Kauppila L I
Department of Forensic Medicine, University of Helsinki.
J Bone Joint Surg Am. 1995 Jan;77(1):26-31. doi: 10.2106/00004623-199501000-00004.
Angiograms were made of twenty-two cadaveric lumbar spines to determine the presence of any new blood vessels between adjacent lumbar vertebrae and corresponding discs. The annulus and adjacent longitudinal ligaments were also analyzed histologically. A total of 105 intervertebral spaces were studied. It was found that the normal anastomosing arteries in the posterior longitudinal ligament were significantly obliterated with advancing degeneration of the disc (p < 0.001), whereas several tiny tortuous arteries--often running between the osteophytic spurs--were seen in the anterolateral aspects of the intervertebral spaces connecting the adjacent vertebrae. Histological examination of the anterolateral part of the annulus showed that the vascularity of the annulus increased significantly with degeneration of the disc (p < 0.001), and most of the arteries had a vertical orientation. Regression analysis showed that vascular changes occurred before degeneration of the disc at every lumbar level, suggesting that disturbances in the nutritional supply may precede degeneration. The correlation coefficient was 0.77 (95 per cent confidence limit, 0.52 to 0.90) for the increase in annular vascularity with an increase in the age of the individual at the time of death and 0.86 (95 per cent confidence limit, 0.69 to 0.94) for the increase in degeneration of the disc with an increase in age.
对22具尸体腰椎进行血管造影，以确定相邻腰椎椎体和相应椎间盘之间是否存在任何新血管。还对纤维环和相邻的纵韧带进行了组织学分析。共研究了105个椎间隙。结果发现，随着椎间盘退变加重，后纵韧带中的正常吻合动脉明显闭塞（p<0.001），而在连接相邻椎体的椎间隙前外侧可见几条细小迂曲的动脉，常走行于骨赘之间。纤维环前外侧部分的组织学检查显示，随着椎间盘退变，纤维环的血管化显著增加（p<0.001），且大多数动脉呈垂直方向。回归分析表明，每个腰椎节段在椎间盘退变之前就发生了血管变化，提示营养供应紊乱可能先于退变。纤维环血管化增加与个体死亡时年龄增加的相关系数为0.77（95%置信区间，0.52至0.90），椎间盘退变增加与年龄增加的相关系数为0.86（95%置信区间，0.69至0.94）。
