Abstract
We investigated histopathological and immunohistochemical properties of the ligamentum flavum of the lumbar spine with calcium crystal deposition. Ligamentum flavum of the lumbar spine containing calcium deposits were harvested from 41 surgical cases. Sections of the ligaments were immunostained for estrogen receptor (ER), progesterone receptor (PR), and transforming growth factor (TGF)-β. The results were compared with those of ligaments without calcium deposits. The elastic fibers of the ligament with calcium deposits showed marked degeneration (irregular arrangement and fragmentation of fiber bundles) and nodular lesions. Deposits of calcium crystals were present in these areas where elastic fibers were degenerated. Immunostaining for ER was positive in these areas, and PR as well as TGF-β-containing chondrocytes were detected around and within the calcified areas. TGF-β, ER and PR-containing chondrocytes appeared to precipitate deposition of calcium crystals in the nodular lesions of the degenerated lumbar ligamentum flavum. Our results suggest that TGF-β and sex hormones play a role in the calcification of the lumbar ligamentum flavum.
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