黄韧带的病理和胶原含量变化及其与颈椎管狭窄症的关系

Alterations of pathology and the contents of collagen in the ligamentum flavum and its relationship to cervical spinal stenosis

目的 :探讨颈椎黄韧带退行性改变的病理和胶原含量变化的特点及其与颈椎管狭窄症的关系。方法 :对比观察颈椎管狭窄症患者组及正常对照组颈椎黄韧带的显微和超微结构变化特点 ,并用Woessner′s法对其胶原含量进行生化测定。结果 :患者组黄韧带弹力纤维减少 ,胶原纤维代偿性增多 ,纤维排列紊乱 ,并出现较明显的变性及钙化 ;黄韧带胶原含量较正常对照组显著增高 (P <0 0 5 )。结论 :患者颈椎黄韧带弹力纤维减少 ,且变性及钙化 ,而胶原含量却显著增高。前者引起黄韧带弹性下降 ,而后者则是黄韧带肥厚的主要原因。黄韧带弹性下降且肥厚可导致或加剧颈椎管狭窄 ,引起颈髓后方受压。

Obsjective:To study the pathology and the contents of collagen of the degenerative cervical ligamentum flavum and its relationship to cervical spinal stenosis. Method:The microstructures and ultrastructures of the cervical ligamentum flavum were observed in 10 patients with cervical spinal stenosis and 10 normal adults,meanwhile,the contents of collagen in ligaments were determined by Woessner′s method.Result:In the patient′s group,cervical ligamentum flavum showed decrease of the elastic fibers and proliferation of the collagen fibers,which run in a random fashion,with marked fibrotic changes as well as calcification.The contents of collagen in the patient′s group was significantly higher than those in the normal adults.There were significant difference between the two groups ( P <0 05).Conclusion: The ligamentum flavum of the patients showed degeneration,and calcification of the elastic fibers,also,significant increase of the contents of collagen quantity were present in the ligament of patients. The former would destroy the elasticity of the ligamentum flavum,the later might be the main factor to the thicking of the ligamentum flavum.These changes could cause or aggravate cervical spinal stenosis. Author′s address Department of Orthopaedics, The First Clinical Medical College of Xi′an Medical University, Xi′an, Shanxi,710061