Histological difference in ligament flavum between degenerative lumbar canal stenosis and non-stenotic group:A prospective,comparative study  

作　　者：Mantu Jain Mukund Sable Amit Purushottam Tirpude Rabi Narayan Sahu Sudeep Kumar Samanta Gurudip Das 

机构地区：[1]Department of Orthopaedics,All India Institute of Medical Sciences Bhubaneswar,Bhuabneswar 751019,Odisha,India [2]Department of Pathology,All India Institute of Medical Sciences Bhubaneswar,Bhubaneswar 751019,Odisha,India [3]Department of Anatomy,All India Institute of Medical Sciences Raipur,Raipur 492009,Chattisgarh,India [4]Department of Neurosurgery,All India Institute of Medical Sciences Bhubaneswar,Bhubaneswar 751019,Odisha,India

出　　处：《World Journal of Orthopedics》2022年第9期791-801,共11页世界骨科杂志（英文版）

基　　金：Institutional research grant(AIIMS Bhubaneswar).

摘　　要：BACKGROUND Ligament flavum(LF)hypertropy is the main etiopathogenesis of lumbar canal stenosis(LCS).The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content,fibrosis,cicatrization,and calcification.However,the morphometric analysis can delineate the LF in patients with LCS from those without LCS,which would help in better understanding LCS pathogenesis.AIM To compare the histopathological changes in LF between the degenerative LCS and non-stenotic(non-LCS)group.METHODS The present prospective study was conducted in 82 patients who were divided into two groups,namely LCS and non-LCS.Demographic details of the patients such as duration of symptoms,level of involvement,and number of segments were recorded.The LF obtained from both groups was histopathologically examined for the fibrosis score,elastic fiber degeneration,calcification,and chondroid metaplasia.Morphometrical details included a change in elastin and collagen percentages,elastin/collagen ratio,elastic fiber fragmentation,and ligamentocyte numbers.All parameters were compared between the two groups by using the independent t test,Chi-square test,and Pearson’s correlation test.RESULTS Out of 82 cases,74 were analysed,34 in LCS and 40 in non-LCS group.The mean±SD age of presentation in LCS and non-LCS group was 49.2±8.9 and 43.1±14.3 respectively.The LCS group(n=34)exhibited significant differences in fibrosis(P=0.002),elastic fiber degeneration(P=0.01),%elastic fragmentation(66.5±16.3 vs 29.5±16.9),%elastic,content(26.9±6.7 vs 34.7±8.4),%collagen content(63.6±10.4 vs 54.9±6.4),reduction of elastic/collagen(0.4±0.1 vs 0.6±0.1),and ligamentocyte number(39.1±19.1 vs 53.5±26.9)as compared to non-LCS group(n=40).The calcification(P=0.08)and Pearson’s correlation between duration and loss of elastin was not significant.The difference in LF morphology is consistent in patient’s≥40 years of age among the groups as found in subgroup analysis.Similarl

关 键 词：Spinal stenosis Lumbar spine Ligamentum flavum HISTOPATHOLOGY MORPHOMETRY 

分 类 号：R681.5[医药卫生—骨科学]