《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (12): 1190-1191.

• 临床研究 • 上一篇    下一篇

先天性与特发性脊柱侧凸患者椎旁肌病理对比分析

吴士文1; 马维娅1; 李端明2; 匡正达2; 张新宇2; 庞晓东2; 叶启彬2   

  1. 1.武警总医院a.神经内科;b.脊柱外科,北京市 100039
  • 收稿日期:2008-11-12 出版日期:2008-12-01 发布日期:2008-12-01

Comparative Study of Paravertebral Muscles in Congenital Scoliosis and Idiopathic Scoliosis Patients

WU Shi-wen, MA Wei-ya, LI Duan-ming, et al   

  1. The Department of Neurology, the General Hospital of Chinese Armed Police Force, Beijing 100039, China
  • Received:2008-11-12 Published:2008-12-01 Online:2008-12-01

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摘要： 目的探讨椎旁肌在脊柱侧凸发病中的作用。方法对手术中留取的37例脊柱侧凸患者(先天性12例、特发性25例)椎旁肌进行冰冻切片、肌肉组织病理染色,分析光镜下的病理改变。结果光镜下可见普遍存在椎旁肌肌源性改变(包括肌肉组织纤维化、肌纤维变性坏死等),但肌纤维再生现象极为少见。先天性脊柱侧凸患者椎旁肌纤维化主要表现为弥漫性改变,同时伴有明显肌纤维走行紊乱;特发性脊柱侧凸患者主要以局灶性且不伴有坏死的纤维化为主。1例先天性脊柱侧凸及4例特发性脊柱侧凸患者椎旁肌显示神经源性改变,其中4例曾经历侧凸矫正术。脊柱侧凸患者椎旁肌肌梭囊壁增厚,肌梭内有结缔组织浸润。结论先天性脊柱侧凸患者椎旁肌的病理与特发性脊柱侧凸患者存在一定的差异,可能在特发性脊柱侧凸的发病中起着特殊的作用。

关键词: 特发性脊柱侧凸, 先天性脊柱侧凸, 椎旁肌

Abstract: Objective To identify the role of paravertebral muscles in the pathogenesis of scoliosis.MethodsParavertebral muscles were gotten from the 37 patients(12 congenital scoliosis patients and 25 idiopathic scoliosis patients) during the operations.Cryostat sections were cut by 10 μm nd stained with H&E,m-GT,NADH-TR,ATPase.ResultsMyogenic changes,incuding muscle fibrosis,fiber necrosis,etc,were common in paravertebral muscles of scoliosis patients,however regenerating fibers were quite rare.Diffuse fibrosis and remarkablely disorganized fiber directions presented in most of congenital scoliosis patients,while focal fibrosis without necrosis in most of idiopathic scoliosis patients.Neurogenic changes were found in one congenital scoliosis patient and 4 idiopathic scoliosis patients,however four of the five patients had undergone orthopedics.Thickened capsule wall of muscle spindles and connective tissue infiltration in muscle spindles were found in both kinds of scoliosis.ConclusionThere are some differences on pathological changes of paravertebral muscles between congenital scoliosis and idiopathic scoliosis,which indicates that paravertebral muscles may play a special role in the pathogenesis of idiopathic scoliosis.

Key words: idiopathic scoliosis, congenital scoliosis, paravertebral muscle