Hungerford D S
Can J Surg. 1981 Nov;24(6):583-7, 590.
Many factors must be considered in the pathogenesis of ischemic necrosis of bone. Etiologic considerations deal with the heterogeneous disease categories that are associated with bone necrosis; these may affect bone circulation either directly or indirectly on either the arterial or the venous side. Moreover, the compartmental nature of bone makes it vulnerable to the direct effects of pathologic processes on the cellular elements of the intraosseous extravascular compartment. Once ischemia has been initiated, whether directly through influence on the circulatory tree or indirectly by the elevation of bone marrow pressure, the effects of ischemia are likely to be further potentiated because of the compartmental nature of bone blood flow. Once a critical level of ischemia is surpassed, it is possible that the condition becomes self perpetuating through increased bone marrow pressure leading to further ischemia. Interruption of this cycle by core decompression can be successful if extensive tissue death has not already occurred at the time of the intervention.
骨缺血性坏死的发病机制必须考虑许多因素。病因学方面涉及与骨坏死相关的多种不同疾病类别；这些疾病可能直接或间接影响动脉或静脉侧的骨循环。此外，骨的分隔性质使其易受病理过程对骨内血管外腔室细胞成分的直接影响。一旦缺血开始，无论是直接通过影响循环系统，还是间接通过骨髓压力升高，由于骨血流的分隔性质，缺血的影响可能会进一步增强。一旦超过临界缺血水平，病情可能会因骨髓压力增加导致进一步缺血而自我持续发展。如果在干预时尚未发生广泛的组织死亡，通过髓芯减压中断此循环可能会成功。
