摘要
目的:对青少年特发性脊柱侧凸(AIS)患者两侧椎旁肌中肌梭与运动终板的病理学变化进行对比研究,探讨其与脊柱侧凸病因学可能存在的关系。方法:选取手术治疗的脊柱病变患者共41例,分3组,其中AIS组20例,平均年龄15.3岁,平均Cobb角56.8°,顶椎位于T7～T12;先天性脊柱侧凸(CS)组11例,平均年龄13.9岁,平均Cobb角66.7°,顶椎位于T7～T12;对照组10例,均为非脊柱侧凸病例,其中1例腰椎滑脱、1例腰椎管肿瘤、2例Scheuermann′s病、6例腰椎间盘突出症,平均年龄17.3岁。经患者知情同意,所有病例均于术中取材,AIS组和CS组取顶椎区两侧椎旁肌,对照组取非病变区两侧椎旁肌。标本分别行HE染色和非特异性酯酶(ANAE)染色,对3组病例两侧椎旁肌中肌梭的形态结构、梭内肌纤维数目、平均横截面积以及运动终板的类型进行比较。结果:AIS组患者两侧椎旁肌标本共发现19个肌梭,CS组患者两侧椎旁肌标本共发现13个肌梭,对照组两侧椎旁肌标本共发现5个肌梭。AIS和CS组患者凸侧椎旁肌肌梭内的肌纤维数目及平均横截面积显著大于凹侧椎旁肌(P<0.05)。AIS和CS组凹侧椎旁肌T0型终板数目和病变终板数目均显著多于凸侧椎旁肌(P<0.05)。对照组两侧椎旁肌T0型终板数目和病变终板数目无显著差异(P>0.05)。结论:AIS患者两侧椎旁肌中肌梭的形态结构和运动终板的类型存在差异,这种差异可能是脊柱侧凸的继发性改变。
Objective：To study the pathological changes of muscle spindle and motor end-plate in bilateral paravertebral muscle in adolescent idiopathic scoliosis （AIS） and analyze their relationship with the aetiology of AIS.Method：AIS group had 20 cases with average age 15.3 years and average Cobb angle 56.8^o.The apex vertebra were from T7 to T12.Congenital scoliosis （CS） group had 11 cases with average age 13.9 years and average Cobb angle 66.7^o.The apex vertebra were from T7 to T12.Control group had 10 cases without scoliosis,including 1 spondylolisthesis,1 lumber spinal tumor,2 scheuermann＇s disease and 6 lumber disc hemia tion.The muscle samples were acquired in operation after agreement of patients.The muscle spindles and the motor end-plates of paravertebral muscle in apex vertebral region in AIS and CS groups and in non-dis- eased region in control group were analyzed.Result：19 muscle spindles were found in bilateral paravertebral muscle in AIS group.13 muscle spindles were found in bilateral paravertebral muscle in CS group.5 muscle spindles were found in bilateral paravertebral muscle in control group.The average number and cross sectional area of intrafusal muscle fiber of muscle spindles in the convex side were more than those in the concave side in AIS and CS groups （P〈0.05）.The average number of TO type motor end-plate and diseased end-plate in the concave side were more numerous than those in the convex side in AIS and CS groups（P〈0.05）.There was no significant difference in control group （P〉0.05）.Conclusion：The changes of muscle spindle and motor end-plate in paravertebral muscle in AIS are existed,but possibly secondary to AIS.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2008年第3期222-226,I0003,共6页
Chinese Journal of Spine and Spinal Cord
基金
江苏省自然科学基金项目(编号:BK2007003)
关键词
脊柱侧凸
椎旁肌
肌梭
运动终板
Scoliosis
Paravertebral muscle
Muscular spindle
Motor end-plate
