| Part One The reduction of estrogen and the occurrence of LBPObjective: Through the analysis of clinical case data,to preliminarily explore the relationship between lumbar degeneration and estrogenMethods: MRI data of female patients who came to our hospital for spine surgery from April 2018 to April 2021 with low back and leg pain were collected.A total of 443 patients were enrolled,including 148 premenopausal women and 295 postmenopausal women.The improved Pfirrmann grading system was used for scoring and statistical analysis was performed.Results: According to the modified Pfirrmann grading system,443 patients with intervertebral disc degeneration were classified.It is found that most premenopausal women have full nucleus pulposus with high signal intensity,clear boundaries between nucleus pulposus and annulus fibrosus,and most of the intervertebral space heights are normal.In postmenopausal women,most of the nucleus pulposus showed low signal,the boundary between the nucleus pulposus and the annulus fibrosus was unclear,and the height of the intervertebral space was reduced to varying degrees.There are significant differences in the MRI classification of Pfirrmann lumbar disc degeneration before and after menopause(P<0.05).Conclusions: The analysis of MRI data of lumbar intervertebral discs in443 clinical patients showed that the reduction of estrogen may be an important factor in the degeneration of intervertebral discs.Part Two IVDD new animal modelObjective: To improve the production of IVDD animal models through animal experimental research.Methods: The rats were randomly divided into 4 groups,Sham group,OVX group,Puncture group and OVX+Puncture group,and the operation was performed respectively.After successful modeling,imaging and histological evaluation were performed after 4,8,and 12 W respectively;Results: After the model was successfully established,3 rats were randomly selected from the Sham,OVX,Puncture,and OVX+Puncture groups at 4,8,and 12 W after the operation for imaging and histological evaluation.1.Micro-MRIMicro-MRI of the intervertebral disc showed that the nucleus pulposus in the Sham group was full,without obvious changes in morphology and signal level;the nucleus pulposus of the OVX,Puncture,OVX+Puncture groups showed varying degrees of morphology and signal levels at 4,8,and 12 W The change,and with time,the more obvious the change.The Pfirrmann grading system was used for scoring,and the rank sum test was used for statistical analysis,and the difference was significant(P<0.05).A pairwise comparison between the horizontal groups and a vertical comparison of the time gradients within each group were carried out.We first performed a horizontal comparison at the same time point and found that when 4W,the difference between the Sham group and the OVX+Puncture group,the OVX group and the OVX+Puncture group was significant(P<0.05),and the difference between the Sham group and the OVX group There were no significant differences between the Sham group and the Puncture group,between the OVX group and the Puncture group,and between the Puncture group and the OVX+Puncture group(P>0.05).At 8W,there were significant differences between the Sham group and the Puncture group,between the Sham group and the OVX+Puncture group,between the OVX group and the Puncture group,and between the OVX group and the OVX+Puncture group(P<0.05),while the Sham group There was no significant difference between the OVX group and the Puncture group and the OVX+Puncture group(P>0.05).At 12 W,there were significant differences between the Sham group and the Puncture group,between the Sham group and the OVX+Puncture group,between the OVX group and the OVX+Puncture group(P<0.05),and between the Sham group and the OVX group,and the OVX group There was no significant difference between the Puncture group and the Puncture group and the OVX+Puncture group(P>0.05).Through comparison,we found that the difference between the OVX group and the Puncture group was significant only at 8W;while at the three time points of 4W,8W,and 12 W,the comparison between the OVX group and the OVX+Puncture group was significantly different,indicating that the OVX+Puncture group Compared with the OVX group,the degeneration is more obvious.Then,we compared the OVX group,Puncture group,and OVX+Puncture group with longitudinal time gradients,and found that in the OVX group,there were significant differences between 4W and 12 W,and 8W and 12W(P<0.05).There was a significant difference between 4W and 12 W in the Puncture group(P<0.05).There was a significant difference between4 W and 12 W in the OVX+Puncture group(P<0.05).By comparison,we found that the degree of degeneration of the intervertebral discs of the three groups is positively correlated with the prolongation of time.2.HE staining,safranine fast green stainingSubsequently,the HE staining between each group was scored,and the histological score of HE was performed.It was found that the AF ring in the Sham group was not distorted,the boundary between the AF ring and the NP was clear,the number of NP cells was normal,and the ECM had no coagulation.However,the OVX group,Puncture group and OVX+Puncture group showed the distortion of the AF ring,the boundary between the AF ring and the NP was unclear,the number of NP cells was greatly reduced,and the ECM was coagulated.Similarly,the horizontal comparison at the same time point was first performed,and the difference was significant(P<0.05).It was found that at 4W there were significant differences between the Sham group and the OVX group,between the Sham group and the Puncture group,between the Sham group and the OVX+Puncture group(P<0.05),and between the OVX group and the Puncture group,and the OVX group There was no significant difference between the OVX+Puncture group and the Puncture group and the OVX+Puncture group(P>0.05).At 8W,there were significant differences between the Sham group and the OVX group,between the Sham group and the Puncture group,between the Sham group and the OVX+Puncture group(P<0.05),and between the OVX group and the Puncture group,between the OVX group and the OVX group There was no significant difference between the +Puncture group,between the Puncture group and the OVX+Puncture group(P>0.05).At 12 W,there were significant differences between the Sham group and the Puncture group,between the Sham group and the OVX+Puncture group,between the OVX group and the OVX+Puncture group(P<0.05),and between the Sham group and the OVX group,and the OVX group There was no significant difference between the Puncture group and the Puncture group and the OVX+Puncture group(P<0.05).Then,we compared the longitudinal time gradient between the OVX group,Puncture group,and OVX+Puncture group,and the difference was significant(P<0.05).It was found that within the OVX group,there were significant differences between 4W and 12 W,and between 4W and 8W(P<0.05).In the Puncture group,there were significant differences between4 W and 12 W,and between 4W and 8W(P<0.05).In the OVX+Puncture group,there were significant differences between 4W and 12 W,and between8 W and 12W(P<0.05).The degree of degeneration of the intervertebral discs in the three groups was positively correlated with the extension of time.Conclusion: Animal experiments show that the OVX+Puncture combined modeling effect is easier to achieve the IVDD effect than OVX alone,and the OVX group,Puncture group and OVX+Puncture group have a positive correlation with the time gradient of the degeneration of the intervertebral discs in the three groups at 4W and 12 w.Part Three The therapeutic effect of estrogen on IVDDObjective: To explore the effect of estrogen in the treatment of intervertebral disc degeneration.Methods: After the model was successfully built,the Sham group was not given special treatment outside of feeding every day.The Veh group underwent bilateral ovarian removal and acu Puncture of the tail intervertebral disc.Corn oil was injected subcutaneously every day after the operation.The E2 group underwent bilateral ovarian removal and acu Puncture of the tail intervertebral disc surgery,and daily subcutaneous injection of estrogen(10ug/kg)after the operation.Micro-MRI and histological evaluation were performed after 12 W.Results: The Veh group received 12 W subcutaneous injection of corn oil daily after the operation,and the E2 group received 12 W subcutaneous injection of estrogen daily after the operation.Imaging and histological evaluation were performed.1.Micro-MRIAfter 12 W of drug intervention,Micro-MRI detection revealed that the disc morphology and T2 signal of the Veh and E2 groups were changed compared with the Sham group.The T2 image signal of the Micro-MRI in the Veh group was significantly weaker than that of the Sham and E2 groups,and grade IV The change in E2 group was less obvious than that in Sham group.The Modified Pfirrmann grading system was used for scoring,and the rank sum test was used for statistical analysis,and the difference was significant(P<0.05).Pairwise comparisons were made between groups,and there were significant differences between the Sham group and the Veh group,and the E2 group and the Veh group(P<0.05).2.Histological evaluationSubsequently,we also performed the histological score of HE and found that the AF ring in the Sham group was not distorted,the boundary between the AF ring and the NP was clear,the number of NP cells was normal,and the ECM had no coagulation.The Veh group showed the distortion of the AF ring,the boundary between the AF ring and the NP was unclear,the number of NP cells was greatly reduced,and the ECM was coagulated.The morphology of AF ring and NP cells in E2 group was similar to that in Sham group.After scoring,the rank sum test was used for statistical analysis,and the difference was significant(P<0.05).Pairwise comparisons were made between groups.There were significant differences between the Sham group and the Veh group,and the E2 group and the Veh group(P<0.05),and the results were consistent with the Micro-MRI score.Conclusions: Animal experiments show that compared with the Veh group,estrogen can effectively alleviate the degeneration of the intervertebral disc after 12 W intervention. |
PDF Full Text Request