张耀;张强;赵昌松;王晶晶;王鹏;孙磊;赵汝岗;李鑫;孙胜;

• 1:首都医科大学附属北京地坛医院骨科/感染病科国家临床重点专科建设项目
• 2:首都医科大学附属北京地坛医院病理科

摘要(Abstract)：

[目的]探讨腰椎布氏菌性脊椎炎病变椎间盘不同时期病理特点。[方法]2012年11月~2015年3月,88例行手术治疗的腰椎布氏菌性脊柱炎患者,男72例,女16例,年龄40~68岁,平均52.6岁。76例行腰椎后路病灶清除、减压、内固定、植骨融合术,12例行椎间孔镜下病灶清除术。术前收集X线片、CT及MRI等影像资料,术中收集病变椎间盘,采用HE和Gimesa染色进行病理观察。[结果]X线片及CT显示88例患者椎间盘均可见炎性改变,其中椎间盘破坏者84例,12例表现为早期椎间隙正常或轻度变窄,多为1~2个临近椎体终板及终板下局灶性骨质毁坏;76例表现为中晚期椎间隙明显变窄,可累及大部分甚至整个椎体,表现为空洞、破坏、硬化、增生。MRI显示12例早期病变椎间盘T1WI呈稍低信号或等信号,T2WI及压脂T2WI呈不均匀混杂高信号,增强后不均匀强化;76例中晚期病变椎间盘T1WI呈低信号,T2WI及压脂T2WI呈高信号,增强后明显强化。病理结果示88例病变椎间盘均可见布鲁氏菌Gimesa染色阳性;HE染色发现早期病变椎间盘大量炎症细胞增殖,包含大量单核细胞、淋巴细胞、中性粒细胞、嗜酸性细胞,中晚期病变椎间盘纤维组织广泛增生。[结论]腰椎布氏菌性脊椎炎病变椎间盘不同时期病理表现具有特征性,对临床诊断和治疗方案的选择可提供重要的参考信息。

关键词(KeyWords)： 腰椎;布氏菌性脊柱炎;椎间盘;病理

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张耀;张强;赵昌松;王晶晶;王鹏;孙磊;赵汝岗;李鑫;孙胜;

Email:

DOI:

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