Yayama T, Baba H, Furusawa N, Kobayashi S, Uchida K, Kokubo Y, Noriki S, Imamura Y, Fukuda M
Division of Orthopaedics and Rehabilitation Medicine, Department of Surgery, University of Fukui, Faculty of Medical Sciences, Shimoaizuki 23, Matsuoka, Fukui, Japan.
Clin Exp Rheumatol. 2005 Sep-Oct;23(5):637-43.
To investigate the histological and immunohistochemical properties of degenerative changes and calcium crystal deposition in the lumbar ligamentum favum.
We examined the ligamentum flavum harvested from 119 surgical cases with symptomatic lumbar spinal stenosis. Sections of the ligament were examined by scanning electron microscopy (SEM), energy dispersive X-ray micro-analysis, and were immunostained for S-100 protein, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and CD34. The results were compared with those of ligament tissue harvested from 10 cases of lumbar disc herniation.
The elastic fibres of the ligamentum favum showed regular, or sometimes irregular, and fragmented fibre bundles. Large areas of fibrosis with reduced elastic component and increased collagenous tissue were frequently seen in the degenerated ligaments. Calcium crystal deposits were observed in these fibrous ligaments, associated with many hypertrophic chondrocytes, and with small blood vessel formation. These chondrocytes stained positively for S-100 protein, VEGF and bFGF Calcium pyrophosphate dihydrate crystals were identified in the calcium deposit area.
We believe that rupture of elastic fibre bundles is the first change to occur in degeneration of the ligamentum favum. Calcium crystal deposition was seen within these fibrous and chondrometaplastic areas. Hypertrophic chondrocytes regulate crystal formation and tissue reconstruction by secreting cytokines.
研究腰椎黄韧带退变及钙晶体沉积的组织学和免疫组化特性。
我们检查了从119例有症状的腰椎管狭窄症手术病例中获取的黄韧带。对韧带切片进行扫描电子显微镜（SEM）检查、能量色散X射线微分析，并对S-100蛋白、血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）和CD34进行免疫染色。将结果与从10例腰椎间盘突出症病例中获取的韧带组织的结果进行比较。
黄韧带的弹性纤维显示出规则的，或有时不规则的、碎片化的纤维束。在退变的韧带中经常可见大片纤维化，弹性成分减少，胶原组织增加。在这些纤维性韧带中观察到钙晶体沉积，伴有许多肥大软骨细胞和小血管形成。这些软骨细胞对S-100蛋白、VEGF和bFGF呈阳性染色。在钙沉积区域鉴定出二水焦磷酸钙晶体。
我们认为弹性纤维束断裂是黄韧带退变中首先发生的变化。在这些纤维性和软骨化生区域内可见钙晶体沉积。肥大软骨细胞通过分泌细胞因子调节晶体形成和组织重建。
