Histological composition of lumbar disc herniations related to the type of herniation and to the age

Objectives: To compare the data for histologic composition of the herniated disc material between
different types of disc herniations and between patients of different age.
Background: Lots of studies have investigated the histologic composition of disc herniations. Few studies have
examined the presence of granulation tissue related to the type of herniations and age of the subjects.
Methods: 120 patients divided in to two age groups underwent MR imaging before microsurgical removal of the
herniations. Disc herniations were divided in to two groups, non migrated and large migrated disc herniations.
The histologic assessment of the herniated material is done by dividing the intercellular matrix into four types.
The existence of areas of granulation tissue and hyaline cartilage is evaluated too.
Results: The tissue composition showed signifi cant differences between patients of different age. Areas of granulation
tissue and neovascularisation are found in 12 % of 64 protrusions and contained extrusions, and in
29 % of 56 large migrated disc extrusions (p=0.029 ). In elderly patients the tissue composition changed with
a signifi cant decrease of prevailing nucleus pulposus composition in 7 % of 60 (p=0.000) and a signifi cant increase
of prevailing fi brous tissue composition in 40 % of 60 (p=0.000). Areas of granulation tissue and neovascularisation
were found in 27 % of 60 patients aged ≤50 and in 13 % of 60 patients aged >50.
Conclusions: The tissue composition of the herniated material showed more expressed differences between subjects
of different age. Granulation tissue and neovascularisation were more frequent fi ndings in large migrated
disc herniations and in patients aged 35 to 50 years (Fig. 8, Ref. 22). Full Text in PDF www.elis.sk.
Key words: magnetic resonance (MR), spine, lumbar disc herniations, histology.