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目的 :探讨黄韧带骨化的病理变化特点和发生机理。方法 :利用组织病理学和组织化学方法对比研究正常黄韧带和 5例病变黄韧带的病理形态学特点、胶原纤维、网状纤维、弹力纤维以及粘液物质的改变。结果 :根据大体形态特点可将黄韧带骨化分为结节型 (增生性 )骨化、周围型骨化和弥漫型骨化 3种类型。组织学上可见病变早期出现胶原纤维肿胀、融合 ,进一步发生软骨化生 ,最终出现钙化和骨化。在肿胀融合的胶原纤维和软骨化生处可见阿新蓝 (pH 2 5 )阳性的粘液性物质。结论 :黄韧带骨化的大体类型代表着同一病变发展的不同阶段 ;韧带的退行性改变是黄韧带骨化的基本原因 ;胶原纤维的肿胀融合及其粘液样变性是黄韧带骨化的起始病变。
Objective: To investigate the pathological changes and pathogenesis of ligamentum flavum ossification. Methods: Histopathological and histochemical methods were used to study the pathological changes, the changes of collagen fibers, reticular fibers, elastic fibers and mucus in the normal ligamentum flavum and the ligamentum flavum in 5 cases. Results: The ossification of the ligamentum flavum could be divided into nodular (hyperplastic) ossification, peripheral ossification and diffuse ossification according to the general morphological characteristics. Histologically, early lesions of collagen fibers appear swelling, fusion, further occurrence of cartilage metaplasia, eventually calcification and ossification. Azithromycin (pH25) -positive mucinous material is seen in the swollen-fusion collagen fibers and in the cartilage-forming sites. CONCLUSION: The general types of ossification of the ligamentum flavum represent different stages of the same lesion; the degenerative changes of ligaments are the basic causes of ossification of the ligamentum flavum. The swelling and fusion of collagen fibers and their myxoid degeneration are the origins of ossification of the ligamentum flavum Lesions.