| ObjectiveLigamentum flavum derives from the lower edge and the inner surface of theupper lamina of vertebral arch to the upper edge and the outer edge of the lowerlamina of vertebral arch.It forms the round wall and lateral wall of the spinal canaland turns more and more thicker from the top to the bottom. Compared with otherspinal ligament, Ligamentum flavum is rich in elastic fibers, so it can not only assistthe paraspinal muscles to control the motion between the vertebra, but also keep thevertebral canal and intervertebral foramen posterior wall smooth. In addition to this,it can ensure the spinal stability when a man sits and stands. The main role is to limitthe excessive flexion of the spinal and maintain a man upright posture, soligamentum flavum is the important connection structure of spinal posterior.Degeneration of the ligamentum flavum is a common clinical disease. It mainlyincludes the Ligamentum flavum hyperplasia, hypertrophy, calcification andossification. With the development of the disease, it often leads to the pain andnumbness of the waist and legs. It seriously affects the patients work and life. Atpresent the most important clinical treatment method is to operate on hypertrophicligamentum flavum. But operation has some defects in some respects, for examplemajor trauma, high risk, many complications and so on. The domestic and foreignresearch demonstrates that fibrosis is the main cause of hypertrophy ligamentumflavum. With the growth of the age, the cumulative increase of mechanical stress is amajor cause of ligamentum flavum fibrosis.Especially when the Ligamentum flavumlocated on dorsal surface of spinal column muckers strech stimulation, the degree ofligamentum flavum fibrosis is higher. The reason is that, compared to the top andend fibers, dorsal fibers bear higher stress, finally leading to hypertrophy of ligamentum flavum. The mechanism of hypertrophy of ligamentum flavumpathogenesis is not clear, which is the reason that we cannot find the effectivetreatment method. So there is no delay to research the pathogenesis of degenerationof ligamentum.NF-B(nuclear factor-kappab, NF-B) is nucleoprotein factor,which canspecifically combine with enhancer B sequence of immunoglobulin-chain. Thisking of nucleoprotein factor is discovered from extracts of B lymphocytes nucleus.NF-B almost exists in all types of tissues and cells, which is a kind of pivotalnuclear transcription factor. Its signal transduction pathway plays an important rolein the process of injury and repair of tissues and cells. The first affirmance and themost common is p50/p65heterologous dimmers. NF-B has multi-directionaladjustment functions. When NF-B activates, it ecan regulate expression of manyintracellular genes and play a role in cell growth, development and apoptosis etc.These functions are worked by regulating expression of genes of many cytokines,chemokines, growth factors, adhesion molecules and enzymes. NF-B also playsan important role in the malignant transformation and fibrosis of cells. There havebeen many studies about NF-B on many diseases, for example the information ofscar tissue, eye diseases and atherosclerosis diseases. But there has not been reportabout NF-B in the degeneration of ligamentum flavum. By histochemical methodswe can learn about the degree of collagen proliferation of hypertrophy of theligamentum flavum. So we can detect the expression of NF-B in hypertrophy ofthe ligamentum flavum by immunohistochemical method and investigate itssignificance.MethodsAll specimens were taken from the ligamentum flavum central part. The groupof degeneration of ligamentum flavum:45patients, aged: between32and65yearsold, average age is53; including32males and13females. And divided into≤40years,40-60years,≥60years group. These patients were confirmed by medicalhistory, clinical manifestations and X-ray, CT, MRI, etc. diagnosed asdegeneration.of ligament flavum. Control group (normal ligamentum flavum tissuewas obtained from patients with traumatic vertebral fractures):45patients, aged15to30years, average age is23; including28males and17females. Preoperativeadministration of conventional X-ray, CT, MRI and other tests, there were no obvious degeneration of ligamentum flavum, such as hypertrophy and ossification.Divided the ligamentum flavum into A, B two parts, both of flavum is5×5mmsize. A part of the ligamentum flavum tissue immediately placed in10%formalinsolution and fixed for different concentrations of alcohol dehydration, Xylenetransparent, paraffin, embedding, paraffin microtome slices, the thickness is5m,anti-slides off the handle, the slice is set80℃oven for2-4hours. Part Bligamentum flavum tissue immediately into ultra-low temperature refrigerator (-80℃) save for immunohistochemistry.Olympus optical microscope were used to observe in blind, HE staining wereobserved, NF-B p65immunohistochemical staining, set Masson staining ofcollagen fibers, NF-B p65after the same intensity of light, then low times on eachof the slices microscopy (×100) and high magnification (×400) were observed.Immunohistochemical staining in each slice at high magnification (×400) randomlyselected from four under the microscope field of view through the camera capture animage and save it. First set the measurement parameters, staining positive cells ineach field area the percentage determined by image analysis system.Immunohistochemical NF-B p65each slice at high magnification (×400)randomly selected staining NF-B p65from four under the microscope field ofview, if you see the cytoplasm and cell membrane brown particles, that is thestandard expression for each specimen Perspective positive cells organize, calculate.Calculated the average number of the percentage of positive cells per section ofcollagen fibers, elastic fibers and NF-B p65, the count is the average number ofpositive cells in each specimen area occupied by the percentage of data x±s(%).Application SPSS15.0statistical software for statistical analysis version, check thehomogeneity of variance or not, if the homogeneity of variance, use t-test of twosample; The t’test was used for variance nonhomogeneity.ResultsIn pathological sections, if elastic fibres of hypertrophy of ligamentum flavumreduce, collagen fibers increase, NF-B p65has some expression in hypertrophicligamentum flavum of lumbar, which suggests that inflammation plays a certain rolein hypertrophy of Ligamentum flavum of lumbar. ConclusionsThe main reason which leads to degeneration of ligamentum flavum is that asignificant reduction and structural disorder of elastic fibers of DLF, and growth innumber of collagen fibers. So overexpression of NF-B p65may be an importantfactor in the occurrence and development of DLF. |
PDF Full Text Request