Temporo-spatial distribution of blood vessels in human lumbar intervertebral discs
Temporo-spatial distribution of blood vessels in human lumbar intervertebral discs
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DOI：
10.1007/s00586-006-0213-x
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发表时间：
2007-04-01
影响因子：
2.8
通讯作者：
Boos, Norbert
中科院分区：
文献类型：
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作者：
Nerlich, Andreas G.;Schaaf, Rainer;Boos, Norbert
虽然文献中已达成共识，认为血管仅限于正常成人椎间盘的纤维外环，但在退变过程中是否有血管生长到椎间盘的内部仍在争论中。因此，我们测试了血管生长不是椎间盘退变的明显特征这一假说。应用特异性内皮细胞标记CD31(PECAM)对42例不同年龄(0~86岁)、不同程度组织形态退变的人腰椎间盘石蜡包埋完整标本进行免疫组织化学研究。此外，本研究还包括了20个来自个人(26-69岁)的手术椎间盘样本。在胎儿至婴儿的椎间盘中，血管穿透软骨终板，伸入纤维内环和外环，但不伸入髓核。在青少年和成人中，除了靠近韧带附着点的纤维环的外区外，没有看到血管。软骨终板没有血管，除了终板有局限性破坏的区域。在进展期的椎间盘退变中，除了少数几例完全的、疤痕样的椎间盘破坏外，没有观察到血管。然而，一些边缘病变和偶尔的主要裂隙被延伸到纤维环更深区域的毛细血管网络所包围。随后的形态计量学分析显示，与年轻、成熟和老年成年个体相比，青少年/青少年椎间盘的血管延伸略深，其后环的延伸明显比前环“深”。对手术标本的分析表明，即使在主要的椎间盘破裂时，也只有稀疏的毛细血管没有延伸到髓核中。我们的结果表明，在椎间盘退变过程中没有观察到比周围更深的血管侵犯，这支持了血管生长不是椎间盘退变的明显特征的假说。
While there is consensus in the literature that blood vessels are confined to the outer anulus fibrosus of normal adult intervertebral disc, debate continues whether there is a vascular in-growths into inner parts of the intervertebral disc during degeneration. We therefore tested the hypothesis that vascular in-growth is not a distinct feature of disc degeneration. The specific endothelial cell marker CD 31 (PECAM) was used to immunohistochemically investigate 42 paraffin-embedded complete mid-sagittal human intervertebral disc sections of various ages (0-86 years) and varying extent of histomorphological degeneration. Additionally, 20 surgical disc samples from individuals (26-69 years) were included in this study. In discs of fetal to infantile age, blood vessels perforated the cartilaginous end plate and extended into the inner and outer anulus fibrosus, but not into the nucleus pulposus. In adolescents and adults, no blood vessels were seen except for the outer zone of the anulus fibrosus adjacent to the insertion to ligaments. The cartilaginous end plate remained free of vessels, except for areas with circumscribed destruction of the end plate. In advanced disc degeneration, no vessels were observed except for those few cases with complete, scar-like disc destruction. However, some rim lesions and occasionally major clefts were surrounded by a small network of capillary blood vessels extending into deeper zones of the anulus fibrosus. A subsequent morphometric analysis, revealed slightly "deeper" blood vessel extension in juvenile/adolescent discs when compared to young, mature and senile adult individuals with significantly "deeper" extension in the posterior than anterior anulus. The analysis of the surgical specimens showed that only sparse capillary blood vessels which did not extend into the nucleus pulposus even in major disc disruption. Our results show that vascular invasion deeper than the periphery was not observed during disc degeneration, which supports the hypothesis that vascular in-growth is not a distinct feature of disc degeneration.