Pathomehcanism of lumbar ligamentum flavum hypertrophy

黄韧带肥厚的病理机制尚不清楚。我们推测其机制与皮肤缺损修复过程中增生性瘢痕形成的机制相似。病理学被认为是纤维增生性疾病（FPD）。为了证实这一假设，我们研究了LF和增生性瘢痕肥大的相似性。在腰椎减压手术中采集肥大LF样本。Masson Trichlome（MT）和Elastica货车Gieson（EVG）染色观察瘢痕和纤维化情况。采用免疫组织化学方法检测1型、3型胶原和α-平滑肌抗原（α-SMA）的表达。在肥大的LF，弹性纤维染色稀疏，尤其是沿着背侧。相反，在LF中证实了瘢痕和纤维组织。在瘢痕形成部位，1型和3型胶原被染色。还证实αSMA染色。因此，LF肥大可能是一种纤维增生性疾病。正常LF的另一种主要基质是1型胶原。我们评估了名为Pentocidine的胶原蛋白中的不良交联，其降低了韧带弹性。我们证实了在LF中存在戊西啶，特别是在1型胶原蛋白显示丰富生产的部位。

The pathomechanism of hypertrophy of ligamentum flavum (LF) is still unknown. We hypothesized that the mechanism would be similar to that in the hypertrophic scar formation during the would repair of skin. The pathology is considered to be fibro-proliferative disorder (FPD). To confirm the hypothesis, we have investigated the similarity of the hypertrophy of LF and hypertrophic scar. Hypertrophied LF samples were taken during the lumbardecompression surgery. Masson Trichlome (MT) and Elastica van Gieson (EVG) stain were uded to understand the scar and fibrosis. The similarity of FPD was investigated using the immunohistochemistry of type 1 and 3 collagen and alfa-smooth muscle antigen (αSMA). In the hypertrophied LF, elastic fiber was stained sparse, especially along the dorsal aspect in LF. Instead, scar and fibroscic tissue was confirmed in the LF. At the scarring site, type 1 and 3 collagen was stained. The αSMA was also confirmed to be stained. Thus, hypertrophy of LF would be a type of the fibro-proliferative disorder. The other major matrix of the normal LF is type 1 collagen. We evaluated the bad crosslink in collagen named Pentocidine, which reduces the ligament elasticity . We confirmed the existence of the pentocidine in LF, especially at the cite where type 1 collagen showed abundant production.