The Correlation Between The Degree Of Lumbar Intervertebral Disc Degeneration And The Morphology Of The Cartilage Endplate And Effects Of Electroacupuncture At Jiaji On Water Diffusing Capacity Of Degenerative Lumbar Intervertebral Disc In Rabbit Model

Objective:Lumbar disc herniation refers a clinical disease caused by blood vessels within the spinal canal,spinal nerve roots,paraspinal muscles and other tissues being oppressed or irritated by damaged annulus and bulging,protruding or prolapsed nucleus pulposus.Lumbar disc herniation is mainly manifested as low back pain,some patients may be accompanied by other symptoms,such as lower extremity pain,and so on.In recent years,the incidence of lumbar disc herniation increasingly higher,seriously affecting the quality of life of patients.Currently,a lot of experimental studies and clinical observations confirmed the therapeutic effect of acupuncture on lumbar disc herniation,but the specific action mechanism is not very clear.Diffusion weighted imaging is not only harmless to the human body,but also has a high sensitivity of the lesion.Diffusion weighted imaging can be used to detect the random diffusion motion of water molecules of lumbar disc.Furthermore,diffusion weighted imaging can be used to assess the degree of dispersion of the intervertebral disc tissue water at the molecular level.Diffusion tensor imaging is developed from the basis of diffusion weighted imaging,moreover,it may be used to reflect the speed and direction of diffusion motion of water molecules.diffusion weighted imaging and diffusion tensor imaging has been more and more widely used to detect the degree of disc degeneration.This subject intervenes model rabbits of lumbar disc degeneration by electroacupuncture at Jiaji and measures the difference in ADC values and FA values of lumbar disc rabbit by DWI and DTI,before and after the acupuncture intervention at Jiaji.Explore the influence of electroacupuncture at Jiaji on the water diffusing capacity of lumbar intervertebral disc.Investigate the mechanism of electroacupuncture at Jiaji for lumbar disc degeneration,providing a strong scientific basis for the clinical treatment of EA on lumbar intervertebral disc degeneration.Current researches on the mechanism of lumbar disc degeneration are more inclined to intervertebral disc tissue itself.Endplate is a structure closely linked with the disc,and part of the nutrient supply of the disc is derived from the endplate.This study is to explore the correlation between the endplate morphology and disc degeneration,to research whether there is a certain relationship between disc degeneration and endplate,to research whether endplate is involved or aggravate the disc degeneration process,to better research the mechanism of disc degeneration,to better serve the clinical.Methods:It included two parts:clinical observation and experimental study.Clinical Observation: Selected 60 patients with the main symptoms of low back pain andmet the diagnostic criteria,inclusion criteria,from those who treated and did lumbar spine MRI examination in Wuhan Hospital of Integrated Chinese and Western Medicine from January 2015 to December.Observe lumbar disc endplate morphology of the subjects by Siemens 3.0T Verio MRI system and graded Lumbar intervertebral disc according to Pfirrmann standard.After data analysis and processing,explored the correlation between the endplate morphology and disc rating.Experimental Study: Four rabbits were randomly selected as the normal group,from forty-four Sprague skeletal maturity healthy adult male New Zealand white rabbits.The remaining rabbits were randomly divided into four groups:electroacupuncture add blocker group,model group,sham-model group and EA group.Made rabbit lumbar disc degeneration model and take appropriate interventions as needed.The rabbits of normal group were naturally fed for three weeks without any treatment.The rabbits of model group were built rabbit models of lumbar disc degeneration by interbody pressure.The rabbits of sham group were established false lumbar disc degeneration animal model,in the same method in the model group,but there was no pressure interbody.The rabbits of EA group were treated with electroacupuncture at jiaji from the first day the models were established successfully.There were four courses in all.The rabbits of electroacupuncture add blocker group were injected AQPs inhibitors,HgCl₂,on the first day the models were established successfully.Then they would be intervened in the same way with the EA group.On the first day and twenty-eighth days of successful modeling,four rabbits were selected respectively from each group to be dismantled pressing device,and removed Kirschner wire,to do DTI and DWI for the corresponding ADC and FA values.Result:Clinical Study Results: by pearson analysis between endplate morphology and disc Pfirrmann grading,pearson correlation coefficient r = 0.359,p <0.05 considered statistically significant.This showed that there is certain correlation,positive correlation,between endplate morphology and disc Pfirrmann grading.Experiment Study Results:There is no statistically significant difference between the normal group and the sham group on the frist day and day 28,P> 0.05.There is statistically significant difference between the normal group and the model group on the frist day and day 28,P<0.05.There is statistically significant difference between the model group and the EA group on the frist day and day 28,P<0.05.There is no statistically significant difference between the normal group and the EA add blocker group on the frist day and day 28,P> 0.05.After the pressure rabbit lumbar disc degeneration models were successfully established.The ADC value and FA value of normal rabbit lumbar disc tissue are maintained at a certain level.After 28 days' pressure,they both decreased.After electroacupuncture intervention,ADC and FA values increased,higher than the model group,lower than the normal group.Before acupuncture intervention,using blocker HgCl₂,ADC and FA values didn't not increased,but decreased slightly.Conclusion:Acupuncture treatment at jiaji of lumbar disc herniation is good,worthing Widely used in clinical practice.The ADC value and FA value of normal rabbit lumbar disc tissue are maintained at a certain level.After Lumbar intervertebral disc degeneration,ADC and FA values decreased.After electroacupuncture intervention,ADC and FA values increased.Before acupuncture intervention,using blocker HgCl₂,ADC and FA values didn't not increased,but decreased slightly.This suggests that AQPs may be involved in the regulation of electroacupuncture for Water dispersion channel.There is positive correlation between endplate morphology and disc Pfirrmann grading.Endplate may be involved in the process of disc degeneration,clinical studies on the mechanism of disc degeneration can also be started from the endplate.