Brock M, Patt S, Mayer H M
Department of Neurosurgery, Klinikum Steglitz, Free University of Berlin, Germany.
Spine (Phila Pa 1976). 1992 Dec;17(12):1457-61. doi: 10.1097/00007632-199212000-00003.
There are no detailed data in literature concerning the histologic nature of the sequestered (extruded) lumbar disc, and on the frequency with which an extruded fragment, a prolapse or a protrusion are found at surgery. A prospective analysis of 100 consecutive cases of sequestered lumbar disc herniation submitted to surgical treatment revealed this group to represent 28.6% of all cases operated on for lumbar disc herniation. Patients (both male and female) with sequestered lumbar discs are significantly older than those with prolapsed (P < 0.01) and protruded (P < 0.001) discs. Single extruded fragments (n = 68) were twice as frequent as multiple ones (n = 32). The general belief that a 'sequestered (extruded) disc' is almost invariably composed of nucleus pulposus is not substantiated by this study: In 54 cases the extruded fragment consisted predominantly of nucleus material, whereas in 44 cases it consisted mainly of end-plate material. Multiple as well as recurrent sequestered fragments almost always consist of end-plate material. These findings may reflect the result of metabolic alterations in the course of disc degeneration.
文献中没有关于游离（脱出）腰椎间盘组织学性质以及手术中发现脱出碎片、脱垂或突出的频率的详细数据。对100例连续接受手术治疗的游离腰椎间盘突出症病例进行的前瞻性分析表明，该组病例占所有接受腰椎间盘突出症手术病例的28.6%。游离腰椎间盘患者（包括男性和女性）的年龄显著大于脱垂（P < 0.01）和突出（P < 0.001）椎间盘患者。单个脱出碎片（n = 68）的出现频率是多个脱出碎片（n = 32）的两倍。本研究并未证实“游离（脱出）椎间盘”几乎总是由髓核组成这一普遍观点：在54例病例中，脱出碎片主要由髓核物质组成，而在44例病例中，它主要由终板物质组成。多个以及复发性游离碎片几乎总是由终板物质组成。这些发现可能反映了椎间盘退变过程中代谢改变的结果。
