一种兔腰椎间融合模型的建立及效果评价
Introduction and evaluation of an anterior interbody fusion model on rabbits
目的 利用兔腰椎骨性结构测量数据建立一种稳定的腰椎椎体间植骨融合模型，为组织工程学研究提供标准化的模型参考。 方法 选用健康新西兰大白兔（2~2.5 kg）44只，随机分为A、B、C、D四组， A组（n=10）用于解剖进行腰椎椎体测量，B组（n=12）行L4/5椎体间椎骨融合术加内固定；C组（n=12只）行L4/5椎体间植骨融合术未进行内固定，D组（n=10）行单纯显露加横突破坏。B、C、D 3组造模后4周行X线检查，术后12周取标本进行大体观察、Micro-CT、生物力学及组织学切片检查。 结果 B组仅出现1例因固定螺钉进入椎管导致脊髓损伤造成双下肢瘫痪。手触法检测B组融合率为100%（12/12），C组融合率为75%(9/12)，D组标本未见椎间盘损伤及间隙破坏。影像学B组植入骨块位置明显优于C组，融合评分明显高于C组（P<0.05）。组织学提示B、C两组椎体间融合部位均可见新生软骨，C组中可见植骨块脱出后形成软组织空腔。生物力学显示B组最大载荷显著高于C组（P<0.05）。 结论 在兔腰椎解剖基础上进行兔腰椎间植骨融合模型制作是安全、可靠的。内固定装置可以为椎间植骨块提供稳定的融合空间，防止植骨块脱离融合位置，有助于提高该模型的融合效率。
Objective In order to provide a standardized model for tissue engineering research，we took measurement of lumbar bodies on rabbits to establish a stable interbody fusion model. Methods Forty-four healthy adult New Zealand white rabbits (2~2.5 kg) were randomly divided into an anatomical analysis group (group A, n=10), an interbody fusion with fixation group (group B, n=12), an interbody fusion with no fixation group(group C, n=12) and a blank control group (group D, n=10). Animals in group B、C、D underwent x-ray examination at 4 weeks after operation. At 12 weeks all rabbits were euthanasized, the fusion segments were tested by manual palpation testing, x-ray, Micro-CT, biomechanical and histological examinations. Results Because of the fixed screws into the spinal canal，one case with spinal cord injury in group B suffered paralysis of the lower limbs. The result of manual palpation testing showed the fusion rate of group B is 100% (12/12), while the group C is 75% (9/12). There is no obvious destruction in intervertebral spaces in group D. The bone graft position of group B was superior to group C and the radiographic score of group B is significantly higher than group C （P<0.05）as shown by imaging tests. The histology indicated there was new formation bone at the fusion position between the interbodies and only soft tissue existed at the failed fusion position. in biomechanic test， the maximal load of group B was higher than that of group C (P<0.05). Conclusions Making a lumbar fusion model on rabbit according to the lumbar anatomy is safe and reliable. The fixation can provide a stable space for the bone grafting fusion ， prevent graft from extruding from the fusion position, as well as do some help to improve the fusion effect.
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国家自然科学基金（31370985）；国家自然科学基金海外联合项目（31228007）；广东省高等学校科技创新重点项目（cxzd1137）
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