Ippolito E, Ponseti I V
J Bone Joint Surg Am. 1981 Feb;63(2):175-82.
Histological and histochemical studies of the spine of a sixteen-year-old boy with juvenile kyphosis who was killed in an automobile accident showed abnormal cartilage in extensive areas of the vertebral and growth plates of the involved vertebrae. In these areas the cartilage matrix was loose, strongly positive when stained with alcian blue and weakly positive to periodic acid-Schiff, and it contained numerous chondrocytes. Some chondrocytes were irregularly shaped and others were in clusters. Vertebral bone growth was stunted under the areas of abnormal vertebral and growth plates. The ossification in the ring apophyses was irregular in areas of abnormal cartilage plate, but necrotic bone was not seen. Schmorl nodes had formed where areas of abnormal cartilage plate adjoining the nucleus pulposus had collapsed, allowing the disc material to herniate into the vertebral body.
The defective vertebral-bone formation in juvenile kyphosis appears to result from abnormal vertebral and growth-plate cartilage. The kyphosis and presumably also the cartilage abnormality can be improved during the florid stage of the disease by decreasing the postural load on the anterior part of the vertebrae with the use of a proper brace.
对一名死于车祸的16岁青少年脊柱后凸男孩的脊柱进行组织学和组织化学研究发现，受累椎体的椎体和生长板广泛区域存在异常软骨。在这些区域，软骨基质疏松，阿利新蓝染色呈强阳性，对高碘酸-希夫染色呈弱阳性，且含有大量软骨细胞。一些软骨细胞形状不规则，其他的则成簇分布。在异常椎体和生长板区域下方，椎体骨生长发育迟缓。在异常软骨板区域，环状骨突的骨化不规则，但未见坏死骨。在异常软骨板与髓核相邻区域塌陷处形成了施莫尔结节，使椎间盘物质疝入椎体。
青少年脊柱后凸中椎体骨形成缺陷似乎是由椎体和生长板软骨异常所致。在疾病的活跃期，通过使用合适的支具减轻椎体前部的姿势负荷，脊柱后凸以及可能存在的软骨异常可以得到改善。
