Weidner N, Rice D T
Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Hum Pathol. 1988 Apr;19(4):406-10. doi: 10.1016/s0046-8177(88)80489-1.
To develop histologic criteria that allow distinction of prolapsed from nonprolapsed intervertebral disk material, we reviewed the histologic features of curetted fibrocartilage from 100 consecutive patients having documented disk prolapse into the spinal canal and contrasted our findings to those in 40 intervertebral disks removed at autopsy from 20 patients without prolapse. Neovascularization, occurring at the edges of fibrocartilage fragments, was present in 50% of prolapsed disk specimens and in none of the control autopsy disks (p = 0.0004). Other histologic features sometimes used as evidence of degeneration and/or prolapse (i.e., fibrillation, chondrocyte "cloning," and granular change) were not helpful in distinguishing prolapsed from nonprolapsed control disks. Although this indicator was only 50% sensitive in our series, we propose that edge neovascularization of the fibrocartilage fragments is the only reliable histologic clue that intervertebral disk prolapse has occurred.
为制定能区分脱出与未脱出椎间盘组织的组织学标准，我们回顾了100例有记录的椎间盘脱出至椎管患者刮除的纤维软骨的组织学特征，并将我们的发现与20例无椎间盘脱出患者尸检时摘除的40个椎间盘的特征进行对比。纤维软骨碎片边缘出现的新生血管形成存在于50%的脱出椎间盘标本中，而对照尸检椎间盘标本中均未出现（p = 0.0004）。其他有时用作退变和/或脱出证据的组织学特征（即原纤维形成、软骨细胞“克隆”和颗粒样改变）对于区分脱出与未脱出的对照椎间盘并无帮助。尽管在我们的系列研究中该指标仅50%敏感，但我们提出纤维软骨碎片边缘新生血管形成是椎间盘脱出已发生的唯一可靠的组织学线索。
