中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (26): 4841-4844.doi: 10.3969/j.issn.1673-8225.2010.26.022

• 骨与关节图像与影像 bone and joint imaging • 上一篇    下一篇

胸腰椎爆裂性骨折Denis B型伤椎下位椎间盘组织学及影像学特点

张 亮1，靳安民2，高梁斌1，李 健1，张 志1   

  1. 1 广州医学院第三附属医院脊柱骨科，广东省广州市  510150；
    2 南方医科大学珠江医院骨科中心，广东省广州市 510282
  • 出版日期:2010-06-25 发布日期:2010-06-25
  • 作者简介:张 亮，男，1971年生，福建省周宁县人，汉族， 2001年解放军第一军医大学毕业，硕士，副主任医师，主要从事脊柱外科方面的研究。 zldxx861@sina. com
  • 基金资助:

    广州市医药卫生科技项目(2009-YB-165)

Imaging and histological features of intervertebral disc under injured vertebral body in Denis type B thoracolumbar burst fracture  

Zhang Liang1, Jin An-min2, Gao Liang-bin1, Li Jian1, Zhang Zhi1   

  1. 1Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou  510150, Guangdong Province, China;
    2Orthopedics Center, Zhujiang Hospital of Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Online:2010-06-25 Published:2010-06-25
  • About author:Zhang Liang, Master, Associate chief physician, Department of Orthopedics, Third Affiliated Hospital of Guangzhou Medical College, Guangzhou 510150, Guangdong Province, China zldxx861@sina.com
  • Supported by:

    the Medical Health Science and Technology Program of Guangzhou, No. 2009-YB-165*

PDF

410

被引次数

28

摘要：

背景：评估伤椎下位椎间盘损伤情况有利于治疗方案的选择，目前有关胸腰椎爆裂性骨折Denis B型伤椎下位椎间盘形态和功能的研究很少。
目的：通过观察脊胸腰椎爆裂性骨折Denis B型伤椎下位椎间盘的影像学和组织学特点，探讨伤胸腰椎爆裂性骨折Denis B型椎下位椎间盘的保留价值。
方法：纳入18例脊柱爆裂性骨折Denis B型患者，X射线测量伤椎下间隙前、后缘高度和正常椎间隙前、后缘高度；MR表现依据Oner分型进行分级，在MR矢状面T2WI上测量腰椎间盘髓核、纤维环及脑脊液的信号强度，分别计算出髓核、纤维环与脑脊液的信号强度的比值。将伤椎下位椎间盘组织和正常对照椎间盘(5例取自脊柱侧弯及脊柱肿瘤)组织进行苏木精-伊红染色，观察椎间盘髓核的组织学改变并行Boos评分；以阿辛蓝染色法测量图像阳性吸光度(A)值。
结果与结论：X射线平片表现为伤椎下位椎间隙前缘及后缘高度与正常椎间隙差异无显著性意义(P >0.05)。18例伤椎下位椎间盘MR表现为OnerⅠ型即间盘形态完整，无Ⅱ~Ⅴ型病例。伤椎下位椎间盘纤维环/脑脊液的信号强度比、伤椎下位椎间盘髓核/脑脊液的信号强度比与正常椎间盘差异均无显著性意义(P > 0.05)。伤椎下位椎间盘髓核组织与正常椎间盘髓核组织Boos评分、阿辛蓝染色A值差异无显著性意义(P > 0.05)。X射线平片、CT、MRI提示Denis B型伤椎下位椎间盘无明显损伤，形态完整，信号强度正常，组织学提示其结构完整具有良好的保留价值。

关键词: 胸腰椎爆裂性骨折, Denis B型, 椎间盘, 影像学, 组织学

Abstract:

BACKGROUND: Evaluation of vertebral disc under the vertebral body facilitates selection of treatments. Currently, studies of Denis type B fracture intervertebral disc appearance and function in vertebral burst fractures are few.

OBJECTIVE: To observe the imaging and histological features of vertebral disc under the vertebral body of Denis type B thoracolumbar burst fracture, to further evaluate the effect of preserving the vertebral disc under the injured vertebral body.

METHODS: A total of 18 cases with Denis type B thoracolumbar burst fracture underwent X-ray, CT, and MRI examination. The anterior and posterior margin of intervertebral height under the injured vertebral body were accessed and compared with the normal height of intervertebrae by X-ray. Oner classification was performed based on the outcome of MRI examination. The signal intensity of nucleus pulposus (NP), annulus fibrosus (AF) and cerebrospinal fluid (CSF) on T2WI in sagittal position was measured, respectively. The ratio of signal intensity for NP/CSF and AF/CSF was calculated. The tissue of interested and normal vertebral disc was collected and measured by hematoxylin-eosin staining and alcian blue staining (absorbance value). The outcomes of staining were measured by Norbert Boos score.

RESULTS AND CONCLUSION: The anterior and posterior margin of intervertebral height under the injured vertebral body was not significantly different compared with the normal intervertebrae by X-ray (P > 0.05). According to Oner classification, all the vertebral discs under the injured vertebral body of 18 cases were in type Ⅰ, i.e., the vertebral disc was normal or near-normal, and there were no vertebral disc of type Ⅱ - Ⅴ. The signal intensity ratio of AF/CSF, the signal intensity ratio of NF/CSF for the vertebral disc under the injured vertebral body displayed no significant differences compared with the normal ratio of NF/CSF (P > 0.05). Norbert Boos histological score and the absorbance values of alcian blue staining of the interested vertebral disc were similar to the normal one (P > 0.05). The vertebral disc under the injured vertebral body remained no obvious damage, and the structure was examined by X-ray, CT, and MR. Histological analysis shows that the vertebral disc could be preserved.

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