Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, University of Oxford, Nuffield Orthopaedic Centre, Oxford OX3 7LD, England.
Spine (Phila Pa 1976). 2011 May 15;36(11):899-904. doi: 10.1097/BRS.0b013e3182050284.
Analysis of lymphatic vessels in childhood and adult normal and pathological vertebral bone and intervertebral disc tissue.
To determine whether lymphatic vessels are present in spinal vertebrae and intervertebral discs in normal children and adults (4-30 years) as well as in pathological lesions of the spine.
There is uncertainty regarding the presence or absence of lymphatic vessels in normal intervertebral discs and the role of lymphatics in the pathobiology of disc degeneration and infective, neoplastic, and other spinal pathology.
The presence of the specific lymphatic endothelial cell markers, podoplanin, and LYVE-1 was determined immuno-histochemically in normal cervical, thoracic, and lumbar disc and vertebral tissues of adults and children, as well as in a wide range of spinal disorders.
Lymphatics were not found in intact normal intervertebral discs or within spinal vertebrae of children or adults. Lymphatics were present in the outer periosteum and paraspinal ligaments and surrounding connective tissue. Lymphatic vessels were seen in infected and displaced degenerate disc tissue. Lymphatic vessels in vertebral bone were seen only when neoplastic and non-neoplastic lesions of the spine were associated with vertebral destruction and the lesion extending through the bone cortex into surrounding connective tissue.
Lymphatics are not found in intact normal spinal vertebrae or the intervertebral discs of children or adults. Lymphatics in vertebral bone are found in pathological lesions of the spine when these have extended beyond the normal anatomical confines of the vertebra or intervertebral disc; this most likely occurs by ingrowth of lymphatics from surrounding connective tissues. These findings strongly suggest that metastatic tumor spread to the spine does not occur by lymphatics and that lymph node involvement of primary malignant spinal tumors occurs only after extraosseous spread.
分析儿童和成人正常及病理脊柱骨和椎间盘中的淋巴管。
确定在正常儿童和成人（4-30 岁）以及脊柱病理病变中，脊柱椎体和椎间盘中是否存在淋巴管。
关于正常椎间盘和淋巴管在椎间盘退变以及感染、肿瘤和其他脊柱病理学中的作用，存在不确定性。
通过免疫组织化学方法检测正常颈椎、胸椎和腰椎间盘以及成人和儿童的脊柱组织以及广泛的脊柱疾病中特定的淋巴管内皮细胞标志物 podoplanin 和 LYVE-1 的存在。
在完整的正常椎间盘或儿童或成人的脊柱椎体中均未发现淋巴管。淋巴管存在于骨外膜和脊柱旁韧带以及周围的结缔组织中。在感染和移位的退变椎间盘组织中可见淋巴管。仅当脊柱的肿瘤和非肿瘤病变与脊柱破坏以及病变延伸穿过骨皮质进入周围结缔组织有关时，才能在椎体骨中看到淋巴管。
在完整的正常脊柱椎体或儿童或成人的椎间盘内未发现淋巴管。当这些病变超出脊柱或椎间盘的正常解剖范围时，在脊柱的病理性病变中可以在椎体骨中发现淋巴管；这最有可能是通过周围结缔组织的淋巴管生长引起的。这些发现强烈表明，脊柱转移瘤的扩散不是通过淋巴管进行的，而原发性恶性脊柱肿瘤的淋巴结受累仅在骨外扩散后发生。
