后肢活动状况,测量体感诱发电位(SSEP)图形和数值变化.结果应用X线及CT成像测得:当球囊内注入造影剂0、(1.3±0.2)、(2.8±0.2)ml时,相对应的椎管占位率分别为0％、33％±2％、89％±4％,分别对应轻度压迫损伤组、中度压迫损伤组、重度压迫损伤组.损伤模型术后第7天SSEP及运动功能受损的记录分析显示,各组损伤程度一致性较高且与剂量有关.结论微创可扩张球囊技术制备的活体山羊急性脊髓压迫损伤模型,可模拟临床急性脊髓压迫损伤状态.经椎板间有限开窗技术能基本满足目前的模型制备需要.
목적 건립일충과학성、가중복성급가조작성교고적대형포유동물적급성척수압박손상모형,위척주、척수손상적발생급수복중건등상관연구제공기술화실험평태.방법 선용성년웅성산양,체중질량35～45 kg,경정맥마취후채용추체후철성형술시사용적구낭계통,경추판간유한개창입로제비활체산양적급성척수압박모형,연후안보취장구낭치우욕연구적파척수절단병가이확장.공장동물수자표법수궤분위4조:가수술조A(3지)(부행파절단적추판절제,병불치입구낭)；가수술조B(4지)(행파절단적추판절제,병치입구낭단불여확장)；파척수절단부분수압조C(4지)(확장구낭점추관전후경약30％)；파척수절단완전수압조D(4지)(확장구낭점추관전후경약90％).술중화술후채용X선화CT중건기술기록구낭소처적척주절단위치、구낭확장후추관적점위정도；기록구낭확장시체도추관점위정도목적시적구낭압강치、용량치급소수시간；채용개량Tarlov운동공능평분기록술전급술후제7천동물적후지활동상황,측량체감유발전위(SSEP)도형화수치변화.결과 응용X선급CT성상측득:당구낭내주입조영제0、(1.3±0.2)、(2.8±0.2)ml시,상대응적추관점위솔분별위0％、33％±2％、89％±4％,분별대응경도압박손상조、중도압박손상조、중도압박손상조.손상모형술후제7천SSEP급운동공능수손적기록분석현시,각조손상정도일치성교고차여제량유관.결론 미창가확장구낭기술제비적활체산양급성척수압박손상모형,가모의림상급성척수압박손상상태.경추판간유한개창기술능기본만족목전적모형제비수요.
Objective To establish a reproducible and manipulable model of acute spinal cord compression injury in large mammals so as to provide a technical and experimental platform for the repair and reconstruction of spinal cord injury (SCI).Methods A total of 15 adult male goats,weighting 35 -45 kg,were selected.After intravenous anesthesia,a model of acute spinal cord compression injury was established with the balloon of kyphoplasty through mini-open laminotomy.The animals were divided into 4 groups,i e.3 in group A and 4 each in groups B,C and D.Goats in group A received mini-open laminotomy without insertion of balloon.In group B,balloons were surgically positioned within the T10-T11 spinal canal but not inflated.The spinal cords of goats in group C were partially compressed by inflating the balloon to approximately 30％ of anterior/posterior diameter of vertebral canal.In group D,the balloon was inflated to occupy approximately 90％ of canal on a lateral view.X-ray and thin-section computed tomography (CT)scans were used to determine the balloon location.CT scans were also used to calculate the magnitude of balloon inflation and the degree of spinal cord compression within vertebral canal.Improved Tarlov motor function grade test and somatosensory evoked potentials (SSEP) were employed to evaluate the goat neurofunction 24 hours before and 7 days after surgery.Results Dye volumes of 0,1.26 ± 0.18 and 2.82 ±0.20 ml were injected into the balloon to produce spinal occupancies of 0％,33％ ±2％ and 89％ ±4％ on X-ray and CT scan.There was a significant dose response for the different levels of injury,with reduced conduction of somatosensory evoked potentials and impaired mobility 7 days after injury.Conclusion A model of acute spinal cord injury hy a tunable compression with a mini-invasive balloon in goats is a useful experiment model of spinal cord injury.It may simulate the clinical situations of acute SCI.