中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (33): 6171-6174.doi: 10.3969/j.issn.1673-8225.2010.33.022

• 组织构建基础实验 basic experiments in tissue construction • 上一篇    下一篇

腰椎终板Modic的改变：生化组织学特点

廖家新1，王  宸2，王建伟1，张爱国1   

  1. 1 无锡市中医医院骨伤科，江苏省无锡市 214001；2 东南大学附属中大医院骨科，江苏省南京市 210009
  • 出版日期:2010-08-13 发布日期:2010-08-13
  • 作者简介:廖家新★，男， 1975年生，安徽省郎溪县人，汉族，2008年东南大学毕业，硕士，主治医师，主要从事腰椎退行变研究。 Ljx_75@yahoo. com.cn

Modic changes of the lumbar endplate: Biochemistrical and histological features

Liao Jia-xin1, Wang Chen2, Wang Jian-wei1, Zhang Ai-guo1   

  1. 1 Deparment of Orthopaedics and Traumatology, Wuxi Traditional Chinese Medicine Hospital, Wuxi  214001, Jiangsu Province, China; 2 Department of Orthopaedics, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009, Jiangsu Province, China
  • Online:2010-08-13 Published:2010-08-13
  • About author:Liao Jia-xin★, Master, Attending physician, Department of Orthopaedics and Traumatology, Wuxi Traditional Chinese Medicine Hospital, Wuxi 214000, Jiangsu Province, China Ljx_75@yahoo.com.cn

PDF

564

摘要：

背景：1988年Modic等系统描述了在退变的腰椎间盘终板及终板下骨质MRI信号改变的类型、分型标准及组织学变化，并将其命名为Modic改变。各型Modic改变的退变程度尚不清楚。
目的：通过对各型Modic改变的组织学观察和生化成分的检测，了解各型终板组织学特点及生化成分，研究各型Modic改变退变程度。
方法：手术取得所需终板36例，手术时根据影像定位，取出所需终板，按Modic改变分型分组：无Modic改变的12例，ModicⅠ型12例，ModicⅡ型12例。将标本行苏木精-伊红染色，在光镜下观察软骨终板组织学特点，用免疫组织化学方法观察Ⅱ型胶原表达，用间苯三酚法测定蛋白多糖的含量。
结果与结论：免疫组织化学染色结果显示，各组在腰椎终板基质中可见棕黄色细颗粒状阳性表达，在有Modic改变的椎体终板中，Ⅱ型胶原积分灰度值比无Modic改变者明显升高(P < 0.05)，ModicⅠ型积分灰度值明显高于ModicⅡ型(P < 0.05)。蛋白多糖检测：在有Modic改变的椎体终板中，蛋白多糖的含量比无Modic改变者明显升高(P < 0.05)，ModicⅠ型蛋白多糖的含量高于ModicⅡ型(P < 0.05)。组织学特点：ModicⅠ型(水肿型)软骨下血管化的纤维组织以及与此相关的软骨终板出现裂隙或破裂；ModicⅡ型(脂肪型)脂肪组织替代正常的软骨或骨组织；Modic(-)病理学无上述变化。结果可发现，Modic改变是腰椎终板退变逐渐加重的连续性过程。

关键词: 腰椎终板, 磁共振, Modic分型, 病理, 下腰痛, Ⅱ型胶原, 蛋白多糖, 退变

Abstract:

BACKGROUND: Modic changes, a common observation in MR imaging, are signal intensity changes in vertebral body marrow adjacent to the endplates of degenerative discs. However, degeneration degree of each type of Modic change remains unclearly.
OBJECTIVE: To understand the degree of each type of Modic change degeneration though studying histology and biochemistry composition of Modic change.
METHODS: A total of 36 endplates were harvested during surgery and divided into 3 groups according Modic changes. 12 cases had no Modic changes, 12 cases with type Ⅰ Modic changes, and 12 cases with type Ⅱ Modic changes. Haematoxylin-eosin staining was performed on each group. The histopathologic features of endplates were observed under a light microscope; expression of type Ⅱ collagen was examined by immunohistochemical method, and the content of proteoglycan was determined by phloroglucin way.
RESULTS AND CONCLUSION: Immunohistochemical staining showed that, brown-yellow positive expression could be found in matrix of vertebral endplates in each group. Compared with patients with normal endplates, the integral grey degree of patients with Modic changes were obviously increased (P < 0.05), which greater in Modic Ⅰ than that of Modic Ⅱ (P < 0.05). Proteoglycan determination showed that, vertebral endplates from patients with Modic Ⅰ, or type Ⅱ endplate changes had significantly more proteoglycan combined with patients with normal endplates (P < 0.05). The proteoglycan content in endplates exhibiting Modic Ⅰ were significantly higher than in endplates exhibiting Modic Ⅱ changes (P < 0.05). Histopathologic features were: there were disruption and fissuring in the endplates and vascularized fibrous tissues in Modic Ⅰ, while type Ⅱ changes demonstrated yellow marrow replacement. However, there was no changes in the Modic(-). The results suggest that Modic changes are successive procedure of aggravated degeneration of vertebral endplates.

中图分类号: