Patt S, Brock M, Mayer H M, Schreiner C, Pedretti L
Department of Neurosurgery, Klinikum Steglitz, Free University of Berlin, Germany.
Spine (Phila Pa 1976). 1993 Feb;18(2):227-31. doi: 10.1097/00007632-199302000-00009.
Chemonucleolysis was unsuccessful in 100 out of 519 patients with herniated lumbar discs treated within a period of 3 years. These patients were subsequently submitted to open surgery. Disc material from 88 of the 100 patients was examined by light microscopy (hematoxylin and eosin, van Gieson's, Nissl's and periodic acid-Schiff staining) to verify the effect of enzymatic activity compared to the histologic findings in a similar control group. In 84 of the 88 cases, signs of enzymatic activity were revealed by eosinophilia of the ground substance, altered Nissl staining and positive periodic acid-Schiff reaction within the chondrocyte halos. These alterations indicate that the enzyme was active and confirm the results of previous studies with smaller numbers of cases. Histologic alterations were quantified according to the intensity and extent of staining. The signs of enzymatic activity were significantly (P < 0.01) stronger after short time intervals between chemonucleolysis and surgery than after long intervals. These findings may be interpreted as indicating a regenerative potential of the nucleus pulposus.
在3年的时间里，接受治疗的519例腰椎间盘突出症患者中，有100例化学髓核溶解术治疗失败。这些患者随后接受了开放手术。对这100例患者中的88例的椎间盘组织进行了光学显微镜检查（苏木精和伊红染色、范吉森染色、尼氏染色和过碘酸希夫染色），以验证酶活性的效果，并与类似对照组的组织学结果进行比较。在88例中的84例中，通过基质嗜酸性粒细胞增多、尼氏染色改变以及软骨细胞晕圈内过碘酸希夫反应阳性，揭示了酶活性的迹象。这些改变表明该酶具有活性，并证实了之前较少病例数研究的结果。根据染色的强度和范围对组织学改变进行量化。化学髓核溶解术与手术之间的时间间隔较短时，酶活性的迹象明显（P < 0.01）强于时间间隔较长时。这些发现可解释为表明髓核具有再生潜力。
