Ruptured And Non-ruptured Lumbar Disc Herniation Clinical Research And For Histological Examination

Objective:Through the comparative study on morphology of ruptured and unruptured lumbar intervertebral disc tissue, observe differences of the index that affect reabsorption and observe the ultrastructure of ruptured and unruptured lumbar intervertebral disc tissue, to explore reabsorption mechanism of lumbar disc tissue and to provide more targeted treatment measures for clinical conservative treatment of lumbar disc herniation.Method:Collect30lumbar intervertebral disc tissue from inpatients who underwent routine operation therapy in Suzhou Hospital of Traditional Chinese Medicine from March2012to October2012due to lumbar disc herniation.14cases are ruptured and16cases are unruptured.(1) by immunohistochemical staining to detect differences and analyze the correlation of positive expression rate of VEGF, TNF-a, of ADAMTS-5, BMP-7of ruptured and unruptured lumbar disc tissue;(2)through transmission electron microscope,observe differences of ultrastructure ruptured and unruptured lumbar disc tissue;(3) detecte differences of BMP-7, FasL, TIMP-1, SOX-9mRNA by RT-PCR.Results:(1) Positive expression rate of VEGF, TNF-a, of ADAMTS-5and BMP-7of ruptured lumbar disc tissue is higher than those of unruptured, the difference is statistically significant; expression of VEGF is positively correlated with TNF-a, expression of VEGF is positively correlated with ADAMTS-5, and expression of VEGF is positively correlated with BMP-7.(2) compared with unruptured lumbar intervertebral disc tissue, ruptured lumbar intervertebral disc tissue’s cell density is low, similar to circular or polygonal, disorganized, cytoplasm, organelles,more metabolically active nuclear, membrane structure is clear, complete membrane,nucleus pulposus cells gradually engulfe apoptotic or necrotic cells.(3) expression of BMP-7, FasL mRNA of ruptured lumbar disc tissue is higher than unruptured, and the difference is statistically significant; expression of TIMP-1, SOX-9mRNA of ruptured lumbar disc tissue is lower than unruptured,and the difference is statistically significant.Conclusions:(1) VEGF, TNF-a of ADAMTS-5, BMP-7is correlated with intervertebral disc tissue reabsorption, and ruptured type is easily to reabsorb than unruptured type.(2) after the breakthrough of the intervertebral disc tissue longitudinal ligament into the epidural space, and through the new blood capillaries, nutrients can be obtained, sub metabolic pathways are recovered, reabsorption are promoted,and autophagy and apoptosis of disc cells can also be seen as a possible way of the reabsorption.(3) BMP-7, FasL, TIMP-1are closely related to reabsorption,but SOX-9is not significant. That angiogenesis inflammatory response, extracellular matrix metabolism imbalances, autoimmune apoptosis, reactive protection mechanisms are likely to promote the re-absorption process.