Disc morphology in health and disease
Disc morphology in health and disease
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DOI：
10.1042/bst0300864
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发表时间：
2002-11-01
影响因子：
3.9
通讯作者：
Roberts, S
中科院分区：
文献类型：
--
作者：
Roberts, S
椎间盘的形态取决于存在的组件的类型和它们组装的方式。反过来，这将决定组织执行其主要的生理功能，即承重，并允许僵硬的脊柱在各个方向上运动。椎间盘以一种有序的方式开始其生命，外纤维环由一系列规则的同心胶原纤维束围绕中心胶质髓核组成。随着年龄的增长，片层的复杂性增加，出现更多的分岔、交错，片层带的数量和大小不规则，这可能是由于盘状细胞对入射载荷变化的综合响应。这种组织本身的变化将导致载荷的改变，因此可能建立一个自我延续的圆盘形态破坏循环，一旦开始，可能是不可逆转的。随着疾病和退化，细胞组织也会发生改变。在诸如脊柱畸形的退变或畸形椎间盘中，可能存在细胞数量增加，细胞增殖形成细胞簇，或细胞死亡增加，无论是坏死还是凋亡；例如，脊柱侧凸。细胞数量的任何变化都可能改变营养需求以及营养物和代谢物的浓度梯度。正常情况下，健康成人无血管的椎间盘可随着退变和病变变得越来越血管化和神经支配。这可能导致向椎间盘提供更多的氧气和营养，但也可能引入其他细胞类型和分子，如细胞因子和生长因子。
The morphology of the intervertebral disc is dependent on the type of components present and the manner in which they are assembled. This, in turn, will determine box,,, the tissue carries out its primary physiological functions of load bearing and allowing movement in all directions of the otherwise rigid spine. The disc starts its life in an ordered fashion, with the outer annulus fibrosus consisting of a series of regular concentric bundles of collagen fibres around the central gelatinous nucleus pulposus. With advancing age there is increased complexity of lamellae, with more bifurcations, interdigitations and irregularity in number and size of lamellar bands, probably as a result of the disc cells' synthetic response to variations in incident loads. This change in organization itself will lead to altered load bearing, hence possibly establishing a self-perpetuating cycle of disruption to disc morphology, which, once started, may be irreversible. There are also alterations to cell organization with disease and degeneration. There may be increased cell number, with clusters of cells forming by cell proliferation, or increased cell death, whether by necrosis or apoptosis, in degenerate or deformed discs such as are found in spinal deformities; for example, scoliosis. Any change in cell number is likely to alter the nutritive requirements and concentration gradients of both nutrients and metabolites. The normally avascular disc in the healthy adult can become increasingly vascularized and innervated with degeneration and disease. This may lead to an increased supply of oxygen and nutrients to the disc, but can also introduce other cells types and molecules such as cytokines and growth factors.