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[脊柱侧弯小关节面关节软骨退变的超微结构研究]

[Ultrastructural studies of articular cartilaginous degeneration in the facet joints in spinal scoliosis].

作者信息

Kita N

机构信息

Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Japan.

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1994 Apr;68(4):184-95.

PMID:8189100
Abstract

The purpose of this study was to determine the relationship between spinal scoliosis and degeneration in the articular cartilage of the intervertebral facet joint. Histological and ultrastructural studies were performed on the articular cartilage of the apical facet joints in the area affected by spinal scoliosis. Histological examinations showed that cartilaginous degeneration in the concave side was more severe than that in the convex side. Over 70 degrees, the histological findings showed increased surface irregularities and hypocellularity in the concave facet joints. A significant correlations were found between the apical degenerative score of the articular cartilage and the pre-operative rotation index and the post-operative correction ratio of the scoliosis. Using transmission electron microscopy (TEM), the development of the organellae of the concave articular cartilage was demonstrated to be commonly disturbed, but the microstructure of the convex cartilage was intact with less than 70 degrees of spinal scoliosis, while similar findings to the concave side were demonstrated over 70 degrees. These results suggest that a biomechanical imbalance disturbed organellae of the cartilage cells in the articular cartilage of the concave apical facet joints initially and this then gradually extended to the convex side over 70 degrees with progressing scoliosis.

摘要

本研究的目的是确定脊柱侧弯与椎间小关节关节软骨退变之间的关系。对脊柱侧弯受累区域顶椎小关节的关节软骨进行了组织学和超微结构研究。组织学检查显示,凹侧软骨退变比凸侧更严重。超过70度时,组织学结果显示凹侧小关节表面不规则性增加且细胞减少。关节软骨的顶椎退变评分与术前旋转指数及脊柱侧弯术后矫正率之间存在显著相关性。使用透射电子显微镜(TEM)观察发现,凹侧关节软骨细胞器的发育普遍受到干扰,但脊柱侧弯小于70度时,凸侧软骨的微观结构完整,而超过70度时,凸侧出现与凹侧相似的表现。这些结果表明,生物力学失衡最初扰乱了凹侧顶椎小关节关节软骨中软骨细胞的细胞器,随着脊柱侧弯进展,这种扰乱随后在超过70度时逐渐扩展到凸侧。

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