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CNAA / Theses / 2016 / May /

The morphological particularities of the degenerative-dystrophic processes of lumbar intervertebral segment


Author: Cociug Adrian
Degree:doctor of medicine
Speciality: 14.00.15 - Pathological Anatomy
Year:2016
Scientific adviser: Ieremia Zota
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Nicolae Caproş
doctor habilitat, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 18 May, 2016
Approved by NCAA on the 5 July, 2016

Abstract

Adobe PDF document – 1.26 Mb / in romanian

Thesis

CZU 616.711.6-003.8

Adobe PDF document 9.19 Mb / in romanian
0 pages

Keywords

intervertebral disc, vertebral artery, degenerative-dystrophic changes

Summary

Thesis structure. The thesis is exposed on 161 pages of electronic text and includes: introduction, four chapters, conclusion, conclusions, practical recommendations and bibliography (308 sources). The thesis is illustrated with 13 tables, 48 figures, 5 annexes. The results are published in 18 scientific papers.

Domain of study: Pathological Anatomy.

The research purpose - evaluation of degenerative-dystrophic damage consecutiveness of the lumbar intervertebral disc with histopathological staging and assessment of biological changes (histological and immunohistochemical) produced in the compromised vertebral segments.

Objectives: Highlighting of the correspondence between histology of the degenerative changes in intervertebral discs and lumbar MRI imaging changes according thr staging of Modic. Determination of the degree and degenerative-dystrophic damage consecutiveness of lumbar intervertebral disc segments and elements. The presence of correlation between histological degenerative-dystrophic aspects of intervertebral discs and lumbar arteries stained by CD34 immunohistochemistry. Identification of the cells attend the inflammatory manifestations in the arteries, and MCT colored by CD68 immunohistochemistry and fibrillary disorganization by orcein and silver impregnation.

Scientific novelty. The correlative studies between MRI and histology of the disc in 80% of cases of herniated disc surgical histology shows changes typical advanced in the outbreak lesion and the early changes and environments, with the presence of fibroblasts reveal character regenerative kernel pulposus and annulus. Investigation of L1 lumbar arteries correlative - L5, stained with CD34, and at this level lumbar of intervertebral discs, examined histologically presents Pearson correlation index r = 0.54, average being interpreted as association, which is a clue in diagnosing degree damage to the disc.

Scientific problem solved: The degree of degeneration of the disc with stage MRI correlated at the same level, and the presence of an association between damage of the arteries wall lumbar with the intervertebral lumbar disc degeneration.

The theoretical significance. The study confirmed the usefulness and priority of the histlogical and immunohistochemical examination in assessing the degree and consistency of damage of the disc, involving of the vertebral segment structures, and stage of the vessel wall damage correlates with the degree of lumbar intervertebral disc degeneration.

The value of the work. The results obtained in the study complete the specialized medical knowledge on the diagnosis, evolution of the degenerative-dystrophic changes, perfecting tactics of treatment and prophylaxis.

Implementaea scientific results. The study results were implemented in the work of PMSI SCTO, Laboratory of Tissue Engineering and Cells Cultures, Tissue bank, SCM,, Holy Trinity "