破裂型椎间盘突出动物模型重吸收过程中自身免疫反应的研究

目的 探讨自身免疫反应在椎间盘突出后重吸收过程中的作用机制.方法 将20只SD雄性大鼠随机分成对照组,实验组.实验组经手术切除尾椎椎间盘,埋植在背部硬膜外.动物30天后处死,取埋植的髓核组织,进行HE染色,流式细胞仪检测.对照组,将线团埋植在硬膜外,30天后处死作对照试验.结果 对照组与实验组突出组织的形态结构与T,B细胞含量有明显差异.结论 破裂型椎间盘突出的髓核组织能够吸引活性的T,B细胞,引发自身免疫反应.     

破裂型椎间盘突出动物模型中新生血管因子与炎性反应的研究

目的 探讨破裂型椎间盘突出后重吸过程中新生血管的长入与炎性反应的存在.方法 将20只SD雄性大鼠,经手术切除尾椎椎间盘.埋植在背部硬膜外.造成破裂型椎间盘突出模型.动物30d后处死,取埋植的髓核组织,进行HE染色,免疫组化检测.结果 30d后椎间盘组织的形态结构发生明显改变,椎间盘组织中新生血管与巨噬细胞的免疫组化染色均呈阳性.结论 破裂型椎间盘突出的髓核组织经过一段时间确实有新生血管的长入与炎性反应的存在,其可能在椎间盘突出重吸收过程中发挥重要作用.     

腰椎间盘突出症和椎间盘源性疼痛的免疫病理学研究

目的通过对突出腰椎间盘组织中免疫因子的测定,进一步探讨腰椎间盘突出症与椎间盘源性疼痛在免疫病理学改变的异同点。方法收集标本:腰椎间盘突出症(A组)30例,椎间盘源性疼痛(B组)30例,确诊后两组均行腰椎后路减压植骨融合术,腰椎爆裂骨折(C组)10例,都行前路手术,共70例椎间盘髓核标本。对各组髓核组织进行组织学观察,通过免疫组化方法对髓核中CD25+T细胞和CD68阳性巨噬细胞进行检测及数据统计分析。结果病理学观察:C组髓核组织细胞形态一致,匀称分布,细胞质无明显退变,无明显炎症细胞浸润;其他两组均见髓核细胞空泡样变、形态不一致,胞质分布不均;A组髓核组织周围能见较多炎症细胞、局部见毛细血管增生;B组髓核细胞质退变明显,髓核组织周围能见少量炎症细胞,无明显毛细血管增生。免疫组化检测:CD68阳性率,B组(50%)A组(33.3%)C组(0%),各组间差异有统计学意义(P0.05)。A组中CD25+T细胞均表现在CD68阳性巨噬细胞相同位置,B组与C组为阴性。结论腰椎间盘突出症髓核周围有显著的自身免疫反应与炎症反应;椎间盘源性疼痛髓核周围有少量炎症细胞与较多巨噬细胞,但未见明显的毛细血管与T淋巴细胞增生,表明周围有炎症反应,但自身免疫反应没有腰椎间盘突出症典型。     

大鼠破裂型椎间盘突出模型的建立及突出物重吸收机制的研究

目的:设计一种新的腰椎间盘突出重吸收模型.方法:取20只体重(300±20) g的3月龄远交群(SD)雄性大鼠,依据随机数字表随机分成实验组和对照组.实验组经手术切除尾椎椎间盘,埋植在硬膜外;动物30 d后处死,取埋植髓核组织,进行HE染色,流式细胞仪以及免疫组化检测.对照组,将线团埋植在背部肌肉内,30 d后处死作实验对照.结果:实验组30 d后的TNF-ɑ、VEGF免疫组化染色呈阳性.实验组的Th、B细胞数量与对照组比较差异有统计学意义.结论:大鼠破裂型椎间盘突出模型能够很好的揭示破裂型椎间盘突出后的重吸收过程,为进一步研究椎间盘突出后的重吸收提供一种新的动物模型.     

不同病理类型椎间盘突出组织的超微结构观察

目的：从细胞水平了解不同病理类型的突出椎间盘细胞结构的病变程度。方法：将4例凸起型、9例破裂型、6例游离型椎间盘突出髓核组织分别切成小块，经组织学处理后行透射电镜观察。结果：(1)凸起型椎问盘突出髓核组织中观察到部分退变细胞、严重退变细胞及坏死细胞；(2)破裂型椎间盘突出髓核组织中观察到少部分退变细胞，大部分为严重退变细胞及坏死细胞；(3)游离型椎间盘突出髓核组织中观察到严重退变细胞及坏死细胞。结论：不同临床病理类型的椎间盘突出组织，其细胞退变严重程度不同，以凸起型为轻，破裂型较重．游离型最为严重．     

颈椎间盘纤维环及髓核的超微结构观察

目的：探讨在颈椎间盘纤维环及髓核退变中组织形态的变化。方法：对正常人、单纯颈椎间盘突出症、脊髓型颈椎病三组椎间盘纤维环及髓核进行电镜观察。结果：三组椎间盘胶原纤维无明显变化,单纯颈椎间盘突出症与脊髓型颈椎病人的退变椎间盘细胞较正常人有明显变化,表现为严重退变或细胞坏死。结论：单纯颈椎间盘突出症患者椎间盘以退变细胞为主,为退变早期阶段功能代偿期,脊髓型颈椎病椎间盘以坏死细胞为主,为退变晚期阶段,为不可逆期;颈腰椎间盘退变的组织形态学不完全相同。     

杜仲腰痛丸对大鼠非压迫性髓核突出神经根损伤的组织形态学研究

目的：观察杜仲腰痛丸对大鼠非压迫性髓核突出神经根损伤的组织形态学变化。方法：取健康雄性Wistar大鼠50只，随机分为假手术组（A组）、模型组（B组）、伸筋丹组（C组）、杜仲腰痛丸高低剂量组（分别为D、E组），每组10只。将大鼠自身的尾椎髓核取出移植于左侧L5、L6神经根背侧，造成大鼠非压迫性髓核突出模型，观察2周时神经根组织形态学变化。结果：B、C、D、E组神经根均产生明显可见的组织形态改变，但C、D、E组改变程度较B组减轻。结论：杜仲腰痛丸可减轻非压迫性髓核突出神经根损伤所导致的组织形态病理学改变，改善或抑制炎症反应，有保护神经根的作用。     

聚集蛋白聚糖酶-1在退变椎间盘中的表达及意义

[目的]探讨聚集蛋白聚糖酶-1(aggrecannase-1,Agase-1)在退变椎间盘组织中的表达、规律及其意义。[方法]实验组为手术切除的腰椎间盘突出患者的退变椎间盘组织,分为纤维环破裂组和未破裂组;对照组为取自腰椎骨折患者的正常腰椎间盘组织。应用HE染色检测各组椎间盘组织的病理形态学变化,RT-PCR检测Agase-1mRNA的表达;Western印迹法检测蛋白多糖(aggrecan)的含量。[结果]Agase-1mRNA在实验组中表达均明显高于对照组,纤维环破裂组明显高于纤维环未破裂组(P<0.01),Aggrecan在实验组中的含量低于对照组,纤维环破裂组中Aggrecan明显低于纤维环未破裂组(P<0.01),HE染色显示髓核细胞数量随着椎间盘退变程度的增加显著减少,纤维环破裂组髓核组织中有血管生成,伴有炎细胞浸润。[结论]Agase-1可能参与了人类椎间盘组织的退变过程,且在突出的椎间盘组织中有增高趋势。     

破裂性椎间盘突出重吸收机制的研究

目的 探讨破裂性椎间盘突出发生重吸收的作用机制.方法 将20只远交群雄性大鼠随机分成对照组、实验组.实验组经手术切除尾椎椎间盘,埋植在硬膜外.30 d后处死,取埋植髓核组织,进行HE染色及免疫组化检测.对照组将线团埋植在背部肌肉内,30 d后处死作试验对照.结果 与对照组比较实验组埋植组织的质量明显缩小,实验组的TNF-α、VEGF免疫组化染色呈阳性.结论 椎间盘突出后发生的重吸收与其游离接触血运有关,新生血管与炎性反应在重吸收过程中发挥很大作用.     

破裂型与未破裂型腰椎间盘突出组织超微结构对比观察

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。     

A study of the relationship between type of lumbar disc herniation,straight leg raising test and peripheral T lymphocytes

Objective: To observe changes in peripheral T lymphocytes of patients with lumbar disc herniation, and investigate the relationship between the type of herniation, signs and T lymphocyte subsets. Methods: Blood samples from 20 healthy blood donors (control group), and 49 patients (27 male and 22 female) with single‐level lumbar intervertebral disc herniation were collected, the latter preoperatively. T lymphocytes subsets were detected by flow cytometer. According to the position of the intervertebral disc observed during surgery, the patients were divided into ruptured disc herniation (RDH) and degenerative disc herniation (DDH) groups. Straight leg raising (SLR) was assessed preoperatively. Results: Percentages of CD3+, CD4+, and ratio of CD4+/CD8+ in the RDH group were significantly higher, and of percentage of CD8+ significantly lower, than were those in the control group. Percentages of CD4+ and ratio of CD4+/CD8+ were significantly higher, and percentage of CD8+ significantly lower, in the positive SLR test group than were those in the negative SLR test group. The positive rate of SLR testing was significantly higher in the RDH than in the DDH group. Conclusion: Our results suggest that changes in T lymphocyte subsets in peripheral blood take place after herniation of the lumbar intervertebral disc. T lymphocyte mediated immune responses may play an important role in the occurrence and development of signs in patients with herniated lumbar intervertebral discs. The SLR test may help to confirm that disc herniation has caused nerve root impairment by mechanical loading or inflammatory stimulus and provide guidance on the choice of treatment.     

TNF-α抑制剂对破裂型腰椎间盘突出重吸收影响的实验研究

目的 研究TNF-α抑制剂(益赛普)对破裂型腰椎间盘突出重吸收的影响作用.方法 将42只雄性SD大鼠在适应性喂养2周后随机分为空白组和药物组.空白组分两种模型:随机分为模型组Ⅰ(椎间盘不刺破组)、模型组Ⅱ(椎间盘刺破组);药物组(TNF-α抑制剂组)给以益赛普注射.动物造模成功后给药4周后处死,所取得的大鼠椎间盘进行T...     

Correlation between radiculalgia and counts of T lymphocyte subsets in the peripheral blood of patients with lumbar disc herniation

Objective: To determine the correlation between the degree of radiculalgia and counts of T lymphocyte subsets in the peripheral blood of patients with lumbar disc herniation. Methods: Forty‐nine patients with lumbar disc herniation (group A) were divided into three subgroups according to Visual Analogue Scale (VAS) pain scores (group A₁: n= 12, VAS 0–4.0; A₂: n= 24, VAS 4.1–7.0; A₃: n= 13, VAS 7.1–10.0. Twenty health blood donors who volunteered to be involved in the study comprised the control group (group B). Peripheral blood counts of various T lymphocyte subsets were measured in each group. Results: (i) The counts of CD4+ T and CD4+/CD8+ lymphocytes were higher in group A than in group B, and the difference between the two groups was statistically significant (P < 0.05). There were also statistically significant differences between group A and group B in the counts of CD3+ and CD8+ T lymphocytes (P < 0.05); (ii) There was no correlation between the VAS scores and the counts of CD3+ T lymphocytes (r= 0.194, P > 0.05). A strong significant correlation was observed between the VAS scores and counts of CD4+ T lymphocytes (r= 0.542, P < 0.05), CD4+/CD8+ (r= 0.468, P < 0.05), which increased with increasing VAS scores in the three subgroups of group A (P < 0.05). However there was a significant negative linear correlation between CD8+ T lymphocyte counts and pain scores (r=?0.462, P < 0.05). Conclusion: Our results suggest that changes in T lymphocyte subsets in peripheral blood take place after prolapse of lumbar intervertebral discs. The current results may provide support for involvement of immunologic mechanisms in low back pain secondary to herniation of the lumbar disc. T lymphocytes may play an important role in the development of symptoms in patients with lumbar intervertebral disc herniation.     

黄芪对尿毒症患者血浆sFasL及外周血淋巴细胞亚群状态的作用

目的 :通过测定血浆中sFasL水平和外周血T淋巴细胞亚群状态的分析 ,探讨黄芪对改善尿毒症患者肾功能可能的机制。方法 :采用流式细胞仪和ELISA方法测定 2 5例尿毒症患者黄芪治疗前后及 2 0例正常人血浆中sFasL水平和外周血淋巴细胞亚群状态 ,以及患者治疗前后的肾功能变化。结果 :与正常人比较 ,尿毒症患者血浆中可溶性Fas配体 (sFasL)水平明显升高 ;CD3 CD4 细胞的百分率明显下降 ,CD8 细胞的百分率明显升高 ,CD4 /CD8 的比例小于 1(P <0 .0 1)。 2 5例患者黄芪治疗后血浆中sFasL水平降低 (P <0 .0 5 )。CD4 /CD8 的比例升高 (P <0 .0 1) ;肌酐 (Scr)和尿素氮 (BUN)水平亦有不同程度降低 (P <0 .0 5 )。且动态观察 12例尿毒症患者血肌酐和尿素氮的下降与血浆中sFasL水平的下调呈正相关 (r =0 .5 6 ,P <0 .0 1)。结论 :黄芪能改善尿毒症患者的肾功能 ,提高患者的细胞免疫功能及减慢患者的细胞凋亡是其可能的机制之一。     

腰椎后路椎间盘镜术后5年疗效分析

目的：探讨腰椎后路椎间盘镜手术治疗腰椎间盘突出症的中期疗效。方法：腰椎间盘突出症患者117例,男63例,女54例;年龄24～72岁,平均50.6岁。单纯腰椎间盘突出症60例,单纯侧隐窝狭窄症10例,腰椎间盘突出症伴有侧隐窝狭窄32例,伴有髓核钙化15例。L3,42例,L4,556例,L5S148例,L4,5合并L5S111例。中央型22例,旁侧型95例。隆起型32例,破裂型73例,游离型12例。单侧98例,双侧19例。采用腰椎后路椎间盘镜椎间盘切除术（MED）对腰椎间盘突出症患者行髓核摘除和神经根管扩大。结果：117例经随访48～84个月,平均5.5年,根据中华骨科学会脊柱学组腰背痛手术评定标准：优93例,良16例,差8例。结论：严格掌握适应证、熟练的操作技术是减少MED手术并发症、提高疗效的关键。     

Prediction of lumbar disc herniation resorption in symptomatic patients: a prospective,multi-imaging and clinical phenotype study

BACKGROUND CONTEXTSymptomatic lumbar disc herniations (LDH) are very common. LDH resorption may occur by a “self-healing” process, however this phenomenon remains poorly understood. By most guidelines, if LDH remains symptomatic after 3 months and conservative management fails, surgical intervention may be an option.PURPOSEThe following prospective study aimed to identify determinants that may predict early versus late LDH resorption.STUDY DESIGN/SETTINGProspective study with patients recruited at a single center.PATIENT SAMPLENinety-three consecutive patients diagnosed with acute symptomatic LDH were included in this study (n=23 early resorption and n=67 late resorption groups) with a mean age of 48.7±11.9 years.OUTCOMES MEASUREBaseline assessment of patient demographics (eg, smoking status, height, weight, etc.), herniation characteristics (eg, the initial level of herniation, the direction of herniation, prevalence of multiple herniations, etc.) and MRI phenotypes (eg, Modic changes, end plate abnormalities, disc degeneration, vertebral body dimensions, etc.) were collected for further analysis. Lumbar MRIs were performed approximately every 3 months for 1 year from time of enrollment to assess disc integrity.METHODSAll patients were managed similarly. LDH resorption was classified as early (<3 months) or late (>3 months). A prediction model of pretreatment factors was constructed.RESULTSNo significant differences were noted between groups at any time-point (p>.05). Patients in the early resorption group experienced greater percent reduction of disc herniation between MRI-0-MRI-1 (p=.043), reduction of herniation size for total study duration (p=.007), and percent resorption per day compared to the late resorption group (p<.001). Based on multivariate modeling, greater L4 posterior vertebral height (coeff:14.58), greater sacral slope (coeff:0.12), and greater herniated volume (coeff:0.013) at baseline were found to be most predictive of early resorption (p<.05).CONCLUSIONSThis is the first comprehensive imaging and clinical phenotypic prospective study, to our knowledge, that has identified distinct determinants for early LDH resorption. Early resorption can occur in 24.7% of LDH patients. We developed a prediction model for early resorption which demonstrated great overall performance according to pretreatment measures of herniation size, L4 posterior body height, and sacral slope. A risk profile is proposed which may aid clinical decision-making and managing patient expectations     

三种不同脊柱旋转手法治疗腰椎间盘突出症的病例对照研究

目的 :评价3种不同脊柱旋转手法对腰椎间盘突出症治疗的有效性和安全性。方法 :2011年9月至2013年4月,180例收治入院的腰椎间盘突出症患者按随机数字表法分为坐位定点旋转组、侧卧位斜扳组和仰卧位旋转组,每组60例。最终剔除和脱落10例,纳入统计坐位定点旋转组57例,侧卧位斜扳组57例,仰卧位旋转组56例。各组的年龄、性别、BMI、节段性放射痛、直腿抬高痛、部分神经功能缺失、突出节段及类型、SF-36和ODI差异无统计学意义(P0.05)。手法隔日1次,3周为1个疗程。观察3组患者疗程结束后6周、3个月、6个月、1年和2年SF-36躯体疼痛指数(BP)、躯体功能指数(PF)和ODI变化及不良反应情况,并进行比较分析。结果:3组患者的BP、PF得分均较治疗前显著提高,ODI得分较治疗前显著下降,差异有统计学意义(P0.05),组间各指标差异无统计学意义(P0.05);均未出现明显和严重的不良反应。结论 :基于中医"骨错缝"病机理论运用3种不同脊柱旋转手法均能有效、安全治疗腰椎间盘突出症,且疗效相近。     

切吸联合不同溶核疗法治疗腰椎间盘突出症

目的分析比较3种不同联合疗法治疗突出型L4,5椎间盘突出症的临床疗效,并观察其不良反应。方法本组59例,男36例,女23例;年龄19～69岁,平均(38.18±10.24)岁。将所有病例随机分为3组进行相应治疗切吸+盘内法组(A组)15例,切吸+盘外法组(B组)26例,切吸+盘内外法组(C组)18例。结果59例术后进行了4个月以上的随访,近期总优良率72.88%,总有效率96.61%;远期总优良率72.88%,总有效率86.44%。但各组间近、远期疗效差异均无显著性意义(P>0.05)。结论以上3种不同联合疗法均是临床治疗突出型腰椎间盘突出的有效方法,且不良反应少。     

腰椎椎间盘突出症和椎间盘源性疼痛的免疫病理学研究

目的 探讨腰椎椎间盘突出症和椎间盘源性疼痛的免疫病理学改变及其异同点.方法 收集71例手术切除的椎间盘髓核标本,分为:腰椎椎间盘突出(A组)30例,腰椎间盘脱出或游离(B组)22例,两组均行椎间盘髓核摘除术;腰椎椎间盘源性疼痛(C组)10例,均经椎间盘造影证实并行前路手术切除;腰椎爆裂骨折(D组)9例,行前路手术切除伤椎远侧相对正常的椎间盘髓核.组织形态学观察各组椎间盘髓核细胞的病理变化;应用免疫组化技术检测髓核CD68阳性巨噬细胞和CD45RO阳性T细胞,并行统计学分析.结果 组织形态学观察:D组髓核细胞形态大小一致,分布均匀,未见明显细胞基质退变及炎性细胞浸润;其他各组均见髓核细胞空泡样变、形态大小不一、分布不均;A组和B组髓核组织边缘可见大量炎性细胞浸润、局灶性小血管增生,以B组更明显;C组细胞基质退变严重,髓核组织边缘可见散在炎性细胞浸润,未见明显血管增生.免疫组化检测:CD68阳性率,B组(63.6%)＞C组(40.0%)＞A组(26.7%)＞D组(0%),各组间差异有统计学意义(P＜0.05).CD45RO阳性T细胞均出现在CD68阳性巨噬细胞同一部位的连续切片上,阳性率B组(59.1%)＞A组(13.3%),C组和D组为阴性,各组间差异有统计学意义(P＜0.05).结论 腰椎椎间盘突出症髓核边缘有明显的炎症和自身免疫反应;椎间盘源性疼痛髓核边缘有散在炎性细胞和较多巨噬细胞,但小血管增生和T淋巴细胞浸润不明显,提示有炎性反应,但自身免疫反应不如椎间盘突出症明显.

Abstract：

Objective To evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain. Methods Seventy-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. Results 1) Pathological observation with HE stain: compare 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). Conclusion The 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.     

腰椎间盘突出症的免疫病理学研究

目的从免疫组织化学角度研究破碎型和完整型腰椎间盘突出症的病理机制和病理过程，比较其差异，探讨腰椎间盘突出症的不同病理学分型。方法选取40例腰椎间盘突出症患者的椎间盘手术标本，依术中所见分为两组：（1）破碎型腰椎间盘突出组（切开突出病变部浅层后纵韧带及纤维环可见破碎椎间盘组织与椎间盘母体分离，突出病变质软，自行溢出或较易钳出）。（2）完整型腰椎间盘突出组（切开突出病变部浅层后纵韧带及纤维环无破碎椎间盘组织溢出，突出病变质硬，必须以器械切除）。所获得的椎间盘标本均行常规HE染色；以鼠抗人CD43RO、CD20单克隆抗体进行免疫组织化学标记，双盲法半定量计数阳性细胞，Ridit等级分析；以FITC标记的兔抗人IgM、IgG抗体进行免疫荧光标记，双盲法半定量计数荧光量，Ridit等级分析。结果两组形态学有显著差异：（1）HE染色可见破碎组标本边缘灶性炎性细胞浸润，血管化；完整组髓核面积减少，纤维环增厚，软骨基质增生；（2）破碎组标本CD。sRO免疫组织化学阳性反应与完整组比较差异有统计学意义（P〈0．05）；（3）破碎组标本IgG和kM免疫荧光阳性反应与完整组比较差异有统计学意义（P〈0．01）。结论（1）破碎型腰椎间盘突出症标本中有T淋巴细胞浸润和免疫球蛋白IgG、IgM沉积，因而其病理机制可能是在损伤基础上的自免疫炎症反席过程。（2）完整犁腰椎间鼎突出以髓核很蛮、软骨某质及纤维环增牛为丰兽表现．