椎间盘退变前驱因素终板退变研究现状

Lamina terminalis degeneration:A precursory factor of intervertebral disc degeneration

明确终板在椎间盘的生理和退变过程中起的作用,对相关知识进行综述。查阅近10年来关于终板与椎间盘退变的文献,整合相关知识,围绕终板及其退变过程对椎间盘退变作出新的解释。结果发现终板可以分为骨性终板和软骨终板,位于椎体和椎间盘之间,起着保护椎体和椎间盘、营养椎间盘的作用。由于基因、年龄、力学负载、损伤等众多因素导致终板的保护作用下降甚至丧失,椎间盘的主要营养通路破坏,终板发生退变,软骨终板钙化,边缘不规则,进而出现椎间隙狭窄、骨赘形成,影像学上出现Modic改变,临床上出现腰痛的症状。终板是椎体-终板-椎间盘系统的重要组成部分,无论对椎体还是椎间盘都有着至关重要的作用。终板退变可能是椎间盘退变的前驱变化,研究终板退变的机制将会对阐明椎间盘退变的机制有重要的意义。

Objective: To determine the physiological and pathological role of lamina terminalisin the progress of intervertebral disc degeneration and review related literature. Methods: Literature in the past decade on lamina terminalisand intervertebral disc degeneration were collected to make a novel interpretation of the intervertebral disc degeneration focusing on the lamina terminalisdegeneration. Results: Lamina terminalisis located between the vertebral body and intervertebral discs with the effects of protecting the vertebral body and intervertebral discs and supplying nutrition to intervertebral discs, which can be divided into bone layer and cartilage layer. Due to many factors such as genes, age, mechanical load and damage, the protective effect of lamina terminalis gradually decreased even lost, damaging the nutrition supply pathway of intervertebral discs, as a result, lamina terminalisdegeneration could occur with cartilage endplate calcification, irregular edges, then the clinical symptoms of low back pain such as intervertebral space narrowing, osteophyte formation and Modic changes on the iconographywill be found. Conclusions: Lamina terminalis is an important part of the vertebral body-lamina terminalis-intervertebral disc system, which has a vital role in both the vertebral body and the intervertebral disc. Lamina terminalis degenerative changes may be the precursor symptom of intervertebral disc degeneration, researches on the mechanisms oflamina terminalis degeneration would be important to clarify the mechanism of intervertebral disc degeneration.