循环机械压力诱导下兔椎间盘退变器官模型的建立及意义

背景：力学因素是导致椎间盘退变（IDD）的重要诱因,建立力学相关性IDD的器官模型能为IDD机制的研究提供理想的模型基础。 目的：建立兔椎间盘器官模型,并施以循环机械压力,探究循环机械压力载荷对IDD的影响。 方法：6月龄新西兰大白兔随机分为加力组和对照组,静脉给予1.3 ml肝素（5000 U/ml）,待肝素体内循环5 min后处死。无菌条件下完整取出带部分椎骨的腰段椎间盘,放入20%胎牛血清的培养液中培养。加力组应用加力器施以0.2 MPa压力值,每日加压1次,每次30 min。经过各个时段的培养后,苏木精-伊红（HE）染色观察椎间盘大体组织形态学变化;氯化硝基四氮唑蓝（NBT）染色及4＇,6-二眯基-2-苯基吲哚（DAPI）复染检测椎间盘细胞成活率;Realtime RT-PCR和Western-blotting检测蛋白多糖（AGN）、Ⅱ型胶原（COLⅡ）的mRNA和蛋白表达。 结果：对照组和加力组培养至第7 d的组织形态学无明显变化,培养至第14 d均表现为组织形态学破坏,且以加力组表现更为明显。对照组培养至第7 d的细胞成活率及AGN、COLⅡ表达与0 d相比无明显变化;对照组培养第14 d与0 d比较,培养第7 d加力组与对照组比较,培养第14 d加力组与对照组比较,均表现为细胞成活率明显下降,AGN、COLⅡ表达下调。 结论：成功建立短周期兔椎间盘体外器官模型,并在此模型基础上阐明循环机械压力载荷可直接导致椎间盘退变样改变。     

淫羊藿苷对大鼠椎间盘退变的影响

[目的]研究淫羊藿苷(ICA)对大鼠尾椎椎间盘退变(IDD)的影响。[方法]体内实验部分,SD大鼠随机分为假手术组(Sham组)、空白对照组(IDD组)和3个淫羊藿苷处理组(ICAL、ICAM、ICAH)。制备椎间盘退变模型,给予相应处理,并行MIR和细胞因子检测。体内实验部分,自假手术与IDD动物椎间盘髓核分离细胞,体外培养,并给予淫羊藿苷处理(ICAL、ICAM、ICAH),检测细胞和上清的细胞因子等。[结果]体内实验表明,术后2周,与IDD组比较,ICAM组椎间盘T2加权信号强度高;术后6周,IDD组信号消失,ICAM组则无明显改变;ICAM组MRI的Pfirrmann评级均明显低于IDD组(P<0.05)。与Sham组比较,IDD组的IL-1β、IL-6蛋白表达显著增高(P<0.05);与IDD组比较,ICA组的IL-1β、IL-6蛋白表达显著降低(P<0.05)。体外实验显示:IDD组NP细胞增殖率明显降低(P<0.05);而ICA组的NP细胞增殖率明显升高(P<0.05)。与Sham组相比,IDD组NP细胞IL-1β、IL-6表达显著上调(P<0.05);与IDD组比较,ICA各组NP细胞IL-1β、IL-6表达显著下调(P<0.05)。与正常对照组相比,IDD组NP细胞Aggrecan和CollagenⅡmRNA及蛋白表达水平显著降低(P<0.05);与IDD组相比,ICA各组Aggrecan和CollagenⅡmRNA及蛋白表达水平显著升高(P<0.05)。[结论]淫羊藿苷可促进退变髓核细胞增殖、蛋白聚糖及II型胶原蛋白合成,减少IL-1β及IL-6表达,延缓椎间盘退变。     

大鼠增龄过程中髓核组织Beclin-1和微管相关蛋白轻链3的表达及其意义

目的 探讨在增龄过程中SD大鼠髓核组织中Beclin-1和微管相关蛋白轻链3(MAPLC3)的表达及其意义.方法 3个月龄、12个月龄、24个月龄SD大鼠各8只,建立青年组、中年组和老龄组大鼠模型,苏木素-伊红(HE)染色检测椎间盘组织的退变;透射电镜检测髓核细胞中自噬体的表达;免疫组织化学染色和逆转录-聚合酶链反应(RT-PCR)法测定髓核组织中Beclin-1和MAPLC3的表达.结果 大鼠增龄过程可较好地体现椎间盘的退变变化;不同年龄组大鼠髓核细胞中均有自噬体的表达;Beclin-1和MAPLC3在不同年龄组SD大鼠髓核细胞中均有表达(0.42±0.05,0.47±0.06,0.52±0.05;0.34±0.06,0.39±0.05,0.46±0.09),且老龄组表达均较青年组高(P<0.01).Beclin-1和MAPLC3 mRNA在不同年龄组SD大鼠髓核组织中均有表达(0.86±0.12,0.93±0.14,1.01±0.13;1.09±0.06,1.15±0.07,1.33±0.11),且老龄组表达较青年组表达明显增高(分别为P<0.05和P<0.01).结论 自噬存在于椎间盘退变过程中,且MAPLC3与Beclin-1在椎间盘退变过程中的表达增加,提示自噬活性的增加可能与椎间盘退变的发展进程有关.     

骨髓间充质干细胞结合藻酸盐治疗椎间盘退变的实验研究

目的观察骨髓间充质干细胞（Bone mesenchymal stem cell,BMSC）结合藻酸盐凝胶支架,治疗兔椎间盘退变的效果。方法将15只新西兰大白兔建立腰椎间盘退变模型,随机分为对照组、空白组和治疗组。体外培养兔BMSC,治疗组椎间隙注射BMSC结合藻酸盐凝胶支架,对照组注射藻酸盐凝胶,空白组注射生理盐水。应用核磁共振、免疫组化和生化分析,观察椎间盘退变的修复效果。结果治疗组影像学、病理组织学观察,以及蛋白多糖和Ⅱ型胶原的含量,均明显优于对照组和空白组,差异有统计学意义。结论 BMSC结合藻酸盐凝胶支架可用于治疗兔腰椎间盘退变。     

"穿刺抽取髓核"诱导腰椎间盘退变的时间相关性评估

目的对穿刺纤维环抽取髓核诱导的腰椎间盘退变模型，进行时间相关的放射学和组织学评估，明确椎间盘退变程度的时间相关性。方法1岁山羊12只，以粗针穿刺纤维环抽取髓核（L1，2-15，6）建立腰椎间盘退变模型。术后第2、4、8、16周分别行放射学观察、髓核蛋白多糖（GAG）定量、组织学及微观结构评估。结果影像学示术后16周椎间隙高度显著降低（P〈0．01），但各椎间盘间差异无统计学意义（P〉0．05）。GAG定量示所有节段髓核内GAG含量随时间持续下降（P〈0．01），但与椎间盘序列间无相关性。大体标本及组织学观察显示，椎间盘退变组织学表现与抽取髓核后时间显著相关：术后2周组织学未见明显异常；4周始出现退变表现；16周时髓核已近完全纤维化。电镜观察示术后2—16周，髓核细胞从基本正常至大量凋亡，髓核基质逐渐纤维化。结论针刺抽取髓核法是较理想的腰椎间盘退变模型诱导方法。本研究观察16周，椎间盘退变未见缓解及自行修复，诱发的退变严重度与术后时间因素显著相关，而与椎间盘节段序列间无相关性。该模型在术后2周尚未出现明显组织学改变，或许是进行干预的良好时机。     

p16INK4a与Fas对椎间盘细胞功能影响的比较

目的分析p16^INK4a及Fas在椎间盘细胞中的功能作用，探讨椎间盘退变的机制。方法利用p16^INK4a及Fas特异性短链干扰RNA（siRNA）转染体外培养的内破裂（IDD）及突出（LIDP）椎间盘细胞。观察p16^INK4a及Fas表达的沉默情况。分析视网膜母细胞瘤（Rb）蛋白磷酸化状态、β-半乳糖苷酶（β-gal）染色阳性率、细胞形态和增殖的变化；放射性同位素标记培养细胞，观察细胞合成氨基葡聚糖（GAG）及核心蛋白的变化。结果p16^INK4a。及Fas特异性siRNA分别有效地沉默了椎间盘细胞内p16^INK4a及Fas表达。p16^INK4a表达沉默使退变椎间盘细胞衰老表型及合成能力得以明显改善；Fas特异性siRNA转染的LIDP椎间盘细胞的生理功能有所恢复，但未及正常水平，而转染的IDD椎间盘细胞的功能无明显变化。结论p16^INK4a。基因介导的细胞衰老是椎间盘退变的一个关键启动因子。     

海藻酸钠复合多能诱导干细胞修复椎间盘研究

[目的]探讨海藻酸钠盐微球凝胶复合多能诱导干细胞(induced pluripotent stem cells, IPS)定向分化的髓核细胞对退变椎间盘修复作用。[方法] 50只新西兰大白兔分为5组,10只作为正常对照组,40只建立兔椎间盘退变模型,并随机分为4组,每组10只。模型组不行治疗,材料组注射不含髓核细胞的海藻酸钠盐微球凝胶材料,细胞组注射诱导分化的髓核细胞,联合组注射IPS定向分化的髓核细胞与海藻酸钠盐微球凝胶材料复合物,治疗8周后,采用组织学Mankin评分评估各组椎间盘软骨退变情况;采用免疫组化分析各组椎间盘组织蛋白多糖、Ⅱ型胶原和MMP3的表达水平。[结果]与细胞组比较,联合组兔椎间盘软骨退变改善最显著,各组组织学评分分别为:对照组(1.27±0.19)分,模型组(19.43±3.48)分,材料组(18.59±4.01)分,细胞组(13.11±3.81)分,联合组(5.90±2.01)分,差异有统计学意义(P0.05)。与细胞组比较,联合组兔椎间盘组织蛋白多糖和Ⅱ型胶原增加更显著,MMP3蛋白下调更显著,差异有统计学意义(P0.05)。[结论]海藻酸钠盐微球凝胶复合IPS定向分化的髓核细胞可显著改善椎间盘内环境,促进退变椎间盘组织修复。     

两种骨水泥渗漏对椎间盘影响的实验研究

目的 探讨椎体成形术时骨水泥渗漏是否会引起椎间盘退变，以及椎间盘退变程度与骨水泥类型是否相关。方法 选用8只成年家犬，以每只犬L2-3、L3-4、L4-5椎间盘为实验对象，随机分为对照组、聚甲基丙烯酸甲酯（polymethylmethacrylate，PMMA）与磷酸钙骨水泥（calcium phosphate cement，CPC）3组。对照组仅行椎间盘穿刺，不注入任何物质，PMMA组及CPC组均各向椎间盘注入0．1ml骨水泥。术前及术后24周摄正、侧位X线片，计算椎间盘高度指数百分数（disc height index percentage，DHIP）。术后24周行MR检查，计算MRI指数。组织学检查参照Masuda标准对椎间盘退变程度评分并分析。结果 术后24周X线片显示对照组椎间隙无狭窄，病理学检查未见椎间盘退变。PMMA、CPC组椎间盘MRI显示：椎间隙有狭窄，R加权像髓核信号不同程度降低且不均一，其相对高信号区面积减小，髓核形态不规则，纤维环与髓核界限不清。组织学检查显示髓核细胞数量不同程度减少，空泡变小。髓核的细胞外基质不同程度压缩，纤维环断裂或扭转。3组DHIP、MRI指数、组织学评分的差异均有统计学意义（P〈0.01）。结论 PMMA、CPC注入椎间盘会导致椎间盘退变，PMMA所致椎间盘退变较CPC更为严重.     

双后肢大鼠椎间盘退变动物模型的建立

目的　为椎间盘相关研究建立一种经济科学的椎间盘退变动物模型。方法　对 15 2只新生SD大鼠采用截除双前肢和特殊饲养的方法培育双后肢大鼠 ,以 10只正常同龄大鼠作为对照 ,18月龄时处死后通过光镜和电镜检查来观察两组大鼠L2～ 3 椎间盘的退变情况。结果　截除双前肢后 ,双后肢大鼠生长良好 ,术后 18个月存活 17只。光镜检查证实其椎间盘均发生了严重的髓核和纤维环退变。有 2例还出现了腰椎间盘突出。超微结构观察发现髓核中脊索细胞出现明显的退变和坏死 ,软骨样细胞中出现大量脂滴。基质中胶原纤维排列紊乱 ,出现大量板层样结构和团块。而正常大鼠的椎间盘仅发生轻度退变 ,胶原纤维排列整齐。结论　本造模方法简单经济、成功率高、重复性好 ,建立的双后肢大鼠模型符合人体椎间盘退变规律。     

被动吸烟大鼠椎间盘中白介素-1β和白介素-1受体Ⅰ的表达及意义

目的：观察被动吸烟大鼠椎间盘中自介素-1β（IL-1β）和白介素-1受体Ⅰ（IL-1RⅠ）的表达，探讨被动吸烟诱发椎间盘退变的机制。方法：取4周龄SD大鼠60只，随机分为6组，第1组不予吸烟，10只；第2-4组分别吸烟2周、4周、8周，第5、6组吸烟8周后予停止吸烟4周、8周，每组10只。在相应时间点处死动物，取L4/5椎间盘行HE染色和IL-1β及IL-1RⅠ免疫组化染色，观察椎间盘退变情况和IL-1β及IL-1RⅠ的表达情况。结果：HE染色显示，吸烟2周时椎间盘无明显退变，吸烟4周时椎间盘出现2～3级退变，吸烟8周时椎间盘出现3-4级退变，停止吸烟后4周退变无明显修复；停止吸烟后8周退变部分修复。免疫组化染色显示，吸烟2周组IL-1β及IL-1RⅠ染色阳性细胞率增加，吸烟4周组染色阳性细胞率大于2周组；吸烟8周组达（76&#177;3．2）％和（46&#177;2．8）％，停止吸烟后4周开始下降，8周时降至（66&#177;2．9）％和38&#177;2．2％。结论：被动吸烟可以诱发大鼠椎间盘退变，且随吸烟时间延长退变加重；其导致退变的机制可能与上调椎间盘内IL-1β和IL-1RⅠ的表达有关。     

An in vivo model of degenerative disc disease.

Although the precise etiology of low back pain is disputed, degeneration of the intervertebral disc is believed to play an important role. Many animal models have been described which reproduce the changes found in degenerative disc disease, but none allow for efficient, large-scale testing of purported therapeutic agents. The purpose of this study was to develop a simple animal model resembling degenerative disc disease using the intervertebral discs found in the tails of rats. The proximal two intervertebral discs in the tails of 20 rats were injected with either chondroitinase ABC or control (phosphate buffered saline, PBS). The tails were harvested at 2 weeks, and measurements were made of intervertebral disc height (measured radiographically and histologically), biomechanics (stiffness, hysteresis, and residual deformation), and histologic appearance. Treatment with chondroitinase ABC resulted in a significant loss in intervertebral disc height (radiographic intervertebral disc height, p=0.001; histologic intervertebral disc height, p<0.001) and significant increases in all biomechanical parameters (stiffness, p<0.001; hysteresis, p=0.006; residual deformation, p=0.004) compared to PBS controls. Intervertebral discs treated with chondroitinase ABC had significantly lower histologic grades for each grading category (nucleus pulposus (NP), annulus fibrosus, and proteoglycan staining) compared to controls. The results of injury with chondroitinase ABC were similar to the findings in degenerative disc disease: reduced intervertebral disc height, diminished proteoglycan content, loss of NP cells, and increased stiffness of the disc. Thus, the model appears to be a reasonable tool for the preliminary in vivo evaluation of proposed treatments for degenerative disc disease.     

Homing of mesenchymal stem cells in induced degenerative intervertebral discs in a whole organ culture system

STUDY DESIGN.: Homing of human bone marrow-derived mesenchymal stem cells (BMSCs) was studied using ex vivo cultured bovine caudal intervertebral discs (IVDs). OBJECTIVE.: To investigate in a whole organ culture whether metabolic and mechanical challenges can induce BMSC recruitment into the IVD. SUMMARY OF BACKGROUND DATA.: Cells from injured tissues release cytokines and mediators that enable the recruitment of progenitor cells. BMSCs have the ability to survive within the IVD. METHODS.: Bovine IVDs with or without endplates were cultured for 1 week under simulated physiological or degenerative conditions; disc cells were analyzed for cell viability and gene expression, whereas media was analyzed for nitric oxide production and chemotaxis. Homing of BMSCs was investigated by supplying PKH-labeled human BMSCs onto cultured IVDs (1 × 10 cells/disc on d 8, 10, and 12 of culture); on day 14, the number of homed BMSCs was microscopically assessed. Moreover, a comparative study was performed between transduced BMSCs (transduced with an adenovirus encoding for insulin-like growth factor 1 [IGF-1]) and nontransduced BMSCs. Disc proteoglycan synthesis rate was quantified via S incorporation. The secretion of IGF-1 was evaluated by enzyme-linked immunosorbent assay on both simulated physiological and degenerative discs. RESULTS.: Discs cultured under degenerative conditions showed reduced cell viability, upregulation of matrix degrading enzymes, and increased nitric oxide production compared with simulated physiological discs. Greater homing occurred under degenerative compared with physiological conditions with or without endplate. Media of degenerative discs demonstrated a chemoattractive activity toward BMSCs. Finally, discs homed with IGF-1-transduced BMSCs showed increased IGF-1 secretion and significantly higher proteoglycan synthesis rate than discs supplied with nontransduced BMSCs. CONCLUSION.: We have demonstrated for the first time that degenerative conditions induce the release of factors promoting BMSC recruitment in an ex vivo organ culture. Moreover, IGF-1 transduction of BMSCs strongly increases the rate of proteoglycan synthesis within degenerative discs. This finding offers a new delivery system for BMSCs and treatment strategy for IVD regeneration.     

退变椎间盘聚集蛋白聚糖中硫酸软骨素链变化的实验研究

目的：研究内破裂及突出椎间盘细胞合成的聚集蛋白聚糖中硫酸软骨素链（CS）在长度及数量分布上的变化.方法：将正常椎间盘、内破裂（IDD）及突出椎间盘（LIDP）髓核或纤维环的组织20mg培养于24孔板中,用放射性同位素35S-硫酸盐和3H-丝氨酸标记新合成的蛋白聚糖分子.将聚集蛋白聚糖单体从培养的组织片中提取,用四氢硼酸钠或木瓜蛋白酶消化后,凝胶包谱分析硫酸软骨链的变化特征.结果：IDD椎间盘组织内细胞合成的聚集蛋白聚糖内CS链的数量明显减少,但长度保持相对正常;突出椎间盘组织中CS的数量和长度有明显下降和缩短,CS链数量的减少较IDD组织中更为严重.结论：IDD组织合成CS的减少主要是由于生成的CS链数量减少所致,而数量的进一步减少以及CS链长度的缩短是LIDP组织中CS合成量下降的主要原因.     

Characterization of an in vitro intervertebral disc organ culture system

Intervertebral disc organ culture has the capacity to control mechanical and chemical boundary conditions while keeping the tissue largely intact, and allowing interventions that would be impossible or unethical on animal studies. Recent studies on ex vivo organ culture has mostly involved small animals, or been limited to development and validation studies. In this study, bovine caudal discs were used. The large animal model design ensures that sufficient tissue is available for measurement of multiple dependent variables on the same disc, and a similar aspect ratio, diffusion distance, composition and rate of proteoglycan synthesis to human lumbar discs. The first goal of this study was to refine a set of dependent variables capable of characterizing the response of the intervertebral disc to culturing and to develop a technique to measure cell viability in all three regions of the disc. The second goal was to use these variables to compare static and diurnal loading as a method of maintaining intervertebral disc structure, composition, and cell metabolism similar to the in vivo state. Static (0.2 MPa) and diurnal loading (0.1 and 0.3 MPa alternating at 12 h intervals) were applied and intervertebral discs were examined after 4 or 8 days with dependent variables including changes in geometry (disc height and diameter), composition (tissue water content, tissue proteoglycan content and proteoglycan content lost to the culture media), cell viability and metabolism (proteoglycan synthesis). Results indicate that there was a decrease in disc height and water content after culture regardless of culture duration or loading condition. Cell viability significantly decreased with culture duration in the inner annulus and nucleus; however, a significant reduction in cell viability for the diurnal versus static loading condition was only observed after 8 days in the nucleus region. No significant differences were seen in viability of the outer annulus region with time, or in any loading groups. We conclude that our system is capable of keeping bovine caudal discs alive for at least 8 days without significant changes in GAG content, or cell metabolism, and that static loading was slightly better able to maintain cell viability than diurnal loading. This system offers promise for the future studies on large intervertebral discs requiring measurements of multiple mechanical and biological dependent variables on the same tissue.     

阻断双侧终板营养途径构建山羊椎间盘退变模型

目的通过建立山羊腰椎双侧终板营养途径阻断的动物模型,观察椎间盘退变(IDD)的情况,研究椎间盘营养途径与IDD的相关性。方法选取8只24月龄雌性关中山羊,每只山羊L2~3、L3~4作为实验椎间盘,麻醉后在平行于终板2 mm的椎体骨质处造成骨缺损,并使用骨水泥填塞,阻断椎体和终板之间的营养通路,L1~2、L4~5作为对照椎间盘。分别于术后4、12、24、48周行X线、MRI检查,各时间点随机处死2只山羊,采集椎间盘标本,计算骨水泥有效阻断面积、椎间高度指数(DHI)和Pfirrmann分级,并行HE、Masson三色、蛋白多糖、番红O染色组织学检查。结果术后骨水泥有效阻断面积达49.6%~69.6%(60.7%±5.3%)。术后48周时实验椎间盘DHI百分比为60.5%~81.7%(72.7%±5.6%),椎间高度丢失较对照差异有统计学意义(P<0.01);术后48周时实验椎间盘Pfirrmann分级为3~5(4.0±0.7)分,较对照差异有统计学意义(P<0.01)。组织学检查证实,实验椎间盘术后12周即发生退变,并随时间(24、48周)逐步加重。结论骨水泥填塞阻断双侧终板营养途径可以构建山羊IDD的动物模型,阻断终板营养途径可以导致IDD发生。     

The effects of simulated microgravity on intervertebral disc degeneration

Background contextAstronauts experience back pain, particularly low back pain, during and after spaceflight. Recent studies have described histologic and biochemical changes in rat intervertebral discs after space travel, but there is still no in vitro model to investigate the effects of microgravity on disc metabolism.PurposeTo study the effects of microgravity on disc degeneration and establish an in vitro simulated microgravity study model.Study designDiscs were cultured in static and rotating conditions in bioreactor, and the characteristics of disc degeneration were evaluated.MethodsThe mice discs were cultured in a rotating wall vessel bioreactor where the microgravity condition was simulated. Intervertebral discs were cultured in static and microgravity condition. Histology, biochemistry, and immunohistochemical assays were performed to evaluate the characteristics of the discs in microgravity condition.ResultsIntervertebral discs cultured in rotating bioreactors were found to develop changes of disc degeneration manifested by reduced red Safranin-O staining within the annulus fibrosus, downregulated glycosaminoglycan (GAG) content and GAG/hydroxyproline ratio, increased matrix metalloproteinase 3 expression, and upregulated apoptosis.ConclusionsWe conclude that simulated microgravity induces the molecular changes of disc degeneration. The rotating bioreactor model will provide a foundation to investigate the effects of microgravity on disc metabolism.     

褪黑素在椎间盘退变中的研究进展

椎间盘退变是下腰痛的主要因素之一,随着老年社会的到来,其发病率逐年升高,由于椎间盘退变(intervertebral disc degeneration,IDD)致病因素众多,其发病机制尚不清楚,目前仍无有效治疗药物.褪黑素(melatonin,MT)作为松果体分泌的一种神经内分泌激素,因其卓越的抗氧化应激、抗炎及抗细...     

Cytokine profiles in conditioned media from cultured human intervertebral disc tissue. Implications of their effect on bone marrow stem cell metabolism

BACKGROUND: Cytokines released from intervertebral discs cultured in vitro have not been profiled, and the effect of these cytokines on human bone marrow stem cells is yet to be studied. MATERIALS AND METHODS: Intervertebral discs from 14 patients who had undergone spinal fusion surgery were cultured separately in vitro. Conditioned media were collected after 48 and 96 h of culture in serum-free Minimum Essential Medium (MEM). Profiling of the cytokines was conducted using pooled media. Conditioned medium from each patient was also tested in human bone marrow stem cell culture, and incorporation of alkaline phosphatase and 3H-thymidine incorporation was evaluated. RESULTS: Of the 18 cytokines screened, 12 were found to be positive, but only eotaxin, IP-10, Rantes IL-6 and IL-8 seemed to be present at high levels. There was a close correlation between IL-6 and IL-8 levels in the medium (R = 0.90, p < 0.001). When the conditioned media were added to human bone marrow stem cell cultures, cellular proliferation was stimulated (p = 0.02), but alkaline phosphatase activity remained unchanged. Cellular proliferation correlated negatively with IL-6 levels (R = -0.44, p = 0.04). INTERPRETATION: Intervertebral discs secrete certain cytokines into the medium when cultured in vitro, and conditioned media from cultured intervertebral discs stimulate proliferation of bone marrow stem cells.     

椎间盘钙化19例报告

目的　对 19例椎间盘钙化的患者 ,通过症状、体征、影像学资料的临床探讨 ,观察其变化规律 ,研究治疗方法。方法　观察患者的临床症状、体征、影像学表现的变化。结果　从影像学看 ,椎间盘钙化可分为 3种类型 :环内钙化、环外钙化、混合钙化 ;本组环内钙化 5例 ;环外钙化 12例 ;混合钙化 2例 ,环内钙化是CT切层呈“铁饼”状 ,形成封闭区的患者 ,病情稳定自限 ,采用保守治疗 ,效果较好。环外钙化 12例 ,8例手术治疗 ,效果满意 ;混合钙化伴有神经症状者 1例手术治疗 ,1例保守治疗 ,均得到较好的治疗效果。结论　纤维环破坏 ,外界物质进入髓核 ,产生反应 ,导致钙化。钙化形成一完整的封闭的与外界隔绝的独立区域时 ,是进入静止期的衡量标准之一 ,椎间盘钙化环内型多采取保守治疗 ,其余可采取手术治疗