破裂型与未破裂型腰椎间盘突出组织超微结构对比观察

Ruptured and unruptured comparative study of lumbar disc tissue ultrastructure

目的对比观察破裂型与未破裂型腰椎间盘突出组织的超微结构,研究破裂型椎间盘组织易于发生重吸收的可能机制。方法选取30例腰椎间盘突出症患者的手术标本,依术中是否突破后纵韧带分为破裂型(14例)和未破裂型(16例),规范处理后制成超薄切片,利用透射电镜观察。结果破裂型椎间盘细胞密度低,胞周胶原纤维短缩,细胞呈多角形或类似圆形,细胞器代谢活跃,"空泡征"明显;未破裂型椎间盘胞周胶原纤维排列较规则,细胞呈长梭形或椭圆形,细胞膜皱褶,细胞器少,出现核仁溶解等细胞凋亡指征。结论破裂型腰椎间盘突出组织突破后纵韧带进入硬膜外腔后,获得营养恢复部分代谢途径,胞浆逐渐丰富,细胞由长梭形又恢复至多角形或圆形,高尔基体、粗面内质网等部分细胞器被激活,"空泡样"结构明显;同时发生免疫自噬和凋亡现象,有助于突出组织重吸收。

Objective To compare ruptured and unruptured lumbar disc tissue ultrastructure to determine reabsorption mechanism. Methods 30 cases of patients with lumbar disc herniation surgical specimens, according to intraopera-tive findings were divided into 14 cases of ruptured and unruptured 16 cases. Treatment was made by the norms ultra-thin sections, the use of transmission electron microscopy. Results Ruptured disc low cell density,cell weeks colla-gen fibers shortening,cells were polygonal or similar round organelles metabolically active,“vacuole sign” clearly;un-ruptured disc periplasmic more regular arrangement of collagen fibers,elongated cells spindle-shaped or oval,mem-brane folds, small organelles,cells appeared indications dissolution nucleolus. Conclusions Lumbar disc rupture af-ter the break longitudinal ligament tissue into the epidural space,access to nutritious part of the metabolic pathway re-store gradually abundant cytoplasm,the cell has returned from long fusiform to polygonal or circular,Golgi apparatus, rough endoplasmic reticulum other parts of the cell is activated,“vacuoles” obvious structure;simultaneous immuno-logical autophagy and apoptosis,help to highlight the organization reabsorption.