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特发性脊柱侧弯椎间盘的组织病理学研究(作者译)

[Histopathological study on the intervertebral discs of idiopathic scoliosis (author's transl)].

作者信息

Nakamura T

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1980 Jun;54(6):523-38.

PMID:7410922
Abstract

To elucidate morphologic events, 74 intervertebral discs removed by Dwyer instrumentation from 15 scoliotic patients and 10 intervertebral discs by anterior spinal wedge osteotomy from 10 patients were examined, along with 33 intervertebral discs from autopsy cases. Paraffin sections were stained with PAS, toluidine blue and alcian blue in addition to routine stainings. The results obtained are as follows: (1) Noticeable differences in stainability of cartilaginous plate, cleft and vacuolation of the matrix of annulus fibrosus and cellular decrease were obtained in nucleus pulposus in scoliotic patients as compared with controls. Chordal cells in nucleus pulposus were found in 30% of scoliotic patients and 9% of controls. (2) In the apical discs, ossification gap of cartilaginous plate decreased, while cleft and vacuolation of annulus fibrosus and formation of cartilage cell cluster in nucleus pulposus were increased. (3) Irregular fiber running, cleft and vacuolation of annulus fibrosus were found in scoliotic patients with the curvature of the spine by more than 60 degrees. Matrix degeneration of cartilaginous plate and irregular fiber running of annulus fibrosus were common in scoliotic patients with higher rotation than grade III of Nash & Moe classification. Conversely, chordal cells in nucleus pluposus were not common in higher rotation cases. Chordal cell remnants were prominent in nucleus pulposus in scoliotic patients. This suggests that some abnormalities occurring during the maturation process of nucleus pulposus are related to the evolution of scoliosis.

摘要

为阐明形态学变化,对15例脊柱侧弯患者经Dwyer器械取出的74个椎间盘、10例患者经前路脊柱楔形截骨取出的10个椎间盘以及33个尸检病例的椎间盘进行了检查。除常规染色外,石蜡切片还用PAS、甲苯胺蓝和阿尔辛蓝染色。结果如下:(1)与对照组相比,脊柱侧弯患者的软骨板染色性、纤维环基质的裂隙和空泡形成以及髓核细胞减少有明显差异。30%的脊柱侧弯患者和9%的对照组患者的髓核中发现了索状细胞。(2)在顶椎椎间盘,软骨板的骨化间隙减小,而纤维环的裂隙和空泡形成以及髓核中软骨细胞簇的形成增加。(3)脊柱侧弯角度超过60度的患者中发现纤维环纤维走行不规则、裂隙和空泡形成。在Nash & Moe分类法中旋转度高于III级的脊柱侧弯患者中,软骨板基质退变和纤维环纤维走行不规则很常见。相反,在旋转度较高的病例中,髓核中的索状细胞并不常见。脊柱侧弯患者的髓核中索状细胞残余明显。这表明髓核成熟过程中发生的一些异常与脊柱侧弯的发展有关。

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