胸椎黄韧带骨化与腰椎黄韧带退变的病理及基本代谢元素的比较研究

目的：探讨胸椎黄韧带骨化的病因。方法：对１４例胸椎黄韧带骨化（包括５例氟骨症）及１４例腰椎管狭窄症患者手术切除的黄韧带标本作病理研究；对患者血清及黄韧带采用雾化原子吸收法等方法测定钙、磷、镁、锌、铜、锰、钼、氟含量，取急性外伤性截瘫患者为对照。结果：（１）骨化黄韧带初期的病理改变与黄韧带退变性质类似；（２）除氟元素外，７种基本代谢元素在骨化与退变患者血清及黄韧带中含量均呈基本一致的变化规律；（３）非氟骨症骨化患者黄韧带中氟含量显著增高（Ｐ＜０．０１）。结论：本文证实胸椎黄韧带骨化发生于黄韧带退变的基础之上，但退变不直接导致骨化，元素氟是诱导退变黄韧带进一步骨化的重要诱因。

A Comparative Study of the Pathology and Basic Metabolic Elements Between Thoracic Ossified Ligamentum Flavum and Lumbar Degenerative Ligamentum Flavum

Objective: To study the etiology of ossifications of the ligamentum flavum(OLF) in the thoracic spine. Methods: Pathological study of ligamentum flavum was carried out in 14 patients with thoracic ossified ligamentum flavum, which included 5 fluorosis and 14 lumbar stenosis, meanwhile, the contents of Ca,P,Mg,Zn,Cu,Mn,Mo,F in ligaments and serums were detected by using atomic absorption spectrometry and fluoride selected electrode. Results: There was similar pathological changes between earlier period of ossification and degeneration of ligamentum flavum, also, there were similar changes of Ca,P,Mg,Zn,Cu,Mn,Mo in ligaments and serums of OLF and degenerations, however fluoride in the ligament was higher in non fluorosis OLF than in degenerations and normal controls. Conclusion: OLF was based on degeneration, but degeneration did not resulted in OLF directly, fluoride played an important role in the progressive changes of degenerative ligamentum flavum to ossification.