Histology of the Ligament Flavumin Degenerative Lumbar Disease / 대한정형외과학회잡지

PURPOSE: To determine the association between the histological findings of ligamentum flavum (LF) and the clinical symptoms or radiological findings of patients with degenerative lumbar disease. MATERIALS AND METHODS: Twenty-six patients with mono-segmental degenerative lumbar diseases (15 patients with spinal stenosis and 11 patients with degenerative spondylolisthesis) underwent a surgical decompression with en bloc resection of the LF. Tissue specimens of the LF were prepared, and the changes in the elastic and collagen fibers were evaluated. The focal lesions were observed in the LF. The following clinical and radiological parameters were investigated in order to determine the possible association with the histological findings: age, gender, preoperative Japanese Orthopaedic Association (JOA) score, the type of neurogenic intermittent claudication, % slip, height of the intervertebral disc, intervertebral angle, intervertebral angle of motion. RESULTS: There were no significant relationships between the changes in the elastic or collagen fibers and the JOA score. In regard to the focal lesions in the LF, vascularization was observed in 15 cases, calcification in 10, chondrocyte in 9, ossification in 8, ganglion-like cystic lesions in 5 and granulation in 4. The average age of the patients with and without calcification were 70.3 and 63.8 years, respectively. The average preoperative JOA scores of the patients with and without calcification were 13.5 and 15.6 points, respectively. Ossification was more commonly observed in those with degenerative spondylolisthesis (7 cases) than in those with spinal stenosis (1 case). CONCLUSION: Various focal lesions in the LF were observed. Calcification was observed more frequently in elderly patients, and the average preoperative JOA scores of the patients with calcification were lower. Ossification was observed more frequently in patients with degenerative spondylolisthesis (7 cases) than in those with spinal stenosis (1 case), suggesting involvement of a mechanical load in the ossification of ligaments.

A Histopathological Study on the Rheumatoid Arthritis of the Knee Joint / 대한정형외과학회잡지

Twenty cases of the rheumatoid arthritis was carried out the histopathological observation from the affected synovial membrane at the knee joint by the Cops biopsy needle, at the Department of Orthopedic Surgery, Chosun University Hospital. The authors researched the difference to compare with the histological finding and its clinical features. The following results were obtained. 1. The average age was 36.9 years old and the sex ratio between the male and female was 1:2.7. 2. The erythrocyte sedimentation rate and protein amont in the synovial fluid was elevated than the normal value. 3. The most common clinical sign was the morning stiffness with multiple joint pain and moderate swelling, tenderess in the involved joint. 4. The test of rheumatoid factors revealed positive about 70% in the serum and 100% in the joint fluid. 5. The characteristic histological finding on the light microscopical examination was the hyperplasia of surface lining cells, deposition of the fibrin with the fibrinoid necrosis, and vascular hypertrophic changes of the blood vessel in all of those cases. 6. The histological finding had no difference to compare with the clinical course.