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。

Ruptured and unruptured comparative study of lumbar disc tissue ultrastructure

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.