徐寶山(Xu Baos- han，Dept Spinal Surg，Tianjin Hosp，Tianjin 300211)…∥Chin J Orthop.－2010，31(1).－66～70

Immunopathological observation of lumbar disc herniation and discogenic pain

徐寶山(Xu Baos- han，Dept Spinal Surg，Tianjin Hosp，Tianjin 300211)…∥Chin J Orthop.－2010，31(1).－66～70

ObjectiveTo evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain.MethodsSeventy-one lumbar disc nucleuses were collected intra-operation，and they were divided into four groups.Group A:30 cases of disc herniation，Group B:22 cases of sequestered disc herniation，and the patients in Group A and B received discectomy;Group C:10 cases of discogenic pain were confirmed by discography，and the painful disc was excised through anterior retroperitoneal approach;Group D:9 cases of lumbar bust fracture who received anterior subtotal corpectomy and discectomy，and the nearly normal caudal disc was collected as control.The disc nucleuses were processed in the following methods:1)HE stain and pathological observation;2)Immunocytochemical test using monoclonal antibodies to CD68 and CD45RO molecule for macrophage and T lymphocytes，respectively.The positive cells were counted and analyzed with statistic method.Results1)Pathological observation with HE stain:compared to control group，the degeneration of nucleus cell was evident in the other groups.There were obvious infiltration of inflammatory cells and focal neovascularization in group A and especially in Group B.In Group C，only diffuse inflammatory cells was found without neovascularization，but the degeneration of matrix was more severe.2)Positive rate of CD68 cells:Group B(63.6%)＞ Group C(40.0%)＞ Group A(26.7%)＞Group D(0%).There were significant differences among groups(P ＜ 0.05).3)Positive rate of CD45RO cells:Group B(59.1%)＞ Group A(13.3%)，Group C and D were negative，and the positive cell were found in slice of the same site of positive CD68 cells.The differences between each group were significant(P ＜0.05).ConclusionThe nucleus of herniated disc has evident inflammatory and autoimmunity reaction.The nucleus of discogenic pain is infiltrated with diffuse inflammatory cells and some macrophages，without T lymphocyte and neovasularization，so the autoimmunity course is not evident.18 refs，3 figs，2 tabs.

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