Rätsep Tõnu, Minajeva Ave, Asser Toomas
Department of Neurology and Neurosurgery, University of Tartu, L.Puusepa 8, 51014, Tartu, Estonia,
Eur Spine J. 2013 Nov;22(11):2474-80. doi: 10.1007/s00586-013-2842-1. Epub 2013 Jun 5.
Lumbar disc degeneration may be associated with intensity of neovascularization in disc herniations. Our study was designed to evaluate how much the severity of histodegeneration is related to the development of neovascularization and to the level of pleiotrophin in the herniated lumbar discs.
Surgically excised lumbar disc specimens were obtained from 29 patients with noncontained (i.e., extruding through the posterior longitudinal ligament) and 21 patients with contained disc herniations. The histodegeneration scores and levels of neovascularization were estimated according to semiquantitative analysis in lumbar disc and endplate samples. Immunohistochemical staining were performed to identify the newly formed blood vessels and to detect the presence of pleiotrophin in the specimens.
Higher levels of disc and endplate neovascularity were registered in noncontained herniations. The level of neovascularization was significantly related to the score of histodegeneration in the herniated disc tissues but not in the endplate specimens. Both contained and noncontained herniations had the highest values of histodegeneration in conjunction with the highest level of neovascularization but the relations between neovascularity and degenerative changes remained to be significant only in the group of noncontained herniations. Registration or frequency of pleiotrophin positive cells did not correlate significantly with histodegeneration or level of neovascularization in the disc samples.
Severe histodegeneration of the lumbar disc herniations is associated with enhanced neovascularization and potentially also spontaneous regression of the herniated tissue.
腰椎间盘退变可能与椎间盘突出症中的新生血管形成强度有关。我们的研究旨在评估组织退变的严重程度与新生血管形成的发展以及腰椎间盘突出症中多效生长因子水平之间的关联程度。
从29例非包容性（即穿过后纵韧带突出）椎间盘突出症患者和21例包容性椎间盘突出症患者身上获取手术切除的腰椎间盘标本。根据腰椎间盘和终板样本的半定量分析来估计组织退变评分和新生血管形成水平。进行免疫组织化学染色以识别新形成的血管并检测标本中多效生长因子的存在。
在非包容性椎间盘突出症中，椎间盘和终板的新生血管形成水平更高。新生血管形成水平与椎间盘突出组织中的组织退变评分显著相关，但与终板标本无关。包容性和非包容性椎间盘突出症在组织退变评分最高且新生血管形成水平最高时出现，但新生血管形成与退变变化之间的关系仅在非包容性椎间盘突出症组中仍然显著。多效生长因子阳性细胞的计数或频率与椎间盘样本中的组织退变或新生血管形成水平无显著相关性。
腰椎间盘突出症的严重组织退变与新生血管形成增强以及突出组织可能的自发消退有关。
