徐宝山(Xu Baos- han,Dept Spinal Surg,Tianjin Hosp,Tianjin 300211)…∥Chin J Orthop.-2010,31(1).-66~70
Immunopathological observation of lumbar disc herniation and discogenic pain
徐宝山(Xu Baos- han,Dept Spinal Surg,Tianjin Hosp,Tianjin 300211)…∥Chin J Orthop.-2010,31(1).-66~70
ObjectiveTo evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain.MethodsSeventy-one lumbar disc nucleuses were collected intra-operation,and they were divided into four groups.Group A:30 cases of disc herniation,Group B:22 cases of sequestered disc herniation,and the patients in Group A and B received discectomy;Group C:10 cases of discogenic pain were confirmed by discography,and the painful disc was excised through anterior retroperitoneal approach;Group D:9 cases of lumbar bust fracture who received anterior subtotal corpectomy and discectomy,and the nearly normal caudal disc was collected as control.The disc nucleuses were processed in the following methods:1)HE stain and pathological observation;2)Immunocytochemical test using monoclonal antibodies to CD68 and CD45RO molecule for macrophage and T lymphocytes,respectively.The positive cells were counted and analyzed with statistic method.Results1)Pathological observation with HE stain:compared to control group,the degeneration of nucleus cell was evident in the other groups.There were obvious infiltration of inflammatory cells and focal neovascularization in group A and especially in Group B.In Group C,only diffuse inflammatory cells was found without neovascularization,but the degeneration of matrix was more severe.2)Positive rate of CD68 cells:Group B(63.6%)> Group C(40.0%)> Group A(26.7%)>Group D(0%).There were significant differences among groups(P < 0.05).3)Positive rate of CD45RO cells:Group B(59.1%)> Group A(13.3%),Group C and D were negative,and the positive cell were found in slice of the same site of positive CD68 cells.The differences between each group were significant(P <0.05).ConclusionThe nucleus of herniated disc has evident inflammatory and autoimmunity reaction.The nucleus of discogenic pain is infiltrated with diffuse inflammatory cells and some macrophages,without T lymphocyte and neovasularization,so the autoimmunity course is not evident.18 refs,3 figs,2 tabs.
(Authors)