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Form and function of the intervertebral disc in health and disease: a morphological and stain comparison study
Author(s) -
Walter B. A.,
Torre O. M.,
Laudier D.,
Naidich T. P.,
Hecht A. C.,
Iatridis J. C.
Publication year - 2015
Publication title -
journal of anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.932
H-Index - 118
eISSN - 1469-7580
pISSN - 0021-8782
DOI - 10.1111/joa.12258
Subject(s) - trichrome , trichrome stain , pathology , intervertebral disc , medicine , h&e stain , masson's trichrome stain , degeneration (medical) , stain , cartilage , anatomy , staining , immunohistochemistry
Multiple histologic measurements are commonly used to assess degenerative changes in intervertebral disc ( IVD ) structure; however, there is no consensus on which stains offer the clearest visualization of specific areas within the IVD . The objective of this study was to compare multiple tinctorial stains, evaluate their ability to highlight structural features within the IVD, and investigate how they influence the capacity to implement a degeneration scoring system. Lumbar IVD s from seven human autopsy specimens were stained using six commonly used stains (Hematoxylin/Eosin, Toluidine Blue, Safranin‐O/Fast Green, Extended FAST , modified Gomori's Trichrome, and Picrosirius Red Alcian Blue). All IVD s were evaluated by three separate graders to independently determine which stains (i) were most effective at discerning different structural features within different regions of the IVD s and (ii) allowed for the most reproducible assessment of degeneration grade, as assessed via the Rutges histological scoring system (Rutges et al. A validated new histological classification for intervertebral disc degeneration. Osteoarthritis Cartilage , 21, 2039‐47). Although Trichrome, XFAST and PR / AB stains were all effective at highlighting different regions of whole IVD s, we recommend the use of PR / AB because it had the highest degree of rater agreement on assigned degeneration grade, allowed greater resolution of degeneration grade, has an inferential relationship between color and composition, and allowed clear differentiation of the different regions and structural disruptions within the IVD . The use of a standard set of stains together with a histological grading scheme can aid in the characterization of structural changes in different regions of the IVD and may simplify comparisons across the field. This collection of human IVD histological images highlights how IVD degeneration is not a single disease but a composite of multiple processes such as aging, injury, repair, and disease, each of which are unique to the individual.