CAJ | 학술논문

背景：腰椎手术失败综合征出现的重要原因是术后硬膜外瘢痕粘连，因此，探索预防腰椎术后硬膜外瘢痕粘连的方法一直是脊柱外科研究的热点。目的：观察肾俞穴磁刺激疗法对腰椎手术失败综合征模型大鼠硬膜外粘连的作用。方法：60只SD大鼠应用椎板切除法建立腰椎手术失败综合征模型，建模成功后均分为2组，肾俞磁疗组于造模后1周开始进行双侧肾俞穴磁刺激，1周治疗5 d，连续6周；空白对照组不干预。造模后13周取材，光镜下观察两组硬膜外瘢痕所占面积比，粘连范围大小，胶原纤维形成情况，并计数成纤维细胞数量；并比较两组瘢痕组织中羟脯氨酸含量及转化生长因子β1表达量。结果与结论：肾俞磁刺激治疗后，模型大鼠硬膜外瘢痕形成少，仅少数成纤维细胞浸润，瘢痕羟脯氨酸含量与转化生长因子β1表达量少，与空白对照组比较差异有非常显著性意义(P <0.001)。提示肾俞磁刺激疗法能明显减少腰椎术后硬膜外瘢痕形成，是其治疗腰椎手术失败综合征的可能机制。
배경：요추수술실패종합정출현적중요원인시술후경막외반흔점련，인차，탐색예방요추술후경막외반흔점련적방법일직시척주외과연구적열점。목적：관찰신유혈자자격요법대요추수술실패종합정모형대서경막외점련적작용。방법：60지SD대서응용추판절제법건립요추수술실패종합정모형，건모성공후균분위2조，신유자료조우조모후1주개시진행쌍측신유혈자자격，1주치료5 d，련속6주；공백대조조불간예。조모후13주취재，광경하관찰량조경막외반흔소점면적비，점련범위대소，효원섬유형성정황，병계수성섬유세포수량；병비교량조반흔조직중간포안산함량급전화생장인자β1표체량。결과여결론：신유자자격치료후，모형대서경막외반흔형성소，부소수성섬유세포침윤，반흔간포안산함량여전화생장인자β1표체량소，여공백대조조비교차이유비상현저성의의(P <0.001)。제시신유자자격요법능명현감소요추술후경막외반흔형성，시기치료요추수술실패종합정적가능궤제。
BACKGROUND:The important reason for failed back surgery syndrome is the postoperative epidural scar adhesions, therefore, exploring the methods of preventing postoperative lumbar epidural scar adhesions has always been a hot research in spine surgery field. OBJECTIVE:To investigate the effect of Shenshu point magnetic stimulation therapy on epidural scar adhesions in rat models of failed back surgery syndrome. METHODS:Sixty Sprague-Dawley rat models of failed back surgery syndrome were successfuly established using the method of laminectomy, and then divided into Shenshu magnetic therapy group and blank control group. Beginning from 1 week after modeling, rats in the Shenshu magnetic therapy group were subjected to bilateral Shenshu magnetic stimulation for 6 weeks, 5 days of treatment per week. Rats in the blank control group were not given any intervention. At 13 weeks after modeling, rats were harvested and the area ratio of epidural scars, range of adhesions and formation of colagen fibers were observed under light microscope. Fibroblasts were counted. Hydroxyproline content and transforming growth factor β1 expression in scar tissue were compared between these two groups.