徳島大学 教育・研究者情報データベース(EDB)

1. (英) Kosaka Hirofumi

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2. 西良 浩一([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.運動機能外科学])

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3. (英) Biyani Ashok

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4. (英) Leaman Douglas

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5. (英) Yeasting Richard

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6. 東野 恒作

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7. 酒井 紀典([徳島大学.病院.中央診療施設等.高度先進整形外科診療部])

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8. 加藤 真介

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9. 佐野 壽昭

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10. (英) Goel K. Vijay

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11. 安井 夏生

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(英) Pathomechanism of loss of elasticity and hypertrophy of lumbar ligamentum flavum in elderly patients with lumbar spinal canal stenosis.

(英) A histologic, biologic, and immunohistochemical assessment using human samples of lumbar ligamentum flavum. To clarify the pathomechanism of loss of elasticity and hypertrophy of the lumbar ligamentum flavum (LF) in the elderly population. The most common spinal disorder in elderly patients is lumbar spinal canal stenosis, causing low back and leg pain, and paresis. Canal narrowing, in part, results from hypertrophy of the LF. Although histologic and biologic literature on this topic is available, the pathomechanism of loss of elasticity and hypertrophy of the LF is still unknown. One fetus, 5 young, and 5 elderly LF were obtained for histologic study. Hematoxylin and eosin, Alcian blue, Masson Trichrome, and Elastica Van Gieson stains were performed for each LF. Nine LF were collected and were used for biologic study of real time RT-PCR to quantitatively measure mRNA expression of Type I collagen and elastin in each LF. In the LF of the fetus, elastic fibers accounted for about 75% of the entire area. In the dural aspect of the LF in the young and elderly group, the ratio was also around 75%; however, the ratio of the dorsal aspect decreased with age. Almost half of the area showing loss of elastic fibers was shown to be converted to cartilaginous tissue producing Type II collagen and proteoglycan by Alcian blue and Type II collagen immunohistochemistry. The area, which did not stain black with EV nor blue with AB stain, was positively stained blue with T stain, indicating scarring. The area of the normal dural layer was 18.0 +/- 2.3 and 33.8 +/- 4.3 (mm2), for young and elderly group, respectively. Accordingly, it was 3.2 +/- 0.8 and 18.0 +/- 10.2 (mm2), for the dorsal abnormal layer. Elastin mRNA showed a relatively strong correlation (r = 0.44) with age; however, the slope was very gentle. Type I collagen mRNA showed a very strong correlation (r = 0.80) with age. The slope was steeper, and the value reached at 1000% (10-fold) around 65 years old when compared with the LF from younger patient. Elastin mRNA showed a weak correlation (r = 0.36) with thickness, and the slope was gentle. Type I collagen mRNA showed relatively strong correlation (r = 0.52) with thickness. The slope was steeper, and the line reached at 1000% (10-fold) around 6.5 (mm) when compared with a thin LF. Decreased elasticity of LF in the elderly is due to the loss of elastic fibers and a concomitant increase of collagenous fibers in the dorsal aspect. LF hypertrophy could be due to the thickening of the normal elastic layer as well as of the abnormal collagenous layer.

1. (英) Adult
2. (英) Age Factors
3. 加齢(aging/->キーワード[老化])
4. (英) Collagen Type I
5. (英) Collagen Type II
6. 弾性(elasticity)
7. (英) Elastin
8. 胎児(fetus)
9. (英) Humans
10. (英) Hypertrophy
11. (英) Ligamentum Flavum
12. (英) Lumbar Vertebrae
13. (英) Middle Aged
14. (英) RNA, Messenger
15. (英) Spinal Stenosis

1. (英) Article.Affiliation: Department of Orthopedics, University of Tokushima, Tokushima, Japan.

2. (英) Article.PublicationTypeList.PublicationType: Comparative Study

3. (英) Article.PublicationTypeList.PublicationType: Journal Article

4. (英) Article.PublicationTypeList.PublicationType: Research Support, Non-U.S. Gov't