Evaluation of Pathogenesis Outcomes of Intervertebral Disc Tissue in Patients with Herniated Disc Based on Histopathological and Histological Grading

Background: the nucleus pulposus NP pulls on the ruptured annulus fibrosus AF, bulging the intervertebral disc IVD and releasing chemicals that may irritate nerves and cause inflammation and pain. This produces histological changes to the IVD, including less gelatinous NP, cracks and fissures, decreased matrix water content, and proteoglycan composition changes. Aim of study: this study aims to investigate the histopathological changes in the Herniated Disc HD tissue, as well as cartilage histopathology grade and stage assessment. Materials and methods: fourty tissue samples of lumbar HD obtained after the operations were kept in 10% formalin. Then all HD sections were processed, and embedded, after that, 5 μm thick glass mounted sections were stained with Hematoxylin and Eosin and Alcian blue (pH 0.02) and examined microscopically for histopathological changes and grading scoring was also conducted based on cell density, structural alterations of collagen fibers, and proteoglycan degeneration. Results: hemorrhage with fibrin deposition, mucous degeneration around chondrocyte clones and degeneration, increased chondrocyte density, expanded lacunae with degenerated chondrocytes, fiber disorientation, cleft formation, mucoid matrix changes, and inflammatory cell infiltration with fibrocyte prefiltration were the most histopathological changes in HD samples. Along with necrotic chondrocyte increase and tissue fiber alterations. Histological cell density grade indicated different-sized clones. All HD tissues revealed collagen fiber structural alterations, with gradients (52.5%) being most common. All HD samples showed mucous (proteoglycans) degradation, especially in gradients abundantly present and intermediate between 1 and 3 (45% and 42.5%). Conclusions: histopathological changes in intervertebral disc associated with HD infection.