摘要
背景:由于缺乏损伤椎间盘病理改变的相关研究,导致治疗损伤椎间盘缺乏理论依据。目的:观察胸腰椎爆裂骨折上下位椎间盘软骨终板的分子病理改变,探讨创伤后椎间盘改变的相关发生机制。设计、时间及地点:病例-对照观察,于2005-10/2007-09在四川大学华西医院骨科完成。对象:收集四川大学华西医院骨科24例胸腰椎爆裂骨折患者的相关病例资料,包括:姓名、年龄、性别、受伤原因、受伤节段以及影像学(X射线平片、MRI)等资料。男16例,女8例。方法:收集经前路椎体切除椎管减压植骨融合内固定治疗患者受伤椎体切除的上下相邻椎间盘组织。收集每例患者上位椎间盘的上下2个软骨终板和下位椎间盘的上下2个软骨终板,共4个软骨终板。主要观察指标:以苏木精-伊红染色、甲苯胺蓝染色以及Masson三色染色后观察创伤后软骨终板的组织形态改变,以免疫组织化学染色后观察白细胞介素1β、诱导型一氧化氮合酶在软骨终板内的表达。结果:胸腰椎爆裂骨折部位相邻椎间盘软骨终板有明显的组织学损伤表现,以上位椎间盘软骨终板在胸腰椎爆裂骨折中更容易受到损伤。上位椎间盘软骨终板内白细胞介素1β及下游重要蛋白酶诱导型一氧化氮合酶的阳性表达率高于下位椎间盘软骨终板(P<0.05)。结论:上位椎间盘终板在胸腰椎爆裂骨折中更容易受到损伤。
BACKGROUND： There are few studies on pathologic mechanism in post-traumatic intervertebral disc, so no evidence guides the treatment. OBJECTIVE： To observe the pathologic changes in superior and inferior cartilage end-plates in burst fracture and discuss the possible mechanism of post-traumatic intervertebral disc changes. DESIGN, TIME AND SETTING： Case-control observation was performed at the Department of Orthopedics, West China Hospital of Sichuan University between October 2005 and September 2007. PARTICIPANTS： Case data of 24 cases of burst fracture, 16 males and 8 females, from West China Hospital of Sichuan University were collected including name, age, sex, injury cause, injured segment, and imaging data （X-ray, MRI）. METHODS： The superior and inferior end-plates cartilage of burst fracture of patients undergoing anterior approach vertebral resection was selected, respectively. So every patient had two superior and inferior end-plates cartilages. MAIN OUTCOME MEASURES： The pathologic changes of tissue structure in the end-plate cartilage after injury were observed using hematoxylin-eosin （HE） staining, toluidine blue staining （TB） staining and Masson staining; By using immunohistochemistry staining, the expressions of inflammatory mediator interleukin-1 （IL-1β） and inducible nitric oxide synthase （iNOS） in the injured end-plate cartilage were observed. RESULTS： Obvious injury was found in most of the discs adjacent to the fractured vertebral bodies, especially the superior disk end-plate in burst fracture. The expressions of IL- 1β and iNOS in superior end-plate cartilage were significantly higher than in inferior end-plate cartilage （P 〈 0.05）. CONCLUSION： The superior disk end-plate injury is frequent in burst fracture.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第37期7215-7218,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
四川省科技攻关计划课题资助项目(05ST022-018-2)~~
