Characteristics of the psoas minor muscle in modeling lateral interbody spondylodesis of the lumbar spine

G. Filimonova, O. V. Diuriagina, N. I. Antonov, S. Ryabykh
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引用次数: 1

Abstract

ВACKGROUND: For the treatment of degenerative diseases of the spine, various deformities, a minimally invasive technique of lateral lumbar interbody fusion is used, which minimizes the risks of spinal cord injury. In the development of these pathologies, the most important role is assigned to the paraspinal muscles, the histological features of which are insufficiently elucidated in the relevant literature when modeling spondylodesis. АIM: To investigate the effect of lateral interbody vertebral fusion (spondylodesis) when introducing titanium implants on the histostructure of the psoas minor muscle. МATERIALS AND METHODS: Experiments were performed in 14 mongrel dogs, 3 individuals the control group (norm). The аnimals underwent discectomy at the level of L45, L56 vertebrae through the lateral approach on the right, and interbody titanium implants were installed. The lumbar spine was stabilized with an external fixator for 30 days. Paraffin muscle sections were stained with hematoxylin-eosin, according to Masson. RESULTS: During the experiment, an increased variety of myosymplast diameters, loss of polygonality of their profiles, fibrosis of the interstitial space, and sclerotization of the vascular membranes were observed in the psoas minor muscle. The volume density of endomysium in both muscles increased 1.5 times relative to the norm after 6 months Other parameters decreased: the volume of myosymplasts was 95%, that of microvessels 73% on the left, 83% on the right. On the other hand, the degree of fatty infiltration increased, amounting to 276% on the left and 394% on the right of the normal parameters. After 18 months, the bulk density of muscle fibers on the left was restored to the value in the control, on the right it was only 95%. The degree of sclerotization in the muscle on the left is 133%, on the right 161% of the norm; the index of fatty infiltration was 146% on the left and 339% on the right of the normal parameter. CONCLUSION: pathohistological changes in the psoas minor during lateral interbody fusion are more pronounced on the side of the operative approach, which necessitates minimizing trauma to the paravertebral muscles during operations in order to prevent sclerotization and fatty involution of muscle tissue.
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腰小肌模拟腰椎侧体间椎体退变的特点
ВACKGROUND:对于脊柱退行性疾病和各种畸形的治疗,采用微创侧腰椎椎体间融合术,将脊髓损伤的风险降至最低。在这些病理的发展中,最重要的作用被认为是脊柱旁肌肉,其组织学特征在相关文献中没有充分阐明。АIM:探讨引入钛植入物对腰大肌组织结构的影响。МATERIALS方法:选取14只杂种犬,3只为对照组(正常)。通过右侧外侧入路在L45、L56椎体水平行椎间盘切除术,并安装体间钛植入物。腰椎用外固定架固定30天。根据Masson的说法,石蜡肌肉切片用苏木精-伊红染色。结果:在实验过程中,腰小肌中观察到肌共体直径的多样性增加,其轮廓的多面性丧失,间质间隙纤维化和血管膜硬化。6个月后,两组肌内膜体积密度较正常值增加1.5倍,其他参数均下降:肌共体体积95%,微血管体积73%,左微血管体积83%。另一方面,脂肪浸润程度增加,分别为正常参数左侧的276%和右侧的394%。18个月后,左图肌纤维的体积密度恢复到对照组的水平,右图肌纤维的体积密度仅为95%。左侧肌肉硬化程度为正常的133%,右侧为正常的161%;脂肪浸润指数左侧为146%,右侧为339%。结论:侧体间融合术中腰小肌的病理组织学改变在手术入路一侧更为明显,这就需要在手术中尽量减少对椎旁肌肉的损伤,以防止肌肉组织硬化和脂肪退化。
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