LIGAMENTA-FLAVA IN LUMBAR DISC HERNIATION AND SPINAL STENOSIS - LIGHT AND ELECTRON-MICROSCOPIC MORPHOLOGY
LIGAMENTA-FLAVA IN LUMBAR DISC HERNIATION AND SPINAL STENOSIS - LIGHT AND ELECTRON-MICROSCOPIC MORPHOLOGY
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DOI：
10.1097/00007632-199404150-00009
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发表时间：
1994-04-15
期刊：
影响因子：
3
通讯作者：
DEMARTINO, C
中科院分区：
文献类型：
--
作者：
POSTACCHINI, F;GUMINA, S;DEMARTINO, C
方法. 对9例腰椎间盘突出症和10例腰椎管狭窄症患者的黄韧带进行了组织学、组织化学和超微结构研究。 方法：选择6例胸腰椎骨折患者行手术切除黄韧带作为对照。 对照组的黄韧带由大的弹性纤维、细的胶原纤维束和少数梭形成纤维细胞组成。 在接近椎板止点处，韧带具有纤维软骨特征。 在50岁或以上的对照受试者中，细胞数量减少，偶尔可见弹性纤维更少更细和胶原成分更丰富的区域。在椎间盘突出症患者中，韧带的形态特征与年龄相仿的对照组相似。 腰椎管狭窄患者的黄韧带显示纤维化区域，其中细胞通常由活跃合成的成纤维细胞和软骨样化生区域代表。 弹力纤维偶见变性，钙化区多见。 黄韧带随年龄增长发生轻度纤维化和软骨化生。 椎间盘突出症患者无特殊变化。 在椎管狭窄症中，纤维化改变、软骨样化生和钙化降低了韧带的弹性，因此，即使韧带厚度正常，在站立位时，韧带也可能凸出到椎管中。
Methods. Ligamenta flava obtained from nine patients with lumbar disc herniation and ten patients with lumbar stenosis were studied at histologic, histochemical, and ultrastructural levels. Lumbar ligamenta flava removed from six patients who underwent surgeries for thoracolumbar fractures were used as controls.Results. Ligamenta flava from control subjects consisted of large elastic fibers, thin bundles of collagen fibers, and few spindle-shaped fibroblasts. In proximity to the laminal insertion, the ligaments had fibrocartilagineous features. In the control subjects who were age 50 or older, the cells decreased in number and areas that had fewer and thinner elastic fibers and a more abundant collagen component were visable occasionally. In patients with disc herniation, the ligaments had similar morphologic features to those of the controls of similar ages. The ligamenta flava from patients with lumbar stenosis showed areas of fibrosis in which the cells were often represented by actively synthesizing fibroblasts and areas of chondroid metaplasia. Degenerating elastic fibers were seen occasionally, while calcified areas were observed often.Conclusions. Ligamenta flava undergo slight fibrotic and chondrometaplastic changes with aging. No peculiar changes occur in patients with disc herniation. In spinal stenosis, fibrotic changes, chondroid metaplasia, and calcification reduce the elasticity of the ligaments, which may thus bulge into the spinal canal in the standing position even in they are normal in thickness.