颈椎软骨终板钙化与颈椎间盘退变和椎体骨赘形成的关系

目的：研究颈椎软骨终板钙化与颈椎间盘退变和颈椎椎体骨赘形成的关系。方法：应用组织学方法观察颈前路环锯手术切下的18例脊髓型颈椎病和4例颈椎过伸性损伤致颈椎间盘突出患者的颈椎间盘及相邻的上下椎体标本，研究不同退变程度颈椎间盘软骨终板和椎间盘的形态学变化及椎体骨赘形成过程。结果：退变程度较轻或基本正常的颈椎间盘软骨终板结构良好，潮标清晰，退变程度较重的颈椎间盘软骨终板发生明显纤维化，潮标前移，钙化软骨和软骨下骨板增厚，退变颈椎间盘周边软骨终板潮标明显前移，钙化和骨化层增厚，形成突向外侧的椎体边缘的骨赘。结论：颈椎软骨终板的不断钙化和骨化导致颈椎间盘营养发生障碍可能是启动颈椎间盘退变的关键因素，退变椎体周边软骨终板的不断钙化和骨化是椎体骨赘形成的根本原因。

Study on the relationship between the cartilage end-plate calcification and intervertebral disc degeneration and vertebral osteophyte formation in cervical vertebrae

Objective:To study the relationship between the end-plate calcification and cervical intervertebral disc degeneration and vertebral osteophyte formation.Method:Histological method was applied to observe cervical interverbral discs with adjacent bilateral vertebrae which were got from 22 patients with cervical spondylotic myelopathy and cervical disc herniation owing to cervical hyperextension injury.The lesions were removed anterior cervical approach,to study the relationship between cartilage end-plate calcification and cervical disc degeneration and the vertebral osteophyte formation mechanism.Result:In mild degenerative cervical disc,morphology of cartilage end-plate showed nearly normal construction,and the tidemark was clear.In severely degenerative disc,its matrix and cells showed fibrosis,tidemark advanced,and calcified cartilage thickened.In peripheral cartilage end-plate of some degenerative cervical discs,its tidemark advanced,calcified and ossified cartilage thickened obviously,and vertebral osteophyte formated.Conclusion:The cartilage end-plate in cervical disc continues to calcify and ossify results in nutrition supply impediment,which is the key factor that initiates cervical disc degeneration.Vertebral osteophyte formation arises from continual calcification and ossification in peripheral cartilage end-plate.