Experimental modeling of tuberculous spondylitis
Background. Tuberculous spondylitis (TS) in the structure of bone and articular tuberculosis in adults is in a leading position and reaches 40–61.5 %. The purpose of this publication is to consider the process of tuberculous spondylitis modeling and its features in guinea pigs for further use of experiment results in medical and scientific practice. Materials and methods. The experiment was conducted on 40 mature guinea pigs. Modeling of tuberculous spondylitis was conducted on the basis of the method developed by us (Patent No. 112423 (UA) Ukraine). All animals were divided into 4 groups. In groups 1, 2, 3 (main ones), M.tuberculosis suspension at a dose of 0.5 ml (0.1 mg of dry weight in 1 ml) was injected into the vertebral body according to the procedure. Group 4 is control one. Animals were injected with a sterile physiological solution (0.9% — 0.5 ml) into the vertebral body. In group 1 (10 pigs), the treatment was carried out with firstline specific antibacterial drugs (ABD) (isoniazid, streptomycin, rifampicin), in group 2 (10 pigs) — using secondline specific ABD (amikacin, rifabutin, ofloxacin), in group 3 (10 pigs), no treatment was performed. A dynamic observation with clinical, Xray, pathomorphological and laboratory tests was conducted in all animals. Sacrificing experimental animals was carried out according to the previously developed schedule — when identifying the signs of studied stages of the tuberculous process. A pathomorphological examination was conducted in all sacrificed animals. The main attention was paid to the pathomorphological study of vertebrae affected by a specific process. Results. The morphological study showed the presence of an active tuberculous process in vertebral bodies and paravertebral tissues in animals with simulated tuberculosis and treatment with a specific firstline ABD as well as in animals without a specific treatment. It is important to note that the degree of destructive changes severity in the affected vertebrae in untreated animals and those who received firstline ABDs are nearly the same. In animals that had modeled tuberculosis and were treated with a specific secondline ABD, the inhibition of the pathological process with the formation of young bone and connective tissue of varying degrees of maturity and the presence of a zone separating the inflammatory focus from healthy tissue at the early stages of the disease (one month) were revealed. As a result of the performed work it was possible to trace the stages of tuberculous spondylitis in guinea pigs and the modern features of clinical, radiological and pathomorphological course. The identity of the model of the main clinical forms of tuberculous spondylitis in guinea pig and human is revealed. Conclusions. This study showed that modern intensive specific antibiotic therapy in experiment allows achieving a delimitation of the destructive process in relatively early stages of the disease (4–5 weeks). The newly received knowledge about the pathomorphological features of tuberculous spondylitis course allows performing radical surgical intervention on the spine without the risk of tuberculous process generalization at earlier stages.
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