RESUMO
Objective To evaluate and compare the immunopathological changes of lumbar disc herniation and discogenic pain. Methods Seventy-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. Results 1) Pathological observation with HE stain: compare 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). Conclusion The 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.
