Skeletal Radiology

, Volume 38, Issue 12, pp 1169–1173

The presence and absence of lymphatic vessels in the adult human intervertebral disc: relation to disc pathology

  • Karolina Kliskey
  • Kelly Williams
  • J. Yu
  • David Jackson
  • Jill Urban
  • Nick Athanasou
Scientific Article

DOI: 10.1007/s00256-009-0770-2

Cite this article as:
Kliskey, K., Williams, K., Yu, J. et al. Skeletal Radiol (2009) 38: 1169. doi:10.1007/s00256-009-0770-2

Abstract

Objective

Although the normal adult human intervertebral disc is considered to be avascular, vascularised cellular fibrous tissue can be found in pathological conditions involving the disc such as disc herniation. Whether lymphatics vessels form a component of this reparative tissue is not known as the presence or absence of lymphatics in herniated and normal disc tissue is not known. We examined spinal tissues and discectomy specimens for the presence of lymphatics.

Methods

The examination used immunohistochemistry to identify the specific lymphatic endothelial cell markers, podoplanin and LYVE1.

Results

Lymphatic vessels were not found in the nucleus pulposus or annulus fibrosus of intact, non-herniated lumbar and thoracic discs but were present in the surrounding ligaments. Ingrowth of fibrous tissue was seen in 73% of herniated disc specimens of which 36% contained LYVE1+/podoplanin + lymphatic vessels. Lymphatic vessels were not seen in the sacrum and coccyx or biopsies of four sacrococcygeal chordomas, but they were noted in surrounding extra-osseous fat and fibrous tissue at the edge of the infiltrating tumour.

Conclusion

Our findings indicate that lymphatic vessels are not present in the normal adult intervertebral disc but that, when there is extrusion of disc material into surrounding soft tissue, there is ingrowth of reparative fibrous tissue containing lymphatic vessels. Our findings also indicate that chordoma, a tumour of notochordal origin, spreads to regional lymph nodes via lymphatics in para-spinal soft tissues.

Keywords

Lymphatics Pathology Spine Disc 

Copyright information

© ISS 2009

Authors and Affiliations

  • Karolina Kliskey
    • 1
  • Kelly Williams
    • 1
  • J. Yu
    • 1
  • David Jackson
    • 2
  • Jill Urban
    • 1
  • Nick Athanasou
    • 1
  1. 1.Nuffield Department of Orthopaedic, Rheumatology and Musculoskeletal ScienceUniversity of OxfordOxfordEngland
  2. 2.Human Immunology UnitWeatherall Institute of Molecular MedicineOxfordUK

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