Experimental Investigation of the Secondary Changes in Imaging After Lumbar Disc Nucleoplasty in Rabbits

作者：Yin, Haidong; Zhang, Xinmei; Huang, Zhiping; Wu, Xiuhua; Zhu, Qingan^*

来源：Turkish Neurosurgery, 2023, 33(4): 576-583.

DOI：10.5137/1019-5149.JTN.37286-21.2

• Nucleoplasty
• Complications
• Lumbar disc
• X-ray
• Rabbits

AIM: To explore the changes in imaging after lumbar disc nucleoplasty in rabbits.MATERIAL and METHODS: Twenty-four rabbits were randomly selected for X-ray, computerized tomography (CT), and magnetic resonance imaging (MRI) at 2, 6, and 12 weeks post operation. Moreover, their L3/4, L4/5, and L5/6 intervertebral discs were randomly selected as the untreated, annulus puncture, and nucleoplasty groups, respectively. Changes in disc height index (DHI%) and MRI grade were measured and compared. CT three-dimensional reconstruction was used to evaluate adjacent bone endplate changes.RESULTS: The untreated group's DHI% decreased slightly at different time points (p>0.05), while that of the nucleoplasty and annulus puncture groups decreased progressively (p<0.05). At six weeks post operation, the nucleoplasty group's DHI% was significantly lower than that of the annulus puncture group (p<0.05), with mild osteosclerosis and local rough changes in the endplate. At 12 weeks post operation, a "bone bridge" connection was observed in the nucleoplasty group. There was no significant difference in MRI grade between the untreated and annulus puncture groups at different time points (p>0.05). MRI grades of the intervertebral disc in the nucleoplasty and annulus puncture groups showed a progressive increase (p<0.05). Compared with the annulus puncture at the same time point, the nucleoplasty group's MRI grade of the intervertebral disc was significantly higher (p<0.05). Thus, damage caused by an annulus puncture can lead to progressive degeneration of the lumbar disc.CONCLUSION: Nucleoplasty may have a cumulative effect with the injury of the annulus puncture. Clinicians need to comprehensively consider advantages and disadvantages of nucleoplasty, strictly grasp indications of treatment, and prevent long-term complications.

• 单位
  南方医科大学