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目的观察纤维环缝合术后不同时期椎间盘生物力学强度及纤维环修复特征。方法成年健康山羊40只,雌雄各20只,随机分为4组,进行椎间盘纤维环暴露术。实验组切开纤维环摘除髓核后进行纤维环缝合;记录髓核摘除量。对照组仅暴露而不切开纤维环及摘除髓核。实验组A组于术后3个月时行椎间盘核磁共振及组织学检查、测定椎间盘内压力及椎间隙高度。B组于术后6个月测量上述指标。C组于术后12个月测量。结果术后3个月椎间盘生物力学强度为(1.39±0.68)兆帕。6个月为(2.04±0.88)兆帕。12个月为(3.58±1.10)兆帕,接近对照组(3.90±1.59)兆帕。实验组术后3个月椎间隙高度丢失为(1.01±0.29)mm,术后6个月为(1.90±0.65)mm,术后12个月为(2.04±0.85)mm。三者进行组间比较有统计学意义。结论纤维环缝合术对维持椎间盘生物力学强度及术后纤维环修复起到积极作用。椎间盘生物力学强度恢复与纤维环修复时间相关。
Objective To observe the biomechanical strength of disc and the characteristics of annulus fibrosus repair in different periods after annulus fibrosus suture. Methods Forty adult healthy goats, 20 male and 20 female, were randomly divided into 4 groups and were treated with disc annulus fibrosus. In the experimental group, the annulus fibrosus was excised by dissecting the annulus fibrosus and the annulus fibrosus was sutured. The amount of nucleus pulposus excised was recorded. The control group was only exposed without incising the annulus and removing the nucleus pulposus. In the experimental group A, the intervertebral disc MRI and histological examination were performed at 3 months after the operation to determine the intravertebral disc pressure and intervertebral space height. B group at 6 months after surgery to measure the above indicators. Group C was measured at 12 months after operation. Results The biomechanical strength of disc at 3 months after operation was (1.39 ± 0.68) MPa. 6 months was (2.04 ± 0.88) MPa. 12 months (3.58 ± 1.10) MPa, close to the control group (3.90 ± 1.59) MPa. In the experimental group, the height loss of intervertebral space was (1.01 ± 0.29) mm at 3 months after operation, (1.90 ± 0.65) mm at 6 months and (2.04 ± 0.85) mm at 12 months after operation. The three groups were statistically significant. Conclusion The suture of annulus fibrosus plays a positive role in maintaining the biomechanical strength of intervertebral disc and repairing the annulus fibrosus. The recovery of disc biomechanics correlates with the recovery time of annulus fibrosus.