Yu S, Haughton V M, Sether L A, Ho K C, Wagner M
Department of Radiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee 53226.
Radiology. 1989 Feb;170(2):523-6. doi: 10.1148/radiology.170.2.2911680.
The purpose of this study was to develop criteria for distinguishing normal and degenerated lumbar intervertebral disks. Cryomicrotome sections from and magnetic resonance images of 31 cadavers were reviewed. The immature nucleus pulposus, found up to age 2 years; the transitional nucleus pulposus, found in teenagers; and the adult nucleus pulposus were associated with an intact anulus fibrosus without tears except for small concentric or transverse tears in the periphery of the anulus fibrosus. Discoloration of the nucleus pulposus, diminishing disk height, and diminishing signal intensity were associated consistently with a radial tear of the anulus fibrosus. The severely degenerated nucleus pulposus was associated also with a radial tear or complete disruption of the anulus fibrosus. The results suggest that intervertebral disk normally progresses from the immature to the transitional to the adult nucleus pulposus. When a radial tear develops in the anulus there is shrinkage and disorganization of fibrocartilage in the nucleus pulposus and replacement of the disk by dense fibrous tissue and cystic spaces.
本研究的目的是制定区分正常和退变腰椎间盘的标准。回顾了31具尸体的冷冻切片和磁共振图像。在2岁以下发现的未成熟髓核、青少年期发现的过渡性髓核以及成人髓核，均与完整的纤维环相关，纤维环无撕裂，除了纤维环周边有小的同心或横向撕裂。髓核变色、椎间盘高度减小和信号强度减弱始终与纤维环的放射状撕裂相关。严重退变的髓核还与纤维环的放射状撕裂或完全破裂相关。结果表明，椎间盘通常从未成熟髓核发展为过渡性髓核，再发展为成人髓核。当纤维环出现放射状撕裂时，髓核中的纤维软骨会收缩和紊乱，椎间盘会被致密纤维组织和囊性间隙取代。
