Histological difference in ligament flavum between degenerative lumbar canal stenosis and non-stenotic group: A prospective, comparative study.

Ligamentum flavum Lumbar spine Morphometry Spinal stenosis histopathology

Journal

World journal of orthopedics
ISSN: 2218-5836
Titre abrégé: World J Orthop
Pays: United States
ID NLM: 101576349

Informations de publication

Date de publication:
18 Sep 2022
Historique:
received: 17 01 2022
revised: 02 03 2022
accepted: 24 08 2022
entrez: 3 10 2022
pubmed: 4 10 2022
medline: 4 10 2022
Statut: epublish

Résumé

Ligament flavum (LF) hypertropy is the main etiopathogenesis of lumbar canal stenosis (LCS). The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content, fibrosis, cicatrization, and calcification. However, the morphometric analysis can delineate the LF in patients with LCS from those without LCS, which would help in better understanding LCS pathogenesis. To compare the histopathological changes in LF between the degenerative LCS and non-stenotic (non-LCS) group. The present prospective study was conducted in 82 patients who were divided into two groups, namely LCS and non-LCS. Demographic details of the patients such as duration of symptoms, level of involvement, and number of segments were recorded. The LF obtained from both groups was histopathologically examined for the fibrosis score, elastic fiber degeneration, calcification, and chondroid metaplasia. Morphometrical details included a change in elastin and collagen percentages, elastin/collagen ratio, elastic fiber fragmentation, and ligamentocyte numbers. All parameters were compared between the two groups by using the independent t test, Chi-square test, and Pearson's correlation test. Out of 82 cases, 74 were analysed, 34 in LCS and 40 in non-LCS group. The mean ± SD age of presentation in LCS and non- LCS group was 49.2 ± 8.9 and 43.1 ± 14.3 respectively. The LCS group ( LF is vital in the pathogenesis of LCS. The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content, fibrosis, cicatrization, and calcification. The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.

Sections du résumé

BACKGROUND BACKGROUND
Ligament flavum (LF) hypertropy is the main etiopathogenesis of lumbar canal stenosis (LCS). The purely elastic LF undergoes a morphological adaptation including a reduction in the elastic fibers and a consequent increase in the collagen content, fibrosis, cicatrization, and calcification. However, the morphometric analysis can delineate the LF in patients with LCS from those without LCS, which would help in better understanding LCS pathogenesis.
AIM OBJECTIVE
To compare the histopathological changes in LF between the degenerative LCS and non-stenotic (non-LCS) group.
METHODS METHODS
The present prospective study was conducted in 82 patients who were divided into two groups, namely LCS and non-LCS. Demographic details of the patients such as duration of symptoms, level of involvement, and number of segments were recorded. The LF obtained from both groups was histopathologically examined for the fibrosis score, elastic fiber degeneration, calcification, and chondroid metaplasia. Morphometrical details included a change in elastin and collagen percentages, elastin/collagen ratio, elastic fiber fragmentation, and ligamentocyte numbers. All parameters were compared between the two groups by using the independent t test, Chi-square test, and Pearson's correlation test.
RESULTS RESULTS
Out of 82 cases, 74 were analysed, 34 in LCS and 40 in non-LCS group. The mean ± SD age of presentation in LCS and non- LCS group was 49.2 ± 8.9 and 43.1 ± 14.3 respectively. The LCS group (
CONCLUSION CONCLUSIONS
LF is vital in the pathogenesis of LCS. The purely elastic LF undergoes a morphological adaptation that includes a reduction in the elastic fibers with a consequent increase in the collagen content, fibrosis, cicatrization, and calcification. The present study provides a detailed morphometric analysis to semiquantitatively delineate the LF changes in patients with LCS from those in patients without LCS.

Identifiants

pubmed: 36189332
doi: 10.5312/wjo.v13.i9.791
pmc: PMC9516625
doi:

Types de publication

Journal Article

Langues

eng

Pagination

791-801

Informations de copyright

©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict-of-interest statement: There is no conflict of interest.

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Auteurs

Mantu Jain (M)

Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhuabneswar 751019, Odisha, India. montu_jn@yahoo.com.

Mukund Sable (M)

Department of Pathology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar 751019, Odisha, India.

Amit Purushottam Tirpude (AP)

Department of Anatomy, All India Institute of Medical Sciences Raipur, Raipur 492009, Chattisgarh, India.

Rabi Narayan Sahu (RN)

Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar 751019, Odisha, India.

Sudeep Kumar Samanta (SK)

Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhuabneswar 751019, Odisha, India.

Gurudip Das (G)

Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhuabneswar 751019, Odisha, India.

Classifications MeSH