Fazzalari N L, Manthey B, Parkinson I H
Division of Tissue Pathology, Institute of Medical and Veterinary Science, Adelaide, Australia.
Anat Rec. 2001 Mar 1;262(3):331-9. doi: 10.1002/1097-0185(20010301)262:3<331::AID-AR1044>3.0.CO;2-H.
Vertebral deformity, intervertebral disc disorganisation, and change to vertebral bone architecture are morphological features that are associated with low back pain. The purpose of this study was to examine the influence of the morphological disorganisation of the intervertebral disc on vertebral body shape indices and vertebral cancellous bone architecture. Lumbar spines, T12-S1, were collected from 27 cadavers. The motion segments T12-L1, L2-L3 and L4-L5 were selected for the study. There were 8 females aged 35-94 years and 19 males aged 20-90 years. An intervertebral disc grade signifying the severity of disc disorganisation was assigned to each disc using the macroscopic disc grading criteria of Hansson and Roos (Spine, 1981; 6:147-153.). Vertebral shape indices and vertebral body bone histomorphometric analyses were performed on the vertebral bodies. Where appropriate, data were age adjusted and the influence of morphological disc disorganisation on vertebral body deformity and cancellous bone architecture analysed. Increased vertebral body axial area and the ratio of vertebral body axial area to sagittal area were associated with an increase in vertebral deformity and disc disorganisation. This suggests that vertebral deformity that remains clinically silent in the general population is influenced by intervertebral disc disorganisation. Vertebral cancellous bone architecture undergoes change associated with increased disc disorganisation, consistent with increased vertebral deformity. Vertebral bodies adjacent to degenerate discs (Grade 4) showed increased BV/TV and Tb.Th and decreased BS/BV. This shows that disc disorganisation may modulate vertebral cancellous bone architecture such that it protects against age-related bone changes. In addition, vertebral body wedging and concavity are associated with smaller vertebral body size and vertebral body compression is associated with larger vertebral body size and compromised cancellous bone architecture.
椎体畸形、椎间盘结构紊乱以及椎体骨结构改变是与腰痛相关的形态学特征。本研究的目的是探讨椎间盘形态结构紊乱对椎体形状指数和椎体松质骨结构的影响。从27具尸体上采集了T12 - S1节段的腰椎。选取T12 - L1、L2 - L3和L4 - L5运动节段进行研究。其中有8名年龄在35 - 94岁的女性和19名年龄在20 - 90岁的男性。使用汉森和罗斯（《脊柱》，1981年；6:147 - 153）的宏观椎间盘分级标准为每个椎间盘指定一个表示椎间盘结构紊乱严重程度的椎间盘分级。对椎体进行椎体形状指数和椎体骨组织形态计量学分析。在适当情况下，对数据进行年龄校正，并分析形态学椎间盘结构紊乱对椎体畸形和松质骨结构的影响。椎体轴向面积增加以及椎体轴向面积与矢状面积之比增加与椎体畸形和椎间盘结构紊乱增加相关。这表明在普通人群中临床上无症状的椎体畸形受椎间盘结构紊乱影响。椎体松质骨结构会随着椎间盘结构紊乱增加而发生变化，这与椎体畸形增加一致。退变椎间盘（4级）相邻的椎体显示骨体积分数（BV/TV）和骨小梁厚度（Tb.Th）增加，骨表面积与骨体积之比（BS/BV）降低。这表明椎间盘结构紊乱可能调节椎体松质骨结构，从而抵御与年龄相关的骨质变化。此外，椎体楔形变和凹陷与较小的椎体尺寸相关，而椎体压缩与较大的椎体尺寸和受损的松质骨结构相关。
