Yuan Hai-feng, Wang Zi-li, Qiao Yong-dong, Ding Hui-qiang, Zhao Hao-ning
Department of Orthopedics, the Affiliated Hospital of Ningxia Medical College, Yinchuan 750004, China.
Zhonghua Wai Ke Za Zhi. 2006 Oct 15;44(20):1381-4.
To investigate the correlation of pathology, bone morphogentic protein (BMP) expression, CT value with the ossification of thoracic ligamentum flavum (TOLF) to afford the evidence to choose appropriate treatment methods.
Twenty-three patients aged 35 - 65 years old had TOLF in my hospital as case. Their courses of disease were 2 months to 9 years. The values of blood calcium, blood phosphorus and AKP in them were normal. The 5 peoples aged 21 - 35 years old who presented fracture of thoracic but not the ligamentum flavum ossification were selected as control. We excluded those who have DISH, ankylosing spondylitis, fluorosis and other disease related with TOLF. The lesion locus were scanned and mensurated by CT. The pathology characteristics were classified into immature ossification and mature ossification by general observation, histology examination. BMP were measured by the immunohistochemical (IHC) staining techniques.
The CT value was significantly higher in the case group (547.2 +/- 131.4) than controlled group (137.7 +/- 10.6) (t = 6.922, P = 0.000). Further, the CT value in the mature ossification (702.9 +/- 17.7) was significantly higher than the immature (480.5 +/- 180.2) (t = 5.623, P = 0.000). In addition, BMP both expressed negative in the mature ossification and the controlled group, but positive in the immature ossification. BMP expression was significantly different between the immature ossification and the mature (chi2 = 70.000, P = 0.000).
The CT values, pathological types and BMP expression results are similar to evaluate the ossification degrees of ligamentum flavum, and then could be indirectly judged the maturation degrees of TOLF by CT to confirm the treatment methods before operation.
探讨胸椎黄韧带骨化(TOLF)的病理学、骨形态发生蛋白(BMP)表达、CT值之间的相关性,为选择合适的治疗方法提供依据。
选取我院23例年龄在35 - 65岁的TOLF患者作为病例组,病程2个月至9年,血钙、血磷及碱性磷酸酶(AKP)值均正常。选取5例年龄在21 - 35岁的单纯胸椎骨折患者作为对照组,排除弥漫性特发性骨肥厚(DISH)、强直性脊柱炎、氟骨症等与TOLF相关疾病。对病变部位行CT扫描及测量,通过大体观察、组织学检查将病理学特征分为未成熟骨化和成熟骨化,采用免疫组织化学(IHC)染色技术检测BMP。
病例组CT值(547.2±131.4)显著高于对照组(137.7±10.6)(t = 6.922,P = 0.000)。此外,成熟骨化组CT值(702.9±17.7)显著高于未成熟骨化组(480.5±180.2)(t = 5.623,P = 0.000)。另外,BMP在成熟骨化组和对照组均呈阴性表达,在未成熟骨化组呈阳性表达,未成熟骨化组与成熟骨化组BMP表达差异有统计学意义(χ2 = 70.000,P = 0.000)。
CT值、病理类型及BMP表达结果在评估黄韧带骨化程度方面具有相似性,可通过CT间接判断TOLF的成熟程度,从而在术前确定治疗方法。