阮狄克 费正奇 陆瓞骥 沈根标 隋延仿 梁智仁 阮狄克 100037北京，海军总医院骨科；费正奇 银川，解放军第五医院骨科；沈根标、隋延仿 西安，第四军医大学；陆瓞骥、梁智仁 香港大学骨科学系 中华骨科杂志 1999 0 19 1


    关键词：冷冻；器官保存；椎间盘；移植；异体；分子生物学；生物力学 期刊 zhgkzz 0 实验研究 fur -->


    

【摘要】目的 观察猴冷冻保存异体椎间盘移植后的X线、组织形态学、分子生物学、生物化学和生物力学的变化，探讨移植椎间盘的长期归宿及临床应用的可能性。方法 17只猴中的12只随机分为0.5、1、1.5、2、6和24个月组。移植椎间盘梯度降温至-196℃保存，术前复温后手术植入。结果 X线显示无脱位，24个月仍能维持正常高度的64.9%。术后2周仅在移植椎间盘终板下骨与宿主椎体骨界面区有轻度免疫排斥反应，4周时较明显，6周后逐渐减轻，8周逐渐趋向正常。分子生物学示移植组DNA含量降低。细胞因子基因片段phIL-6、phIL-8、phTNF和iINOS早期较对照组增高，晚期与对照组比较，差异无显著性意义。生化结果示移植椎间盘髓核和纤维环代谢均有不同程度变化。生物力学结果示术后早期移植间盘在旋转、水平和轴向位移方面均有失稳倾向，但对腰椎整体活动无明显影响，术后中、晚期各方向稳定性恢复。结论 结合以往研究认为椎间盘移植有一定的临床应用前景。

    Frozen Intervertebral DiscAllografting

RUAN Dike ^* , FEI Zhengqi， LU Dieji， et al.

    ^* Departmentof Orthopaedic Surgery, Naval General Hospital,Beijing 100037

【 Abstract 】 Objective This study is a furtherexploration based on our previous studies of auto-and fresh allografting of intervertebral disc. Methods Twelve rhesus monkeys were divided into 6 groups. The donor disc tissue was procured fromtwo monkeys and the procured disc tissues were then preserved at - 196 degrees in liquid nitrogen. Osteotomies were performedat the endplates of L _{4 - 5} intervertebral disc, then, the frozen discs were transferred in L _{4 - 5} spaces. The 6 groups ofanimals were sacrificed after 0.5, 1, 1.5, 2, 6 and 24 months respectively. Results Radiograph demonstrated gradual loss of intervertebral disc height in the early stagepostoperatively, the disc height was still kept 64.9% of its original height at 24 months postoperatively. Therewas a mild immune rejection in the interface between allograft and recipient vertebralbody from 2 to 8 weeks postoperatively. However, the allografts of intervertebral discshow edevidence of ‘ Human- aging-like’ progressive disc degeneration 2 years after transplantation. DNA content was not normal, but RNA content was as normal as control. There was an increase of factors phIL-6, phIL- 8,phTNF and iNOS in early stage postoperatively, then,there was a revision in late stage. Metabolic function of frozen allografts ofintervertebral discs was not as normal as control, but was still maintained in a newlevel. Biomechanically, hypermobility of allografted segments was observed in flexion-extension, lateral bending androtation at 2 months, then, there was a revision of hypermobility at 6 monthspostoperatively. Conclusion Combined with our previous work,the results indicate thatallografts of intervertebral discs do have a clinical potential in the future.

     ......