椎间盘(IVD)通常被称为人体最大的无血管结构,然而,尚不存在表征IVD血管化的集体资源.为了解决这个差距,这项研究的目的是对文献进行全面搜索,以回顾和总结人类IVD中血液供应的流行和局部化的最新知识,进行范围审查。在六个电子数据库中进行了关于人类IVD血管化主题的同行评审出版物的全面搜索:PubMed,EMBASE,MEDLINE,Scopus,WebofScience,和BIOSIS预览。包括对人类的研究,无论年龄大小,性别,种族,和健康状况,除了IVD疝。两名独立审稿人根据资格标准筛选标题和摘要以及全文。审查是根据系统审查的首选报告项目扩展范围审查指南进行和报告的。我们的搜索产生了3122篇文章,22篇文章符合纳入标准。研究样本的年龄范围从胎儿到>90岁,包括两种性别,各种健康状况,并使用不同的方法(例如,组织学,医学成像,和大体解剖)以评估脉管系统。总的来说,一致的观察结果是(a)IVD的髓核在一生中是无血管的,(b)软骨终板和纤维环接受相当多的血液供应在生命早期,随着寿命减少,和(c)血管向内生长到软骨终板和纤维环的内层通常与受损或破裂的组织有关,不论年龄。组织学和免疫组织化学通常用于报告IVD的血管形成。目前的文献表明,IVD不应被概括为无血管组织。相反,IVD的血管形成因组成组织而异,他们的年龄,和退化或损伤的状态。
Intervertebral discs (IVDs) are often referred to as the largest avascular structures of the human body, yet a collective resource characterizing the vascularization of the IVD does not exist. To address this gap, the objective of this study was to conduct a comprehensive search of the literature to
review and summarize current knowledge of the prevalence and localization of blood supply in human IVDs, with a scoping
review. A comprehensive search of peer-reviewed publications on the topic of IVD vascularization in humans was conducted across six electronic databases: PubMed, EMBASE, MEDLINE, Scopus, Web of Science, and BIOSIS Previews. Studies of humans were included regardless of age, sex, ethnicity, and health status, with the exception of IVD herniation. Two independent reviewers screened titles and abstracts and full-texts according to eligibility criteria. The
review was conducted and reported according to Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews guidelines. Our search yielded 3122 articles, with 22 articles meeting the inclusion criteria. The study samples ranged in age from fetal to >90 years and included both sexes, various health statuses, and used different methodologies (eg, histology, medical imaging, and gross dissection) to assess vasculature. Overall, consistent observations were that (a) the nucleus pulposus of the IVD is avascular throughout life, (b) both the cartilage endplates and annulus fibrosus receive considerable blood supply early in life that diminishes over the lifespan, and (c) vascular ingrowth into the cartilage endplates and inner layers of the annulus fibrosus is commonly associated with damaged or disrupted tissue, irrespective of age. Histology and immunohistochemistry are often used to report vascularization of the IVD. The body of the current literature suggests that the IVD should not be generalized as an avascular tissue. Instead, vascularization of the IVD differs based on the constituent tissues, their age, and state of degeneration or damage.