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- W3029589037 abstract "Objective To introduce a pathological classification of lumbar disc protrusion for guidance of surgical treatment.Methods From February 2001 to October 2010,812 patients of lumbar disc protrusion underwent surgical treatment,and three types of protrusions were defined according to intraoperative findings,namely damage-herniation type,degeneration-protrusion type,and posterior vertebral osteochondrosis with disc protrusion type.All of 124 specimens of the first two types were observed by microscopic pathology,immunohistochemistry and electron microscopy.Results Damage-herniation type was observed in 495 patients,with an average age of 38.6 years old,the history of slight trauma and positive straight leg raising test (SLRT) existed in 80.4％ and 76.8％ of them,respectively.Pathological examinations showed inflammation and revascularization,T-lymphocytes and macrophage infiltration,IgG and IgM deposition,and IL-7 expression,while ultrastructive examination showed mainly destructive signs,which suggested the presence of injury mechanism.Degeneration-protrusion type was observed in 215 patients with an average of 55.7 years old,the intermittent claudicating and positive SLRT existed in 85.1％ and 14.9％ of them,respectively.Pathological examinations showed dense proliferation and disarrangement of the collagenous fibers and cartilage matrix,none or minimal inflammation or immune response,while ultrastructive examination showed mainly hyperplasia signs including active cell synthesis,which suggested the degenerative and proliferative mechanism.The third type protrusion was observed in 102 patients.Osseous protrusion and defect in the vertebral body were showed by X-ray and CT.Conclusion Lumbar disc protrusion has different pathological types,pathogenesis and clinical characteristics.Damage-herniation type had obvious inflammations and damage responses,so the herniated and broken nucleus pulpous should be removed adequately during surgical treatment.Degeneration-protrusion type protrusion had obvious degeneration and stenosis,so the surgery was based on minimally invasive nerve decompression,and discectomy was usually not needed.Key words: Lumbar vertebrae; Intervertebral disc displacement; Pathology; Surgical procedures, operative" @default.
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- W3029589037 date "2014-09-01" @default.
- W3029589037 modified "2023-09-23" @default.
- W3029589037 title "Pathological classification of lumbar disc protrusion and its guidance for surgical treatment" @default.
- W3029589037 doi "https://doi.org/10.3760/cma.j.issn.0253-2352.2014.09.001" @default.
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