摘要
目的 探讨脊髓型颈椎病(CSM)后纵韧带肥厚的病理学机制与临床意义。方法 回顾分 析460例CSM手术病例,取60例典型肥厚后纵韧带及8例确定没有病变的相邻间隙的正常后纵韧 带做病理切片,采用免疫组化,特殊染色法在光镜下观察病理学改变;观察胶原纤维变化及免疫组化 检测IL-1、IL-6、TN-α等的表达。结果 8例正常后纵韧带组织无炎性细胞因子阳性表达,60例病 例不同程度纤维化增生,胞浆及胞核中炎性细胞因子IL-1、IL-6、TNF-α等不同程度阳性表达。结论 CSM中后纵韧带增生肥厚的部分原因是炎性细胞因子IL-1、IL-6、TNF-α等参与调控失常的胶原 纤维增生,由于其增殖性瘢痕的作用,对脊髓神经根产生了直接的压迫,强调临床手术过程中对肥厚 后纵韧带予以切除达到彻底减压目的。
Objectiv To discuss pathological mechanical change and clinical significance of posterior longitudinal ligament hypertrophy in cervical spondylotic myelopathy. Methods The resection of posterior longitudinal ligament was applied in 60 cases,8 cases, of no pathological change in 460 cases of cervical spondylotic myelopathy undergone anterior cervical operation and their clinical data and operative effect were reviewed. Collagen,IL-1,IL-6,TNF-α level were measured with immunohistological methods. Results There were no inflammation cell expressed in 8 normal longitudinal ligaments. But fibrosis proliferation of different degree were observed in 60 cases. The level of IL-1,IL-6,TNF-αwere higher than the control. Conclusion One cause of hypertrophy in posterior longitudinal ligament of the cervical spondylotic myelopathy was fibrosis proliferation in which inflammation cytokines have participated. Resection of posterior longitudinal ligament in the anterior cervical operation of cervical spondylotic myelopathy can improve outcome.
出处
《颈腰痛杂志》
2005年第6期417-420,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
脊髓型颈椎病
后纵韧带
病理变化
炎性细胞因子
纤维增生
cervical spondylotic myelopathy
posterior longitudinal ligament
pathological change
inflammation cytokines
fibrosis proliferation
