退变椎间盘的微观评估：临床意义及可能的治疗挑战

Microscopic assessment of degenerated intervertebral disc: clinical implications and possible therapeutic challenge.

作者信息

Oprea Manuel, Popa Iulian, Cimpean Anca Maria, Raica Marius, Poenaru Dan V

机构信息

Second Department of Orthopedics, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.

Department of Morphologic Microscopy/Histology, Angiogenesis Research Center, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania

出版信息

In Vivo. 2015 Jan-Feb;29(1):95-102.

PMID:25600536

Abstract

AIM

To investigate a possible correlation between the histological and morphometric properties of herniated intervertebral disc, clinical and magnetic resonance imaging (MRI) characteristics of patients with lumbar disc degeneration (LDD).

MATERIALS AND METHODS

Thirty six patients with LDD were clinically evaluated using Japanese Orthopaedic Association Score (JOAS), visual analogue scale (VAS) for pain in the lower back or in the pelvic limb; MRI-based classification according to Pfirrmann and Modic criteria. All patients underwent decompressive surgery and herniated intervertebral disc samples were histologically and morphometrically analyzed. Data obtained were statistically analyzed for bivariate and partial correlations.

RESULTS

The mean area size of chondron clusters correlated with age, JOAS (r=-0.385, p=0.032, tau=-0.279, rho=-0.380), Pfirrmann (r=0.505, p=0.002, tau=0.289, rho=0.365) and Modic (r=0.500, p=0.002, tau=0.331, rho=0.419) grading. There was a strong correlation between maximum area size of chondrons and JOAS (r=-0.427, p=0.009, tau=-0.299, rho=-0.430), Pfirrmann changes (r=0.432, p=0.008, tau=0.309, rho=0.388) and Modic endplate changes (r=0.444, p=0.007, tau=0.343, rho=0.434). JOAS correlated with both MRI classifications used for LDD.

CONCLUSION

The intervertebral disc cells tend to aggregate in clusters and the size of the chondrons from LDD correlated with JOAS, Pfirrmann and Modic. JOAS correlates with the imagistic evaluation systems Pfirrmann and Modic.

摘要

目的

研究腰椎间盘退变（LDD）患者椎间盘突出的组织学和形态学特征、临床及磁共振成像（MRI）特征之间可能存在的相关性。

材料与方法

采用日本骨科协会评分（JOAS）、下背部或骨盆肢体疼痛视觉模拟量表（VAS）对36例LDD患者进行临床评估；根据Pfirrmann和Modic标准进行基于MRI的分类。所有患者均接受减压手术，并对突出的椎间盘样本进行组织学和形态学分析。对获得的数据进行双变量和偏相关性统计分析。

结果

软骨细胞簇的平均面积大小与年龄、JOAS（r = -0.385，p = 0.032，tau = -0.279，rho = -0.380）、Pfirrmann分级（r = 0.505，p = 0.002，tau = 0.289，rho = 0.365）和Modic分级（r = 0.500，p = 0.002，tau = 0.331，rho = 0.419）相关。软骨细胞的最大面积大小与JOAS（r = -0.427，p = 0.009，tau = -0.299，rho = -0.430）、Pfirrmann改变（r = 0.432，p = 0.008，tau = 0.309，rho = 0.388）和Modic终板改变（r = 0.444，p = 0.007，tau = 0.343，rho = 0.434）之间存在强相关性。JOAS与用于LDD的两种MRI分类均相关。