Sato Nori, Higashino Kosaku, Sakai Toshinori, Terai Tomoya, Goel Vijay K, Biyani Ashok, Ebraheim Nabil, Takata Yoichiro, Hayashi Fumio, Yamashita Kazuta, Morimoto Masatoshi, Manabe Hiroaki, Sairyo Koichi
Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School.
ECORE, Department of Bioengineering and Orthopedic Surgery, University of Toledo.
J Med Invest. 2018;65(1.2):85-89. doi: 10.2152/jmi.65.85.
Ligamentum flavum (LF) hypertrophy is one of the main factors of lumbar spinal canal stenosis (LSCS). The primary object of this study is to clarify the existence of epiligament in the LF and its role in hypertrophy, and to develop an LF hypertrophy animal model. A cadaveric spine from a 30-year-old man was used to investigate the existence of epiligament in LF. Five LF samples from LSCS patients were obtained to evaluate hypertrophied LF. To create a rat model, we destabilized the lumbar spine. Each LF was sagittally cut for histological evaluation. The epiligament was clearly evident in normal LF specimens, which stained pink on Elastica van Gieson and green on Masson Trichrome. One layer was observed on the dural side and another on the dorsal side of the LF. LSCS patients had an enlarged dorsal epiligament, at around 30 times that of the regular thin epiligament on the dural side. The destabilized rat model showed an enlarged dorsal epiligament, with a mean thickness 8-fold that of the control. LF hypertrophy may be due to enlargement of the dorsal epiligament. Mechanical loading of the LF is an important factor for inducing hypertrophy in the rat model. J. Med. Invest. 65:85-89, February, 2018.
黄韧带（LF）肥厚是腰椎管狭窄症（LSCS）的主要因素之一。本研究的主要目的是阐明黄韧带中外韧带的存在及其在肥厚中的作用，并建立一种黄韧带肥厚的动物模型。使用一名30岁男性的尸体脊柱来研究黄韧带中外韧带的存在。获取了5例腰椎管狭窄症患者的黄韧带样本以评估肥厚的黄韧带。为创建大鼠模型，我们使腰椎失稳。将每条黄韧带矢状切开以进行组织学评估。在正常黄韧带标本中，外韧带清晰可见，在弹性Van Gieson染色中呈粉红色，在Masson三色染色中呈绿色。在黄韧带的硬膜侧观察到一层，在背侧观察到另一层。腰椎管狭窄症患者的背侧外韧带增大，约为硬膜侧正常薄外韧带的30倍。失稳大鼠模型显示背侧外韧带增大，平均厚度为对照组的8倍。黄韧带肥厚可能是由于背侧外韧带增大所致。在大鼠模型中，黄韧带的机械负荷是诱导肥厚的重要因素。《医学调查杂志》65:85 - 89，2018年2月。
