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目的:通过影像学观察,探讨单侧椎弓根螺钉内固定建立脊柱侧凸动物模型的可行性和有效性。方法:选择14只5～8周龄雌性山羊,采用T6～L2单侧椎弓根螺钉内固定、右侧T8～T12肋骨部分切除的方法建立脊柱侧凸模型,建模时间8周。术前、术后均摄后前位及侧位X线片,术后每4周拍照一次,观察山羊脊柱弯曲在生长过程中的演变特点。将已建立脊柱侧凸模型的山羊单纯取出后路内固定,不治疗,继续观察8周后随机抽取2只山羊进行CT三维重建,观察该侧凸模型的三维结构特点。结果:共有12只山羊成功建立了脊柱侧凸模型。术后即刻Cobb角平均29.0°(23.0°～38.0°),术后4周时Cobb角平均36.8°(27.0°～48.0°),脊柱轻微旋转;术后8周时Cobb角平均43.0°(36.0°～58.0°),脊柱出现明显旋转。CT三维重建示弯曲内脊柱前后结构完整,没有任何融合迹象。CT冠状面显示椎管内脊髓信号正常,椎体出现明显楔形变,主弯内椎体突向右侧胸廓。CT横断面示胸廓两侧不对称,主弯内椎体明显旋转。结论:单侧椎弓根螺钉不对称内固定建立的脊柱侧凸模型是一个三维骨性畸形模型,其结构特点与特发性脊柱侧凸相似。
Objective: To investigate the feasibility and effectiveness of establishing a scoliosis animal model by unilateral pedicle screw fixation through imaging observation. Methods: Fourteen female goats aged 5-8 weeks were selected. The scoliosis model was established by T6-L2 unilateral pedicle screw fixation and right T8-T12 rib partial excision. The modeling time was 8 weeks. The anterior and lateral radiographs were taken before and after the operation. The images were taken every 4 weeks after operation to observe the evolution of the goat’s curvature during the growth. The goat with established scoliosis model was simply removed and fixed in the posterior approach. After 8 weeks of continuous observation, 2 goats were randomly selected for CT three-dimensional reconstruction to observe the three-dimensional structural features of the scoliosis model. Results: A total of 12 goats successfully established scoliosis model. The average Cobb angle was 29.0 ° (23.0 ° ~ 38.0 °) immediately after operation, and the mean Cobb angle was 36.8 ° (27.0 ° ~ 48.0 °) at 4 weeks after operation. The spine rotated slightly and the Cobb angle was 43.0 ° at 36 weeks ° ~ 58.0 °), the spine showed significant rotation. Three-dimensional reconstruction of CT showed a complete anterior and posterior spinal column structure without any signs of fusion. Coronal CT showed spinal cord normal spinal cord, vertebral obvious wedge-shaped change, the main curvature of the vertebral body to the right thorax. CT cross-section shows asymmetric sides of the thoracic, vertebral body rotation significantly. CONCLUSION: The scoliosis model established by unilateral pedicle screw asymmetric fixation is a three-dimensional model of skeletal malformation with structural features similar to idiopathic scoliosis.