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Sample records for degenerated intervertebral discs

  1. Intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bergknut, Niklas

    2011-01-01

    Back pain is common in both dogs and humans, and is often associated with intervertebral disc (IVD) degeneration. The IVDs are essential structures of the spine and degeneration can ultimately result in diseases such as IVD herniation or spinal instability. In order to design new treatments halting

  2. Magnetic resonance imaging of intervertebral disc degeneration

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    Maeda, Hiroshi; Noguchi, Masao (Kitakyushu City Yahata Hospital, Fukuoka (Japan)); Kira, Hideaki; Fujiki, Hiroshi; Shimokawa, Isao; Hinoue, Kaichi

    1993-02-01

    The aim of this study was to correlate the degree of lumbar intervertebral disc degeneration with findings of magnetic resonance imaging (MRI). Seventeen autopsied (from 7 patients) and 21 surgical (from 20 patients) intervertebral discs were used as specimens for histopathological examination. In addition, 21 intervertebral discs were examined on T2-weighted images. Histopathological findings from both autopsied and surgical specimens were well correlated with MRI findings. In particular, T2-weighted images reflected increased collagen fibers and rupture within the fibrous ring accurately. However, when severely degenerated intervertebral discs and hernia protruding the posterior longitudinal ligament existed, histological findings were not concordant well with T2-weighted images. Morphological appearances of autopsy specimens, divided into four on T2-weighted images, were well consistent with histological degeneration. This morphological classification, as shown on T2-weighted images, could also be used in the evaluation of intervertebral disc degeneration. (N.K.).

  3. Biomechanical study of intervertebral disc degeneration

    OpenAIRE

    González Guitiérrez, Ramiro Arturo

    2012-01-01

    Degeneration and age affect the biomechanics of the intervertebral disc, by reducing its stiffness, flexibility and shock absorption capacities against daily movement and spinal load. The biomechanical characterization of intervertebral discs is achieved by conducting mechanical testing to vertebra-disc-vertebra segments and applying axial, shear, bend and torsion loads, statically or dynamically, with load magnitudes corresponding to the physiological range. However, traditional testing does...

  4. Biomechanical study of intervertebral disc degeneration

    OpenAIRE

    González Guitiérrez, Ramiro Arturo

    2012-01-01

    Degeneration and age affect the biomechanics of the intervertebral disc, by reducing its stiffness, flexibility and shock absorption capacities against daily movement and spinal load. The biomechanical characterization of intervertebral discs is achieved by conducting mechanical testing to vertebra-disc-vertebra segments and applying axial, shear, bend and torsion loads, statically or dynamically, with load magnitudes corresponding to the physiological range. However, traditional testing does...

  5. Stem cell horizons in intervertebral disc degeneration

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    Joseph Ciacci

    2009-01-01

    Full Text Available Joseph Ciacci1, Allen Ho1,2, Christopher P Ames3, Rahul Jandial41Division of Neurosurgery, University of California, San Diego, La Jolla, California, USA; 2Del E Webb Neurosciences, Aging and Stem Cell Research Center, The Burnham Institute for Medical Research, La Jolla, California, USA; 3Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; 4Division of Neurosurgery, Department of Surgery, City of Hope Cancer Center, Duarte, CA, USAAbstract: Intervertebral disc degeneration remains a pervasive and intractable disease arising from a combination of aging and stress on the back and spine. The growing field of regenerative medicine brings the promise of stem cells in the treatment of disc disease. Scientists and physicians hope to employ stem cells not only to stop, but also reverse degeneration. However, there are many important outstanding issues, including the hostile avascular, apoptotic physiological environment of the intervertebral disc, and the difficulty of obtaining mesenchymal stem cells, and directing them towards chondrocytic differentiation and integration within the nucleus pulposus of the disc. Given the recent advances in minimally invasive spine surgery, and developing body of work on stem cell manipulation and transplantation, stem cells are uniquely poised to bring about large-scale improvements in treatment and outcomes for degenerative disc disease. In this review we will first discuss the cellular and molecular factors influencing degeneration, and then examine the efficacy and difficulties of stem cell transplantation.Keywords: intervertebral disc degeneration, stem cells, disc disease, mesenchymal stem cells, stem cell transplantation

  6. Gene expression profile analysis of human intervertebral disc degeneration

    OpenAIRE

    Kai Chen; Dajiang Wu; Xiaodong Zhu; Haijian Ni; Xianzhao Wei; Ningfang Mao; Yang Xie; Yunfei Niu; Ming Li

    2013-01-01

    In this study, we used microarray analysis to investigate the biogenesis and progression of intervertebral disc degeneration. The gene expression profiles of 37 disc tissue samples obtained from patients with herniated discs and degenerative disc disease collected by the National Cancer Institute Cooperative Tissue Network were analyzed. Differentially expressed genes between more and less degenerated discs were identified by significant analysis of microarray. A total of 555 genes were signi...

  7. Delivery systems for the treatment of degenerated intervertebral discs

    NARCIS (Netherlands)

    Blanquer, S.B.G.; Grijpma, D.W.; Poot, A.A.

    2015-01-01

    The intervertebral disc (IVD) is the most avascular and acellular tissue in the body and therefore prone to degeneration. During IVD degeneration, the balance between anabolic and catabolic processes in the disc is deregulated, amongst others leading to alteration of extracellular matrix production,

  8. Delivery systems for the treatment of degenerated intervertebral discs

    NARCIS (Netherlands)

    Blanquer, S. B. G.; Grijpma, D. W.; Poot, A. A.

    2015-01-01

    The intervertebral disc (ND) is the most avascular and acellular tissue in the body and therefore prone to degeneration. During IVD degeneration, the balance between anabolic and catabolic processes in the disc is deregulated, amongst others leading to alteration of extracellular matrix production,

  9. New treatment strategies for canine intervertebral disc degeneration

    NARCIS (Netherlands)

    Smolders, L.A.

    2013-01-01

    Degeneration of the intervertebral disc (IVD) is a common problem in dogs and humans. IVD degeneration can lead to herniation of the IVD with subsequent compression of neural structures and various clinical signs, including back pain. Current treatment of IVD disease is conservative or surgical. How

  10. Notochord Cells in Intervertebral Disc Development and Degeneration

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    Matthew R. McCann

    2016-01-01

    Full Text Available The intervertebral disc is a complex structure responsible for flexibility, multi-axial motion, and load transmission throughout the spine. Importantly, degeneration of the intervertebral disc is thought to be an initiating factor for back pain. Due to a lack of understanding of the pathways that govern disc degeneration, there are currently no disease-modifying treatments to delay or prevent degenerative disc disease. This review presents an overview of our current understanding of the developmental processes that regulate intervertebral disc formation, with particular emphasis on the role of the notochord and notochord-derived cells in disc homeostasis and how their loss can result in degeneration. We then describe the role of small animal models in understanding the development of the disc and their use to interrogate disc degeneration and associated pathologies. Finally, we highlight essential development pathways that are associated with disc degeneration and/or implicated in the reparative response of the tissue that might serve as targets for future therapeutic approaches.

  11. Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

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    Hoppe, Sven; Quirbach, Sebastian; Krause, Fabian G.; Benneker, Lorin M. [Inselspital, Berne University Hospital, Department of Orthopaedic Surgery, Berne (Switzerland); Mamisch, Tallal C. [Inselspital, Berne University Hospital, Department of Radiology, Berne (Switzerland); Werlen, Stefan [Clinic Sonnenhof, Department of Radiology, Berne (Switzerland)

    2012-09-15

    To demonstrate the potential benefits of biochemical axial T2* mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting. Ninety-three patients suffering from lumbar spine problems were examined using standard MRI protocols including an axial T2* mapping protocol. All discs were classified morphologically and grouped as ''healthy'' or ''abnormal''. Differences between groups were analysed regarding to the specific T2* pattern at different regions of interest (ROIs). Healthy intervertebral discs revealed a distinct cross-sectional T2* value profile: T2* values were significantly lower in the annulus fibrosus compared with the nucleus pulposus (P = 0.01). In abnormal IVDs, T2* values were significantly lower, especially towards the centre of the disc representing the expected decreased water content of the nucleus (P = 0.01). In herniated discs, ROIs within the nucleus pulposus and ROIs covering the annulus fibrosus showed decreased T2* values. Axial T2* mapping is effective to detect early stages of degenerative disc disease. There is a potential benefit of axial T2* mapping as a diagnostic tool, allowing the quantitative assessment of intervertebral disc degeneration. circle Axial T2* mapping effective in detecting early degenerative disc disease. (orig.)

  12. [Research advances in animal models of intervertebral disc degeneration].

    Science.gov (United States)

    Zhang, Wenli; Liu, Hao; Li, Tanzhu

    2007-11-01

    To review the research advances in animal models of human disc degeneration. The relative articles in recent years were extensively reviewed. Studies both at home and abroad were analyzed and classified. The advantages and disadvantages of each method were compared. Studies were classified as either experimentally induced models or spontaneous models. The induced models were subdivided as mechanical (alteration of forces on the normal disc), structural (injury or chemical alteration) and genetically induced models. Spontaneous models included those animals that naturally developed degenerative disc disease. Animal model of intervertebral disc degeneration is an important path for revealing the pathogenesis of human disc degeneration, and play an important role in testing novel interventions. With recent advances in the relevance of animal models and humans, it has a great prospect in study of human disc degeneration.

  13. Degenerated human intervertebral discs contain autoantibodies against extracellular matrix proteins

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    S Capossela

    2014-04-01

    Full Text Available Degeneration of intervertebral discs (IVDs is associated with back pain and elevated levels of inflammatory cells. It has been hypothesised that discogenic pain is a direct result of vascular and neural ingrowth along annulus fissures, which may expose the avascular nucleus pulposus (NP to the systemic circulation and induce an autoimmune reaction. In this study, we confirmed our previous observation of antibodies in human degenerated and post-traumatic IVDs cultured in vitro. We hypothesised that the presence of antibodies was due to an autoimmune reaction against specific proteins of the disc. Furthermore we identified antigens which possibly trigger an autoimmune response in degenerative disc diseases. We demonstrated that degenerated and post-traumatic IVDs contain IgG antibodies against typical extracellular proteins of the disc, particularly proteins of the NP. We identified IgGs against collagen type II and aggrecan, confirming an autoimmune reaction against the normally immune privileged NP. We also found specific IgGs against collagens types I and V, but not against collagen type III. In conclusion, this study confirmed the association between disc degeneration and autoimmunity, and may open the avenue for future studies on developing prognostic, diagnostic and therapy-monitoring markers for degenerative disc diseases.

  14. Degenerated human intervertebral discs contain autoantibodies against extracellular matrix proteins.

    Science.gov (United States)

    Capossela, S; Schläfli, P; Bertolo, A; Janner, T; Stadler, B M; Pötzel, T; Baur, M; Stoyanov, J V

    2014-04-04

    Degeneration of intervertebral discs (IVDs) is associated with back pain and elevated levels of inflammatory cells. It has been hypothesised that discogenic pain is a direct result of vascular and neural ingrowth along annulus fissures, which may expose the avascular nucleus pulposus (NP) to the systemic circulation and induce an autoimmune reaction. In this study, we confirmed our previous observation of antibodies in human degenerated and post-traumatic IVDs cultured in vitro. We hypothesised that the presence of antibodies was due to an autoimmune reaction against specific proteins of the disc. Furthermore we identified antigens which possibly trigger an autoimmune response in degenerative disc diseases. We demonstrated that degenerated and post-traumatic IVDs contain IgG antibodies against typical extracellular proteins of the disc, particularly proteins of the NP. We identified IgGs against collagen type II and aggrecan, confirming an autoimmune reaction against the normally immune privileged NP. We also found specific IgGs against collagens types I and V, but not against collagen type III. In conclusion, this study confirmed the association between disc degeneration and autoimmunity, and may open the avenue for future studies on developing prognostic, diagnostic and therapy-monitoring markers for degenerative disc diseases.

  15. Biomechanical study of intervertebral disc degeneration

    OpenAIRE

    González Guitiérrez, Ramiro Arturo

    2012-01-01

    La degeneración y edad afectan la biomecánica del disco intervertebral, reduciendo la capacidad de rigidez, flexibilidad y atenuación de impactos, contra el movimiento y carga del raquis. La caracterización biomecánica del disco se realiza con ensayos mecánicos a segmentos de vértebra-disco-vértebra y aplicando cargas axiales, cortantes, flexión y torsión, estáticas ó dinámicas, con magnitudes de carga según el intervalo fisiológico. Sin embargo, las pruebas tradicionales no dan una visión de...

  16. ROS: Crucial Intermediators in the Pathogenesis of Intervertebral Disc Degeneration

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    Chencheng Feng

    2017-01-01

    Full Text Available Excessive reactive oxygen species (ROS generation in degenerative intervertebral disc (IVD indicates the contribution of oxidative stress to IVD degeneration (IDD, giving a novel insight into the pathogenesis of IDD. ROS are crucial intermediators in the signaling network of disc cells. They regulate the matrix metabolism, proinflammatory phenotype, apoptosis, autophagy, and senescence of disc cells. Oxidative stress not only reinforces matrix degradation and inflammation, but also promotes the decrease in the number of viable and functional cells in the microenvironment of IVDs. Moreover, ROS modify matrix proteins in IVDs to cause oxidative damage of disc extracellular matrix, impairing the mechanical function of IVDs. Consequently, the progression of IDD is accelerated. Therefore, a therapeutic strategy targeting oxidative stress would provide a novel perspective for IDD treatment. Various antioxidants have been proposed as effective drugs for IDD treatment. Antioxidant supplementation suppresses ROS production in disc cells to promote the matrix synthesis of disc cells and to prevent disc cells from death and senescence in vitro. However, there is not enough in vivo evidence to support the efficiency of antioxidant supplementation to retard the process of IDD. Further investigations based on in vivo and clinical studies will be required to develop effective antioxidative therapies for IDD.

  17. Protective Effect of Ligustrazine on Lumbar Intervertebral Disc Degeneration of Rats Induced by Prolonged Upright Posture

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    Qian-Qian Liang

    2014-01-01

    Full Text Available Most chronic low back pain is the result of degeneration of the lumbar intervertebral disc. Ligustrazine, an alkaloid from Chuanxiong, reportedly is able to relieve pain, suppress inflammation, and treat osteoarthritis and it has the protective effect on cartilage and chondrocytes. Therefore, we asked whether ligustrazine could reduce intervertebral disc degeneration. To determine the effect of ligustrazine on disc degeneration, we applied a rat model. The intervertebral disc degeneration of the rats was induced by prolonged upright posture. We found that pretreatment with ligustrazine for 1 month recovered the structural distortion of the degenerative disc; inhibited the expression of type X collagen, matrix metalloproteinase (MMP-13, and MMP3; upregulated type II collagen; and decreased IL-1β, cyclooxygenase (COX-2, and inducible nitric oxide synthase (iNOS expression. In conclusion, ligustrazine is a promising agent for treating lumbar intervertebral disc degeneration disease.

  18. Intervertebral disc (IVD): Structure, degeneration, repair and regeneration

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    Whatley, Benjamin R.; Wen Xuejun, E-mail: xjwen@clemson.edu

    2012-02-01

    Low back pain affects a large portion of the population, resulting in high care costs for therapy and treatment. One primary cause of low back pain is the degeneration of the intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. Exact causes of degeneration are unknown, but it is thought that natural aging, and both biological and genetic factors may play a significant role in the degenerative process. Conventional methods to alleviate low back pain include spinal fusion and artificial disc replacement. Traditional treatments through spinal fusion may eliminate pain yet do not restore disc function and lead to further degeneration of adjacent levels by altering disc biomechanics and natural kinematics. Recently, artificial IVD replacements have started to gain interest, with two IVD implants currently approved in the United States. Although these implants facilitate the preservation of motions and disc space height, they are unable to sustain compressive forces due to their lack of elasticity. In addition, the implants may produce wear debris that can cause osteolysis and other deleterious effects. As an alternative to these conventional approaches, tissue engineered IVD constructs offer the advantage of biointegration while preserving the essential attributes of natural motion and disc space restoration. There is a great need for the development of tissue engineered scaffolds that simulate the natural 3D morphology and microenvironment of the targeted tissue. Scaffolds should facilitate biological transport to satisfy nutrition and waste removal requirements within the IVD. The discrete tissue architectures of the nucleus pulposus (NP) and annulus fibrosus (AF) have posed great challenges to IVD tissue engineering. Current attempts have not been able to satisfy the biological functions and/or mechanical properties of native tissue. Therefore, these current scaffolds are far from satisfactory. This review highlights the

  19. Transplantation of gene-modified nucleus pulposus cells reverses rabbit intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    LIU Yong; LI Jian-min; HU You-gu

    2011-01-01

    Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 (AAV2)-mediated connective tissue growth factor (CTGF) and tissue inhibitor of metalloproteinases 1 (TIMP1) genes in vitro.Methods Computer tomography (CT)-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits. rAAV2-CTGF-IRES-TIMP1-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs (transplantation group),phosphate-buffered saline (PBS) was injected into degenerative lumbar intervertebral discs (degeneration control group)and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index (DHI) and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging (MRI) analysis.The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type Ⅱ collagen and proteoglycan was detected by RT-PCR.Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture.Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen Ⅱ mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the

  20. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

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    Issy, A.C.; Castania, V.; Castania, M. [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Salmon, C.E.G. [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Nogueira-Barbosa, M.H. [Divisão de Radiologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Bel, E. Del [Departamento de Morfologia, Fisiologia e Patologia Básica, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Defino, H.L.A. [Departamento de Biomecânica, Medicina e Reabilitação do Sistema Locomotor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-03-15

    Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  1. Experimental model of intervertebral disc degeneration by needle puncture in Wistar rats

    Directory of Open Access Journals (Sweden)

    A.C. Issy

    Full Text Available Animal models of intervertebral disc degeneration play an important role in clarifying the physiopathological mechanisms and testing novel therapeutic strategies. The objective of the present study is to describe a simple animal model of disc degeneration involving Wistar rats to be used for research studies. Disc degeneration was confirmed and classified by radiography, magnetic resonance and histological evaluation. Adult male Wistar rats were anesthetized and submitted to percutaneous disc puncture with a 20-gauge needle on levels 6-7 and 8-9 of the coccygeal vertebrae. The needle was inserted into the discs guided by fluoroscopy and its tip was positioned crossing the nucleus pulposus up to the contralateral annulus fibrosus, rotated 360° twice, and held for 30 s. To grade the severity of intervertebral disc degeneration, we measured the intervertebral disc height from radiographic images 7 and 30 days after the injury, and the signal intensity T2-weighted magnetic resonance imaging. Histological analysis was performed with hematoxylin-eosin and collagen fiber orientation using picrosirius red staining and polarized light microscopy. Imaging and histological score analyses revealed significant disc degeneration both 7 and 30 days after the lesion, without deaths or systemic complications. Interobserver histological evaluation showed significant agreement. There was a significant positive correlation between histological score and intervertebral disc height 7 and 30 days after the lesion. We conclude that the tail disc puncture method using Wistar rats is a simple, cost-effective and reproducible model for inducing disc degeneration.

  2. Increased MMP-2 activity during intervertebral disc degeneration is correlated to MMP-14 levels

    NARCIS (Netherlands)

    Rutges, J. P. H. J.; Kummer, J. A.; Oner, F. C.; Verbout, A. J.; Roestenburg, H. J. A.; Dhert, W. J. A.; Creemers, L. B.

    2008-01-01

    Intervertebral disc (IVD) degeneration is associated with the increased expression of several matrix metalloproteinases (MMPs), in particular MMP-2. However, little is known about the actual activity of MMP-2 in healthy and degenerated discs, or what mechanisms are involved in its activation. A majo

  3. Effect of Electro-acupuncture on Matrix Metalloproteinase in Degenerated Cervical Intervertebral Disc of Rats

    Institute of Scientific and Technical Information of China (English)

    SHI Zheng; HUANG Qiang; MA Xiao-peng; LIU Shi-min; LIU Hui-rong; ZHU Zhong-chun

    2007-01-01

    To observe the effect of electro-acupuncture on matrix metalloproteinase in degenerated cervical intervertebral disc rats.Methods:The rat model of cervical intervertebral disc degeneration was induced by unbalanced dynamic and static forces,then the rats were randomly allocated to model group,electro-acupuncture groupⅠ(acupoints Dazhu(BL 11) and Tianzhu(BL 10) were electro-acupunctured),and electro-acupuncture group Ⅱ(acupoints Dazhu (BL 11),Tianzhu(BL 10)and Shenshu(BL 23) were electro-acupunctured),with the normal rats as control.then the HE staining method was adopted to observe the morphological change of cervical intervertebral disc and the immunohistochemical staining method was used to detect the marx metalloproteinases-1(MMP-1) and matrix metalloproteinases-3(MMP-3) in cervical intervertebral disc.Results:The morphological observation showed that after electro-acupuncture treatment,the degrees of cervical intervertebral disc degeneration in electro-acupuncture groupⅠand electro-acupuncture group Ⅱ were alleviated,and the electro-acupuncture group Ⅱ was superior to electro-acupuncture group Ⅰ.The expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were increased(P<0.01),and after electro-acupuncture treatment,the expressions of MMP-1 and MMP-3 in degenerated cervical intervertebral disc were decreased,especially the electro-acupuncture group Ⅱpresented the better effect as compared with electro-acupuncture group Ⅰ(P<0.05).Conclusions:Electro-acupuncture at acupoints Dazhu (BL 11) and Tianzhu (BL 10) had a certain therapeutic effect on cervical intervertebral disc degeneration,and in combination with acupoint Shenshu(BL 23),this therapeutic effect could be enhanced,its action mechanism might be that electro-acupuncture can reduce the expressions of MMP-l and MMP-3 in degenerated cervical intervertebral disc,inhibit the degradation of matrix in intervertebral disc.so as to relieve cervical intervertebral disc

  4. Aging and degeneration of the intervertebral disc: review of basic science

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    Josemberg da Silva Baptista

    2015-06-01

    Full Text Available Currently there is a growing interest in the study of intervertebral discs due to loss of manpower brought to society by low back and neck pains. These papers seek to delineate the difference between normal aging and disc degeneration, trying to understand what factor would be determining for the second condition. Thus, the morphology field was expanded and knowledge on the structure of intervertebral discs currently uses the research field of cell and molecular biology, and genetics. The results indicate that regardless of age or condition, the intervertebral disc undergoes long and extensive remodeling of its constituents, which are influenced by several factors: environmental, soluble, cell growth and extracellular matrix. In this literature review we describe the biological characteristics of the cervical and lumbar intervertebral disc with a focus on basic science of aging and degeneration, selecting the latest findings and discussions of the area, which influence future research and clinical thoughts.

  5. Potential regenerative treatment strategies for intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bach, Frances C|info:eu-repo/dai/nl/369494954; Willems, Nicole; Penning, Louis C|info:eu-repo/dai/nl/110369181; Ito, Keita; Meij, Björn P|info:eu-repo/dai/nl/164045805; Tryfonidou, Marianna A|info:eu-repo/dai/nl/24306599X

    Pain due to spontaneous intervertebral disc (IVD) disease is common in dogs. In chondrodystrophic (CD) dogs, IVD disease typically develops in the cervical or thoracolumbar spine at about 3-7 years of age, whereas in non-chondrodystrophic (NCD) dogs, it usually develops in the caudal cervical or

  6. Potential regenerative treatment strategies for intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bach, Frances C; Willems, Nicole; Penning, Louis C; Ito, Keita; Meij, Björn P; Tryfonidou, Marianna A

    2014-01-01

    Pain due to spontaneous intervertebral disc (IVD) disease is common in dogs. In chondrodystrophic (CD) dogs, IVD disease typically develops in the cervical or thoracolumbar spine at about 3-7 years of age, whereas in non-chondrodystrophic (NCD) dogs, it usually develops in the caudal cervical or lum

  7. Effect of osteoporosis and intervertebral disc degeneration on endplate cartilage injury in rats

    Institute of Scientific and Technical Information of China (English)

    Lei Wang; Wei Cui; Jean Pierre Kalala; Tom Van Hoof; Bao-Ge Liu

    2014-01-01

    Objective:To investigate the effect of osteoporosis and intervertebral disc degeneration on the endplate cartilage injury in rats.Methods:A total of48 femaleSpragueDawley rats(3 months) were randomly divided intoGroupsA,B,C andD with12 rats in each group.Osteoporosis and intervertebral disc degeneration composite model, simple degeneration model and simple osteoporosis model were prepared inGroupsA,B andC respectively.After modeling, four rats of each group at12th,18th and24th week were sacrificed.Intervertebral height of cervical vertebra C6/C7 was measured.Micro-CT was used to image the endplate of cephalic and caudal cartilage atC6/C7 intervertebral disc.Abraded area rate ofC6 caudal andC7 cephalic cartilage endplate was calculated, and thenC6/C7 intervertebral disc was routinely embedded and sectioned, stained with safraninO to observe histological changes microscopically.Results:At12,18 and 24 weeks, intervertebral disc height ofC6/C7 were(0.58±0.09) mm,(0.53±0.04) mm and(0.04±0.06) mm inGroupA rats,(0.55±0.05) mm,(0.52±0.07) mm and(0.07±0.05) mm inGroupB rats.At24th week, intervertebral disc height ofGroupA rats was significantly lower than that ofGroupB rats (P0.05).At12 and18 weeks, the abraded rate ofC6 caudal andC7 cephalic cartilage endplate inGroupA rats were significantly higher than that inGroupsB,C andD rats(P0.05).Microscopic observation ofCT showed that ventral defects inC6 caudal orC7 cephalic cartilage endplate inGroupsA andB appeared after12 weeks of modeling;obvious cracks were found in front of theC6 andC7 vertebral body, and cartilage defect shown the trend of "repairing" at18 and24 weeks after modeling.Conclusions:Intervertebral disc degeneration and osteoporosis can cause damage to the cartilage endplate.Co-existence of these two factors can induce more serious damage to the endplate, which has possitive correlation with intervertebral disc degeneration.Osteoporosis plays a certain role in intervertebral disc degeneration process, and

  8. Treatment of the degenerated intervertebral disc; closure, repair and regeneration of the annulus fibrosus

    NARCIS (Netherlands)

    Sharifi, Shahriar; Bulstra, Sjoerd K.; Grijpma, Dirk W.; Kuijer, Roel

    2015-01-01

    Degeneration of the intervertebral disc (IVD) and disc herniation are two causes of low back pain. The aetiology of these disorders is unknown, but tissue weakening, which primarily occurs due to inherited genetic factors, ageing, nutritional compromise and loading history, is the basic factor causi

  9. Treatment of the degenerated intervertebral disc; closure, repair and regeneration of the annulus fibrosus

    NARCIS (Netherlands)

    Sharifi, Shahriar; Bulstra, S.K.; Grijpma, Dirk W.; Kuijer, R.

    2015-01-01

    Degeneration of the intervertebral disc (IVD) and disc herniation are two causes of low back pain. The aetiology of these disorders is unknown, but tissue weakening, which primarily occurs due to inherited genetic factors, ageing, nutritional compromise and loading history, is the basic factor

  10. Localization of cathepsins D, K, and L in degenerated human intervertebral discs.

    Science.gov (United States)

    Ariga, K; Yonenobu, K; Nakase, T; Kaneko, M; Okuda, S; Uchiyama, Y; Yoshikawa, H

    2001-12-15

    Localization of cathepsins D, K, and L in degenerated intervertebral discs was examined by immunohistochemistry. To determine the involvement of cathepsins in the pathomechanism of intervertebral disc degeneration by monitoring the immunolocalization of cathepsins in degenerated intervertebral disc tissue. Cathepsins D, K, and L are enzymes that contribute to the matrix destruction seen in the articular cartilage affected by osteoarthritis and rheumatoid arthritis. However, little is known about the contribution of these cathepsins to intervertebral disc degeneration. Paraffin-embedded sections of degenerated intervertebral disc tissue collected at the time of surgery (13 discs from 12 patients) were immunohistochemically stained with antibodies for cathepsins D, K, and L. For further characterization of the stained cells, immunohistochemical detection of CD68 and TRAP staining were performed. Hematoxylin and eosin staining revealed obvious signs of degeneration in all sections. Cathepsins D and L were immunolocalized in disc fibrochondrocytes at various sites exhibiting degeneration. Cathepsins K were found in tartrate-resistant acid phosphatase-positive multinucleated cells, in particular near the cleft within the cartilaginous endplate. However, few cells were positive for these cathepsins in anulus fibrosus that maintained the lamellar structure of collagen fibers. Marked expression of cathepsins D and L was observed at the site of degeneration. Cathepsins D and K localized in tartrate-resistant acid phosphatase-positive multinucleated cells existed at the cleft between the cartilaginous endplate and vertebral body. The site-specific localization of these cathepsins suggests the association of these proteinases with endplate separation and disorganization of the anulus fibrosus in degenerative spinal disorders.

  11. Heme oxygenase-1 modulates degeneration of the intervertebral disc after puncture in Bach 1 deficient mice.

    Science.gov (United States)

    Ohta, Ryo; Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Kamei, Naosuke; Nakamae, Toshio; Izumi, Bunichiro; Fujioka, Yuki; Ochi, Mitsuo

    2012-09-01

    Intervertebral disc degeneration is considered to be a major feature of low back pain. Furthermore, oxidative stress has been shown to be an important factor in degenerative diseases such as osteoarthritis and is considered a cause of intervertebral disc degeneration. The purpose of this study was to clarify the correlation between oxidative stress and intervertebral disc degeneration using Broad complex-Tramtrack-Bric-a-brac and cap'n'collar homology 1 deficient (Bach 1-/-) mice which highly express heme oxygenase-1 (HO-1). HO-1 protects cells from oxidative stress. Caudal discs of 12-week-old and 1-year-old mice were evaluated as age-related models. Each group and period, 5 mice (a total of 20 mice, a total of 20 discs) were evaluated as age-related model. C9-C10 caudal discs in 12-week-old Bach 1-/- and wild-type mice were punctured using a 29-gauge needle as annulus puncture model. Each group and period, 5 mice (a total of 60 mice, a total of 60 discs) were evaluated. The progress of disc degeneration was evaluated at pre-puncture, 1, 2, 4, 8 and 12 weeks post-puncture. Radiographic, histologic and immunohistologic analysis were performed to compare between Bach 1-/- and wild-type mice. In the age-related model, there were no significant differences between Bach 1-/- and wild-type mice radiologically and histologically. However, in the annulus puncture model, histological scoring revealed significant difference at 8 and 12 weeks post-puncture. The number of HO-1 positive cells was significantly greater in Bach 1-/- mice at every period. The apoptosis rate was significantly lower at 1 and 2 weeks post-puncture in Bach 1-/- mice. Oxidative stress prevention may avoid the degenerative process of the intervertebral disc after puncture, reducing the number of apoptosis cells. High HO-1 expression may also inhibit oxidative stress and delay the process of intervertebral disc degeneration.

  12. Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration.

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    João W Silveira

    Full Text Available Disc degeneration is a multifactorial process that involves hypoxia, inflammation, neoinnervation, accelerated catabolism, and reduction in water and glycosaminoglycan content. Cannabidiol is the main non-psychotropic component of the Cannabis sativa with protective and anti-inflammatory properties. However, possible therapeutic effects of cannabidiol on intervertebral disc degeneration have not been investigated yet. The present study investigated the effects of cannabidiol intradiscal injection in the coccygeal intervertebral disc degeneration induced by the needle puncture model using magnetic resonance imaging (MRI and histological analyses. Disc injury was induced in the tail of male Wistar rats via a single needle puncture. The discs selected for injury were punctured percutaneously using a 21-gauge needle. MRI and histological evaluation were employed to assess the results. The effects of intradiscal injection of cannabidiol (30, 60 or 120 nmol injected immediately after lesion were analyzed acutely (2 days by MRI. The experimental group that received cannabidiol 120 nmol was resubmitted to MRI examination and then to histological analyses 15 days after lesion/cannabidiol injection. The needle puncture produced a significant disc injury detected both by MRI and histological analyses. Cannabidiol significantly attenuated the effects of disc injury induced by the needle puncture. Considering that cannabidiol presents an extremely safe profile and is currently being used clinically, these results suggest that this compound could be useful in the treatment of intervertebral disc degeneration.

  13. Protective effects of cannabidiol on lesion-induced intervertebral disc degeneration.

    Science.gov (United States)

    Silveira, João W; Issy, Ana Carolina; Castania, Vitor A; Salmon, Carlos E G; Nogueira-Barbosa, Marcello H; Guimarães, Francisco S; Defino, Helton L A; Del Bel, Elaine

    2014-01-01

    Disc degeneration is a multifactorial process that involves hypoxia, inflammation, neoinnervation, accelerated catabolism, and reduction in water and glycosaminoglycan content. Cannabidiol is the main non-psychotropic component of the Cannabis sativa with protective and anti-inflammatory properties. However, possible therapeutic effects of cannabidiol on intervertebral disc degeneration have not been investigated yet. The present study investigated the effects of cannabidiol intradiscal injection in the coccygeal intervertebral disc degeneration induced by the needle puncture model using magnetic resonance imaging (MRI) and histological analyses. Disc injury was induced in the tail of male Wistar rats via a single needle puncture. The discs selected for injury were punctured percutaneously using a 21-gauge needle. MRI and histological evaluation were employed to assess the results. The effects of intradiscal injection of cannabidiol (30, 60 or 120 nmol) injected immediately after lesion were analyzed acutely (2 days) by MRI. The experimental group that received cannabidiol 120 nmol was resubmitted to MRI examination and then to histological analyses 15 days after lesion/cannabidiol injection. The needle puncture produced a significant disc injury detected both by MRI and histological analyses. Cannabidiol significantly attenuated the effects of disc injury induced by the needle puncture. Considering that cannabidiol presents an extremely safe profile and is currently being used clinically, these results suggest that this compound could be useful in the treatment of intervertebral disc degeneration.

  14. Can vertebral density changes be explained by intervertebral disc degeneration?

    NARCIS (Netherlands)

    Homminga, Jasper Johan; Aquarius, R.; Bulsink, Vera Elisabeth; Jansen, C.T.J.; Verdonschot, Nicolaas Jacobus Joseph

    2012-01-01

    One of the major problems facing the elderly spine is the occurrence of vertebral fractures due to low bone mass. Although typically attributed to osteoporosis, disc degeneration has also been suggested to play a role in vertebral fractures. Existing bone adaptation theories and simulations may

  15. Effects of controlled dynamic disc distraction on degenerated intervertebral discs: an in vivo study on the rabbit lumbar spine model.

    Science.gov (United States)

    Kroeber, Markus; Unglaub, Frank; Guehring, Thorsten; Guegring, Thorsten; Nerlich, Andreas; Hadi, Tamer; Lotz, Jeffrey; Carstens, Claus

    2005-01-15

    An in vivo study on the rabbit lumbar spine model. Effects of temporary dynamic distraction on intervertebral discs were studied on the lumbar spine rabbit model to characterize the changes associated with disc distraction and to evaluate feasibility of temporary disc distraction to previously compressed discs in order to stimulate disc regeneration. Studies have shown that accelerated degeneration of the intervertebral disc results from altered mechanical loading conditions. The development of methods for the prevention of disc degeneration and the restoration of disc tissue that has already degenerated are needed. New Zealand white rabbits (n = 32) were used for this study. The rabbits were randomly assigned to one of five groups. In 12 animals, the discs were first loaded for 28 days using a custom-made external loading device to stimulate disc degeneration. After 28 days loading time, the discs in six animals were distracted for 7 days and in six animals for 28 days using the same external device, however, modified as dynamic distraction device. In six animals, the discs were distracted for 28 days without previous loading; and in six animals, the discs were loaded for 28 days and afterwards the loading device removed for 28 days for recovery without distraction. Six animals were sham operated. The external device was situated; however, the discs remained undistracted and they also served as controls. After 28 to 56 days loading and distraction time, the animals were killed and the lumbar spine was harvested for examination. Disc height, disc morphology, cell viability, relative neutral zone, and tangent modulus were measured. After 28 days of loading, the discs demonstrated a significant decrease in disc space. Histologically, disorganization of the architecture of the anulus occurred. The number of dead cells increased significantly in the anulus and cartilage endplate. These changes were reversible after 28 days of distraction. The disc thickness increased

  16. Genetic susceptibility of intervertebral disc degeneration among young Finnish adults

    OpenAIRE

    2011-01-01

    Abstract Background Disc degeneration (DD) is a common condition that progresses with aging. Although the events leading to DD are not well understood, a significant genetic influence has been found. This study was undertaken to assess the association between relevant candidate gene polymorphisms and moderate DD in a well-defined and characterized cohort of young adults. Focusing on young age can be valuable in determining genetic predisposition to DD. Methods We investigated the associations...

  17. Class 3 semaphorins expression and association with innervation and angiogenesis within the degenerate human intervertebral disc

    NARCIS (Netherlands)

    Binch, Abbie L A; Cole, Ashley A; Breakwell, Lee M; Michael, Anthony L R; Chiverton, Neil; Creemers, Laura B; Cross, Alison K; Le Maitre, Christine L

    2015-01-01

    Nerve and blood vessel ingrowth during intervertebral disc degeneration, is thought to be a major cause of low back pain, however the regulation of this process is poorly understood. Here, we investigated the expression and regulation of a subclass of axonal guidance molecules known as the class 3 s

  18. A computational study of intervertebral disc degeneration in relation to changes in regional tissue composition and disc nutrition

    OpenAIRE

    2015-01-01

    Up to 85% of the world population suffers from low back pain, a clinical condition often related to the intervertebral disc (IVD) degeneration (DD). Altered disc cell nutrition affects cell viability and can generate catabolic cascades that degrade the extracellular matrix (ECM). Also, a major degenerative biochemical change in the disc is the proteoglycan (PG) loss, which affects the osmotic pressure and hydration that is critical for cell nutrition. However, the relationship between biochem...

  19. Human cells derived from degenerate intervertebral discs respond differently to those derived from non-degenerate intervertebral discs following application of dynamic hydrostatic pressure.

    Science.gov (United States)

    Le Maitre, Christine Lyn; Frain, Jennie; Fotheringham, Andrew P; Freemont, Anthony J; Hoyland, Judith Alison

    2008-01-01

    The intervertebral disc (IVD) is one of the body's most important load-bearing structures with the major mechanical force experienced in the nucleus pulposus (NP) being hydrostatic pressure (HP). Physiological levels of HP have an anabolic effect on IVD matrix metabolism in cells derived from non-degenerate animal and herniated IVD while excessive HP has a catabolic effect. However, no studies have investigated the response of non-degenerate and degenerate human disc cells derived from non-herniated discs to HP. Here we investigate the effect of physiological HP on such cells using a novel loading rig. Human IVD cells (both NP and AF) cultured in alginate were subjected to dynamic HP (0.8-1.7 MPa 0.5 Hz) for 2 h. Cell viability was assessed, RNA extracted and qRT-PCR for 18 s, c-fos, Sox-9, collagen type II, aggrecan and MMP-3 performed. Cell viability was unaffected by the loading regime. In non-degenerate NP cells, HP increased c-fos, aggrecan, Sox-9 and collagen type II (significantly so in the case of c-fos and aggrecan), but not MMP-3 gene expression. In contrast, application of HP to AF or degenerate NP cells had no effect on target gene expression. Our data shows that cells obtained from the healthy NP respond to dynamic HP by up-regulating genes indicative of healthy matrix homeostasis. However, responses differed in degenerate NP cells suggesting that an altered mechanotransduction pathway may be operational.

  20. Acid-sensing ion channel 1a regulates the survival of nucleus pulposus cells in the acidic environment of degenerated intervertebral discs

    Directory of Open Access Journals (Sweden)

    Feng Cai

    2016-08-01

    Conclusion: The present findings suggest that further understanding of ASIC1a functionality may provide not only a novel insight into intervertebral disc biology but also a novel therapeutic target for intervertebral disc degeneration.

  1. Calcium pentosan polysulfate and sodium pentosan polysulfate may be used to treat intervertebral disc degeneration.

    Science.gov (United States)

    Zhao, Jia-Guo; Wang, Jia; Xin, Qi; Zhang, Peng; Zhang, Sheng-Fei; Qi, Feng; Mao, Dong; Zhang, Zhi-Cheng

    2011-04-01

    Intervertebral disc degeneration (IDD) is a major health problem world-wide, and several spinal disorders are closely associated with it. Although people have invested a great deal of time and effort, how to prevent and reverse the IDD for the researchers is still a difficult and hot issue. Intervertebral disc belongs to cartilage tissue, and IDD also is the cartilage degeneration disease. A large quantity of studies have shown that Calcium pentosan polysulfate (CaPPS) and sodium pentosan polysulfate (NaPPS) possess chondroprotective activities and play an important role in maintaining cartilage integrity. We reasonably hypothesize that NaPPS and CaPPS may be used to treat IDD. The possible mechanism may include that: (1) the significant effects of NaPPS and CaPPS in improving capillary blood flow could maintain nutritional supply to intervertebral disc, and preserve intervertebral disc tissue against degeneration; (2) CaPPS and NaPPS preserve cartilage integrity, proteoglycan synthesis, and improve cartilage biomechanical properties; (3) as the multifaceted exosite inhibitors of proteinases NaPPS and CaPPS strongly impede the activity and production of proteinases; (4) promotion of the balance between proteinases and TIMPs also may be involved in treating IDD; (5) NaPPS and CaPPS exhibit potent anti-inflammatory effects, and then reduce inflammation-induced IDD. If the hypothesis were conformed, the symptoms caused by IDD and its related diseases would be a corresponding alleviation or even disappearance, which could greatly alleviate the suffering of patients from disc degeneration diseases. Certainly, many roles of CaPPS and NaPPS, such as effectiveness, safety and side effects, need to be tested, and further works such as animal model and clinical trial, need to be done to prove this hypothesis.

  2. Class 3 semaphorins expression and association with innervation and angiogenesis within the degenerate human intervertebral disc.

    Science.gov (United States)

    Binch, Abbie L A; Cole, Ashley A; Breakwell, Lee M; Michael, Anthony L R; Chiverton, Neil; Creemers, Laura B; Cross, Alison K; Le Maitre, Christine L

    2015-07-30

    Nerve and blood vessel ingrowth during intervertebral disc degeneration, is thought to be a major cause of low back pain, however the regulation of this process is poorly understood. Here, we investigated the expression and regulation of a subclass of axonal guidance molecules known as the class 3 semaphorins, and their receptors; plexins and neuropilins within human NP tissue and their regulation by pro-inflammatory cytokines. Importantly this determined whether semaphorin expression was associated with the presence of nerves and blood vessels in tissues from human intervertebral discs. The study demonstrated that semaphorin3A, 3C, 3D, 3E and 3F and their receptors were expressed by native NP cells and further demonstrated their expression was regulated by IL-1β but to a lesser extent by IL-6 and TNFα. This is the first study to identify sema3C, sema3D and their receptors within the nucleus pulposus of intervertebral discs. Immunopositivity shows significant increases in semaphorin3C, 3D and their receptor neuropilin-2 in degenerate samples which were shown to contain nerves and blood vessels, compared to non-degenerate samples without nerves and blood vessels. Therefore data presented here suggests that semaphorin3C may have a role in promoting innervation and vascularisation during degeneration, which may go on to cause low back pain.

  3. [Research progress of cellular senescence and senescent secretary phenotype in intervertebral disc degeneration].

    Science.gov (United States)

    Wang, Feng; Zheng, Chenjingmei; Wu, Xiaotao

    2012-12-01

    To summarize the role of cellular senescence and senescent secretary phenotype in the intervertebral disc (IVD) degeneration. Relevant articles that discussed the roles of cellular senescence in the IVD degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. The senescent phenomenon during IVD degeneration, senescent secretary phenotype of the disc cells, senescent pathways within the IVD microenvironment, as well as the anti-senescent approaches for IVD regeneration were systematically reviewed. During aging and degeneration, IVD cells gradually and/or prematurely undergo senescence by activating p53-p21-retinoblastoma (RB) or p161NK4A-RB senescent pathways. The accumulation of senescent cells not only decreases the self-renewal ability of IVD, but also deteriorates the disc microenvironment by producing more inflammatory cytokines and matrix degrading enzymes. More specific senescent biomarkers are required to fully understand the phenotype change of senescent disc cells during IVD degeneration. Molecular analysis of the senescent disc cells and their intracellular signaling pathways are needed to get a safer and more efficient anti-senescence strategy for IVD regeneration. Cellular senescence is an important mechanism by which IVD cells decrease viability and degenerate biological behaviors, which provide a new thinking to understand the pathogenesis of IVD degeneration.

  4. Genetic susceptibility of intervertebral disc degeneration among young Finnish adults

    Directory of Open Access Journals (Sweden)

    Kelempisioti Anthi

    2011-11-01

    Full Text Available Abstract Background Disc degeneration (DD is a common condition that progresses with aging. Although the events leading to DD are not well understood, a significant genetic influence has been found. This study was undertaken to assess the association between relevant candidate gene polymorphisms and moderate DD in a well-defined and characterized cohort of young adults. Focusing on young age can be valuable in determining genetic predisposition to DD. Methods We investigated the associations of existing candidate genes for DD among 538 young adults with a mean age of 19 belonging to the 1986 Northern Finland Birth Cohort. Nineteen single nucleotide polymorphisms (SNP in 16 genes were genotyped. We evaluated lumbar DD using the modified Pfirrmann classification and a 1.5-T magnetic resonance scanner for imaging. Results Of the 538 individuals studied, 46% had no degeneration, while 54% had DD and 51% of these had moderate DD. The risk of DD was significantly higher in subjects with an allele G of IL6 SNPs rs1800795 (OR 1.45, 95% CI 1.07-1.96 and rs1800797 (OR 1.37, 95% CI 1.02-1.85 in the additive inheritance model. The role of IL6 was further supported by the haplotype analysis, which resulted in an association between the GGG haplotype (SNPs rs1800797, rs1800796 and rs1800795 and DD with an OR of 1.51 (95% CI 1.11-2.04. In addition, we observed an association between DD and two other polymorphisms, SKT rs16924573 (OR 0.27 95% CI 0.07-0.96 and CILP rs2073711 in women (OR 2.04, 95% CI 1.07-3.89. Conclusion Our results indicate that IL6, SKT and CILP are involved in the etiology of DD among young adults.

  5. A role for TNFα in intervertebral disc degeneration: A non-recoverable catabolic shift

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    Purmessur, D.; Walter, B.A. [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Roughley, P.J. [Shriners Hospital for Children, Montreal, QC (Canada); Laudier, D.M.; Hecht, A.C. [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States); Iatridis, James, E-mail: james.iatridis@mssm.edu [Leni and Peter W. May Department of Orthopaedics, Icahn School of Medicine at Mount Sinai, New York, NY 10029 (United States)

    2013-03-29

    Highlights: ► TNFα induced catabolic changes similar to human intervertebral disc degeneration. ► The metabolic shift induced by TNFα was sustained following removal. ► TNFα induced changes suggestive of cell senescence without affecting cell viability. ► Interventions are required to stimulate anabolism and increase cell proliferation. -- Abstract: This study examines the effect of TNFα on whole bovine intervertebral discs in organ culture and its association with changes characteristic of intervertebral disc degeneration (IDD) in order to inform future treatments to mitigate the chronic inflammatory state commonly found with painful IDD. Pro-inflammatory cytokines such as TNFα contribute to disc pathology and are implicated in the catabolic phenotype associated with painful IDD. Whole bovine discs were cultured to examine cellular (anabolic/catabolic gene expression, cell viability and senescence using β-galactosidase) and structural (histology and aggrecan degradation) changes in response to TNFα treatment. Control or TNFα cultures were assessed at 7 and 21 days; the 21 day group also included a recovery group with 7 days TNFα followed by 14 days in basal media. TNFα induced catabolic and anti-anabolic shifts in the nucleus pulposus (NP) and annulus fibrosus (AF) at 7 days and this persisted until 21 days however cell viability was not affected. Data indicates that TNFα increased aggrecan degradation products and suggests increased β-galactosidase staining at 21 days without any recovery. TNFα treatment of whole bovine discs for 7 days induced changes similar to the degeneration processes that occur in human IDD: aggrecan degradation, increased catabolism, pro-inflammatory cytokines and nerve growth factor expression. TNFα significantly reduced anabolism in cultured IVDs and a possible mechanism may be associated with cell senescence. Results therefore suggest that successful treatments must promote anabolism and cell proliferation in

  6. Association between intervertebral disc degeneration and disturbances of blood supply to the vertebrae

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; QI Hui

    2010-01-01

    @@ Low back pain is a common public health problem in western industrialized societies and the world as well. Studies indicate that the prevalence rate ranges from 12% to 35%, with around 10% of patients becoming chronically disabled. It also places an enormous economic burden on society. Although the exact cause of low back pain has yet to be defined, intervertebral disc degeneration is considered a major source of it. Since patients with degenerative discs are often asymptomatic, the mechanisms of it are still unclear.

  7. Effects of Tobacco Smoking on the Degeneration of the Intervertebral Disc: A Finite Element Study.

    Science.gov (United States)

    Elmasry, Shady; Asfour, Shihab; de Rivero Vaccari, Juan Pablo; Travascio, Francesco

    2015-01-01

    Tobacco smoking is associated with numerous pathological conditions. Compelling experimental evidence associates smoking to the degeneration of the intervertebral disc (IVD). In particular, it has been shown that nicotine down-regulates both the proliferation rate and glycosaminoglycan (GAG) biosynthesis of disc cells. Moreover, tobacco smoking causes the constriction of the vascular network surrounding the IVD, thus reducing the exchange of nutrients and anabolic agents from the blood vessels to the disc. It has been hypothesized that both nicotine presence in the IVD and the reduced solute exchange are responsible for the degeneration of the disc due to tobacco smoking, but their effects on tissue homeostasis have never been quantified. In this study, a previously presented computational model describing the homeostasis of the IVD was deployed to investigate the effects of impaired solute supply and nicotine-mediated down-regulation of cell proliferation and biosynthetic activity on the health of the disc. We found that the nicotine-mediated down-regulation of cell anabolism mostly affected the GAG concentration at the cartilage endplate, reducing it up to 65% of the value attained in normal physiological conditions. In contrast, the reduction of solutes exchange between blood vessels and disc tissue mostly affected the nucleus pulposus, whose cell density and GAG levels were reduced up to 50% of their normal physiological levels. The effectiveness of quitting smoking on the regeneration of a degenerated IVD was also investigated, and showed to have limited benefit on the health of the disc. A cell-based therapy in conjunction with smoke cessation provided significant improvements in disc health, suggesting that, besides quitting smoking, additional treatments should be implemented in the attempt to recover the health of an IVD degenerated by tobacco smoking.

  8. The relationship between apoptosis of endplate chondrocytes and aging and degeneration of the intervertebral disc.

    Science.gov (United States)

    Ariga, K; Miyamoto, S; Nakase, T; Okuda, S; Meng, W; Yonenobu, K; Yoshikawa, H

    2001-11-15

    Apoptosis in cervical intervertebral disc cells and cartilaginous endplate cells was examined by the nick end labeling (TUNEL) technique during the process of natural aging and in a mouse experimental spondylosis model. To determine the role of apoptosis in aging and degeneration of intervertebral discs by monitoring chronologic changes in the quantity and localization of apoptotic cells. Apoptosis occurs within human intervertebral discs, but little is known about the pathologic significance of this process. On the other hand, the cartilaginous endplate is known to decrease in thickness and to disappear with aging and degeneration. The cause of this age-related change remains unclear. A mouse spondylosis model was prepared via surgical resection of the posterior spinal element in 12 mice to examine the experimentally induced spondylosis process. Eighteen naturally aged mice were also used to examine the influence of aging. Paraffin-embedded midsagittal sections of the cervical spine were obtained 2, 3, 6, and 12 months after surgery in the spondylosis model and in the age-matched naturally aged mice, as well as in 4-week-old and 18-month-old naturally aged mice. Sections were stained with hematoxylin and eosin, safranin-O, and the TUNEL procedure. The number of apoptotic cells and vital cells were counted in the cartilaginous endplate of the intervertebral disc excluding the growth cartilage, and the degree of disappearance of the cartilaginous endplate was evaluated. Apoptosis, particularly noticeable in the cartilaginous endplate, increased with age and resulted in a marked decrease in cell density. Subsequently, the structure of the cartilaginous endplate began to disappear. Apoptosis was more evident and the structure of the cartilaginous endplate began to disappear more rapidly in the surgically treated group than in the naturally aged group. TUNEL-positive cells in the cartilaginous endplate increased with age, with destruction of the cartilaginous endplate

  9. Glucosamine Supplementation Demonstrates a Negative Effect On Intervertebral Disc Matrix in an Animal Model of Disc Degeneration

    Science.gov (United States)

    Jacobs, Lloydine; Vo, Nam; Coehlo, J. Paulo; Dong, Qing; Bechara, Bernard; Woods, Barrett; Hempen, Eric; Hartman, Robert; Preuss, Harry; Balk, Judith; Kang, James; Sowa, Gwendolyn

    2013-01-01

    Study Design Laboratory based controlled in vivo study Objective To determine the in vivo effects of oral glucosamine sulfate on intervertebral disc degeneration Summary of Background Data Although glucosamine has demonstrated beneficial effect in articular cartilage, clinical benefit is uncertain. A CDC report from 2009 reported that many patients are using glucosamine supplementation for low back pain (LBP), without significant evidence to support its use. Because disc degeneration is a major contributor of LBP, we explored the effects of glucosamine on disc matrix homeostasis in an animal model of disc degeneration. Methods Eighteen skeletally mature New Zealand White rabbits were divided into four groups: control, annular puncture, glucosamine, and annular puncture+glucosamine. Glucosamine treated rabbits received daily oral supplementation with 107mg/day (weight based equivalent to human 1500mg/day). Annular puncture surgery involved puncturing the annulus fibrosus (AF) of 3 lumbar discs with a 16G needle to induce degeneration. Serial MRIs were obtained at 0, 4, 8, 12, and 20 weeks. Discs were harvested at 20 weeks for determination of glycosaminoglycan(GAG) content, relative gene expression measured by RT-PCR, and histological analyses. Results The MRI index and NP area of injured discs of glucosamine treated animals with annular puncture was found to be lower than that of degenerated discs from rabbits not supplemented with glucosamine. Consistent with this, decreased glycosaminoglycan was demonstrated in glucosamine fed animals, as determined by both histological and GAG content. Gene expression was consistent with a detrimental effect on matrix. Conclusions These data demonstrate that the net effect on matrix in an animal model in vivo, as measured by gene expression, MRI, histology, and total proteoglycan is anti-anabolic. This raises concern over this commonly used supplement, and future research is needed to establish the clinical relevance of these

  10. The Effects of Platelet-Rich Plasma on Halting the Progression in Porcine Intervertebral Disc Degeneration.

    Science.gov (United States)

    Cho, Hongsik; Holt, David C; Smith, Richard; Kim, Song-Ja; Gardocki, Raymond J; Hasty, Karen A

    2016-02-01

    Disc degeneration and the subsequent herniation and/or rupture of the intervertebral disc (IVD) are due to a failure of the extracellular matrix of the annulus to contain the contents of the nucleus. This results from inadequate maintenance of the matrix components as well as the proteolytic activity of matrix metalloproteinases (MMPs) that degrade matrix molecules. Arresting progression of disc degeneration in the annulus holds greater clinical potential at this point than prevention of its onset in the nucleus. Therefore, in this study, we have therapeutic aims that would decrease levels of the cytokines and growth factors that indirectly lead to disc degeneration via stimulating MMP and increase levels of several beneficial growth factors, such as transforming growth factor-β, with the addition of platelet-rich plasma (PRP) that would stimulate cell growth and matrix synthesis. For this study, we attempted to address these imbalances of metabolism by using tumor necrosis factor-α treated annulus fibrosus cells isolated from porcine IVD tissue and incubating the cells in a growth factor rich environment with PRP. These results indicate that the PRP in vitro increased the production of the major matrix components (type II collagen and aggrecan) and decreased the inhibitory collagenase MMP-1. This application will address a therapeutic approach for intervening early in the degenerative process.

  11. MRI assessment of lumbar intervertebral disc degeneration with lumbar degenerative disease using the Pfirrmann grading systems.

    Directory of Open Access Journals (Sweden)

    Li-Peng Yu

    Full Text Available BACKGROUND: To evaluate by MRI intervertebral disc degeneration in patients with lumbar degenerative disease using the Pfirrmann grading system and to determine whether Modic changes correlated with the Pfirrmann grades and modified Pfirrmann grades of disc degeneration. METHODS: The clinical data of 108 surgical patients with lumbar degenerative disease were reviewed and their preoperative MR images were analyzed. Disc degeneration was evaluated using the Pfirrmann grading system. Patients were followed up and low back pain was evaluated using the visual analog scale (VAS and the effect of back pain on the daily quality of life was assessed using Oswestry disability index (ODI. RESULTS: Forty-four cases had normal anatomical appearance (Modic type 0 and their Pfirrmann grades were 3.77±0.480 and their modified Pfirrmann grades were of 5.81±1.006. Twenty-seven cases had Modic type I changes and their Pfirrmann grades were 4.79±0.557 and their modified Pfirrmann grades were 7.00±0.832. Thirty-six cases exhibited Modic type II changes and their Pfirrmann grades and modified Pfirrmann grades were 4.11±0.398 and 6.64±0.867, respectively. One case had Modic type III changes. Kruskal-Wallis test revealed significant difference in modified Pfirrmann grade among Modic type 0, I and II changes (P0.05. Binary regression analysis showed that Modic changes correlated most strongly with disc degeneration. Follow up studies indicated that the VAS and ODI scores were markedly improved postoperatively. However, no difference was noted in VAS and ODI scores among patients with different Modic types. CONCLUSION: Modic changes correlate with the Pfirrmann and modified Pfirrmann grades of disc degeneration in lumbar degenerative disease. There is no significant correlation between Modic types and surgical outcomes.

  12. Ultrastructure of inclusion bodies in annulus cells in the degenerating human intervertebral disc.

    Science.gov (United States)

    Gruber, H E; Hanley, E N

    2009-06-01

    The rough endoplasmic reticulum (rER) of the cell has an architectural editing function that checks whether protein structure and three-dimensional assembly have occurred properly prior to export of newly synthesized material out of the cell. If these have been faulty, the material is retained within the rER as an inclusion body. Inclusion bodies have been identified previously in chondrocytes and osteoblasts in chondrodysplasias and osteogenesis imperfecta. Inclusion bodies in intervertebral disc cells, however, have only recently been recognized. Our objectives were to use transmission electron microscopy to analyze more fully inclusion bodies in the annulus pulposus and to study the extracellular matrix (ECM) surrounding cells containing inclusion bodies. ECM frequently encapsulated cells with inclusion bodies, and commonly contained prominent banded aggregates of Type VI collagen. Inclusion body material had several morphologies, including relatively smooth, homogeneous material, or a rougher, less homogeneous feature. Such findings expand our knowledge of the fine structure of the human disc cell and ECM during disc degeneration, and indicate the potential utility of ultrastructural identification of discs with intracellular inclusion bodies as a screening method for molecular studies directed toward identification of defective gene products in degenerating discs.

  13. New in vivo animal model to create intervertebral disc degeneration and to investigate the effects of therapeutic strategies to stimulate disc regeneration.

    Science.gov (United States)

    Kroeber, Markus W; Unglaub, Frank; Wang, Haili; Schmid, Carsten; Thomsen, Marc; Nerlich, Andreas; Richter, Wiltrud

    2002-12-01

    A new rabbit model was developed that produces disc degeneration through the application of controlled and quantified axial mechanical load. To characterize the changes associated with disc degeneration, and to evaluate the feasibility of local transfer of agents to the compressed discs to stimulate disc regeneration. Studies have shown that accelerated degeneration of the intervertebral disc results from altered mechanical loading conditions. The development of methods for the prevention of disc degeneration and the restoration of disc tissue that has already degenerated is needed. New Zealand white rabbits (n = 33) were used for this study. The discs in five animals remained unloaded and served as controls, whereas in 28 animals the discs were axially compressed using a custom-made external loading device. After 1 (n = 7), 14 (n = 7), and 28 (n = 7) days of dynamic loading, or 28 (n = 7) days of loading followed by 28 days of unloaded recovery time, the animals were killed and the lumbar spine was harvested for tissue preparation. Disc height, disc morphology, cell viability, disc stiffness, and load to failure were measured. Recombinant adenovirus encoding for two different marker genes (Ad-Luciferase and Ad-LacZ) was injected into the discs in loaded specimens and the gene expression was measured. The unloaded intervertebral discs of the rabbits consisted of a layered anulus fibrosus, a cartilaginous endplate, and a nucleus pulposus comparable with those of humans. After 14 and 28 days of loading, the discs demonstrated a significant decrease in disc space. Histologically, disorganization of the architecture of the anulus occurred. The number of dead cells increased significantly in the anulus and cartilage endplate. These changes were not reversible after 28 days of unloading. The stiffness and the load to failure did not change significantly in the discs after 28 days of loading, as compared with the unloaded control discs. Adenovirus-mediated gene transfer

  14. Poroelastic behaviour of the degenerating human intervertebral disc: a ten-day study in a loaded disc culture system

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    KS Emanuel

    2015-06-01

    Full Text Available The intervertebral disc (IVD allows flexibility to the vertebral column, and transfers the predominant axial loads during daily activities. Its axial biomechanical behaviour is poroelastic, due to the water-binding and releasing capacity of the nucleus pulposus. Degeneration of the intervertebral disc presumably affects both the instantaneous elastic response to the load on the IVD and the subsequent interstitial flow of fluid. This study aims to quantify the poroelastic behaviour of the IVD and its change with degeneration, as defined by the magnetic resonance imaging-based Pfirrmann Score (PS. For a period of ten days, 36 human lumbar IVDs were loaded with a simulated physiological axial loading regime, while deformation was monitored. The IVDs responded to the loads with instantaneous elastic and slow poroelastic axial deformation. Several mechanical parameters changed throughout the first five days of the experiment, until the IVDs settled into a dynamic equilibrium. In this equilibrium, degeneration was significantly related to a decrease in disc height loss during the daytime high load phase (ρ = -0.49, and to a decrease in the rate of this deformation during the final half hour of each day (ρ = -0.53. These properties were related to the nucleus glycosaminoglycan/hydroxyproline (GAG/HYP ratio, rather than GAG content alone, indicating that remodelling of the extracellular matrix reduces poroelastic properties of the IVD. This implies that the degenerated discs have a reduced capacity to bind water and/or a reduced resistance against fluid flow. The resulting loss in hydrostatic pressure may further change cell behaviour in the nucleus pulposus.

  15. Cell and molecular biology of intervertebral disc degeneration: current understanding and implications for potential therapeutic strategies.

    Science.gov (United States)

    Wang, S Z; Rui, Y F; Lu, J; Wang, C

    2014-10-01

    Intervertebral disc degeneration (IDD) is a chronic, complex process associated with low back pain; mechanisms of its occurrence have not yet been fully elucidated. Its process is not only accompanied by morphological changes, but also by systematic changes in its histological and biochemical properties. Many cellular and molecular mechanisms have been reported to be related with IDD and to reverse degenerative trends, abnormal conditions of the living cells and altered cell phenotypes would need to be restored. Promising biological therapeutic strategies still rely on injection of active substances, gene therapy and cell transplantation. With advanced study of tissue engineering protocols based on cell therapy, combined use of seeding cells, bio-active substances and bio-compatible materials, are promising for IDD regeneration. Recently reported progenitor cells within discs themselves also hold prospects for future IDD studies. This article describes the background of IDD, current understanding and implications of potential therapeutic strategies.

  16. Hyaluronic Acid (HA)-Polyethylene glycol (PEG) as injectable hydrogel for intervertebral disc degeneration patients therapy

    Science.gov (United States)

    Putri Kwarta, Cityta; Widiyanti, Prihartini; Siswanto

    2017-05-01

    Chronic Low Back Pain (CLBP) is one health problem that is often encountered in a community. Inject-able hydrogels are the newest way to restore the disc thickness and hydration caused by disc degeneration by means of minimally invasive surgery. Thus, polymers can be combined to improve the characteristic properties of inject-able hydrogels, leading to use of Hyaluronic Acid (a natural polymer) and Polyethylene glycol (PEG) with Horse Radish Peroxide (HRP) cross linker enzymes. The swelling test results, which approaches were the ideal disc values, were sampled with variation of enzyme concentrations of 0.25 µmol/min/mL. The enzyme concentrations were 33.95%. The degradation test proved that the sample degradation increased along with the decrease of the HRP enzyme concentration. The results of the cytotoxicity assay with MTT assay method showed that all samples resulted in the 90% of living cells are not toxic. In vitro injection, models demonstrated that higher concentration of the enzymes was less state of gel which would rupture when released from the agarose gel. The functional group characterization shows the cross linking bonding in sample with enzyme adding. The conclusion of this study is PEG-HA-HRP enzyme are safe polymer composites which have a potential to be applied as an injectable hydrogel for intervertebral disc degeneration.

  17. Estrogens and the intervertebral disc.

    Science.gov (United States)

    Calleja-Agius, J; Muscat-Baron, Y; Brincat, M P

    2009-09-01

    Intervertebral discs are an integral part of the vertebral column. It has been shown that menopause has a negative effect on bone and on intervertebral discs. Estrogen has a beneficial effect of preserving the health of collagen-containing tissues, including the intervertebral disc. The intervertebral disc allows for mobility of the spine, and maintains a uniform stress distribution of the area of the vertebral endplates. Also, the disc influences spinal height. The disc tissue is adapted for this biomechanical function. The function of the spine is impaired if there is a loss of disc tissue. Narrowing of the disc space due to degeneration of intervertebral discs is associated with a significantly increased risk of vertebral fractures. Estrogen should be seen as the first-choice therapy for bones and other collagen-rich tissues, such as intervertebral discs, because it maintains homeostasis of the bone-remodelling unit. Unlike bisphosphonates, estrogen is unique in its ability to regenerate bone collagen after its disintegration, apart from suppressing osteoclastic activity. Besides, there is insufficient data on deterioration in bone qualities and micro-cracks in patients on long-term bisphosphonates.

  18. lncRNAs: novel players in intervertebral disc degeneration and osteoarthritis.

    Science.gov (United States)

    Chen, Wen-Kang; Yu, Xiao-Hua; Yang, Wei; Wang, Cheng; He, Wen-Si; Yan, Yi-Guo; Zhang, Jian; Wang, Wen-Jun

    2017-02-01

    The term long non-coding RNA (lncRNA) refers to a group of RNAs with length more than 200 nucleotides, limited protein-coding potential, and having widespread biological functions, including regulation of transcriptional patterns and protein activity, formation of endogenous small interfering RNAs (siRNAs) and natural microRNA (miRNA) sponges. Intervertebral disc degeneration (IDD) and osteoarthritis (OA) are the most common chronic, prevalent and age-related degenerative musculoskeletal disorders. Numbers of lncRNAs are differentially expressed in human degenerative nucleus pulposus tissue and OA cartilage. Moreover, some lncRNAs have been shown to be involved in multiple pathological processes during OA, including extracellular matrix (ECM) degradation, inflammatory responses, apoptosis and angiogenesis. In this review, we summarize current knowledge concerning lncRNAs, from their biogenesis, classification and biological functions to molecular mechanisms and therapeutic potential in IDD and OA.

  19. Running Exercise Alleviates Pain and Promotes Cell Proliferation in a Rat Model of Intervertebral Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Shuo Luan

    2015-01-01

    Full Text Available Chronic low back pain accompanied by intervertebral disk degeneration is a common musculoskeletal disorder. Physical exercise, which is clinically recommended by international guidelines, has proven to be effective for degenerative disc disease (DDD patients. However, the mechanism underlying the analgesic effects of physical exercise on DDD remains largely unclear. The results of the present study showed that mechanical withdrawal thresholds of bilateral hindpaw were significantly decreased beginning on day three after intradiscal complete Freund’s adjuvant (CFA injection and daily running exercise remarkably reduced allodynia in the CFA exercise group beginning at day 28 compared to the spontaneous recovery group (controls. The hindpaw withdrawal thresholds of the exercise group returned nearly to baseline at the end of experiment, but severe pain persisted in the control group. Histological examinations performed on day 70 revealed that running exercise restored the degenerative discs and increased the cell densities of the annulus fibrosus (AF and nucleus pulposus (NP. Furthermore, immunofluorescence labeling revealed significantly higher numbers of 5-bromo-2-deoxyuridine (BrdU-positive cells in the exercise group on days 28, 42, 56 and 70, which indicated more rapid proliferation compared to the control at the corresponding time points. Taken together, these results suggest that running exercise might alleviate the mechanical allodynia induced by intradiscal CFA injection via disc repair and cell proliferation, which provides new evidence for future clinical use.

  20. A rat tail temporary static compression model reproduces different stages of intervertebral disc degeneration with decreased notochordal cell phenotype.

    Science.gov (United States)

    Hirata, Hiroaki; Yurube, Takashi; Kakutani, Kenichiro; Maeno, Koichiro; Takada, Toru; Yamamoto, Junya; Kurakawa, Takuto; Akisue, Toshihiro; Kuroda, Ryosuke; Kurosaka, Masahiro; Nishida, Kotaro

    2014-03-01

    The intervertebral disc nucleus pulposus (NP) has two phenotypically distinct cell types-notochordal cells (NCs) and non-notochordal chondrocyte-like cells. In human discs, NCs are lost during adolescence, which is also when discs begin to show degenerative signs. However, little evidence exists regarding the link between NC disappearance and the pathogenesis of disc degeneration. To clarify this, a rat tail disc degeneration model induced by static compression at 1.3 MPa for 0, 1, or 7 days was designed and assessed for up to 56 postoperative days. Radiography, MRI, and histomorphology showed degenerative disc findings in response to the compression period. Immunofluorescence displayed that the number of DAPI-positive NP cells decreased with compression; particularly, the decrease was notable in larger, vacuolated, cytokeratin-8- and galectin-3-co-positive cells, identified as NCs. The proportion of TUNEL-positive cells, which predominantly comprised non-NCs, increased with compression. Quantitative PCR demonstrated isolated mRNA up-regulation of ADAMTS-5 in the 1-day loaded group and MMP-3 in the 7-day loaded group. Aggrecan-1 and collagen type 2α-1 mRNA levels were down-regulated in both groups. This rat tail temporary static compression model, which exhibits decreased NC phenotype, increased apoptotic cell death, and imbalanced catabolic and anabolic gene expression, reproduces different stages of intervertebral disc degeneration.

  1. Organ culture bioreactors--platforms to study human intervertebral disc degeneration and regenerative therapy.

    Science.gov (United States)

    Gantenbein, Benjamin; Illien-Jünger, Svenja; Chan, Samantha C W; Walser, Jochen; Haglund, Lisbet; Ferguson, Stephen J; Iatridis, James C; Grad, Sibylle

    2015-01-01

    In recent decades the application of bioreactors has revolutionized the concept of culturing tissues and organs that require mechanical loading. In intervertebral disc (IVD) research, collaborative efforts of biomedical engineering, biology and mechatronics have led to the innovation of new loading devices that can maintain viable IVD organ explants from large animals and human cadavers in precisely defined nutritional and mechanical environments over extended culture periods. Particularly in spine and IVD research, these organ culture models offer appealing alternatives, as large bipedal animal models with naturally occurring IVD degeneration and a genetic background similar to the human condition do not exist. Latest research has demonstrated important concepts including the potential of homing of mesenchymal stem cells to nutritionally or mechanically stressed IVDs, and the regenerative potential of "smart" biomaterials for nucleus pulposus or annulus fibrosus repair. In this review, we summarize the current knowledge about cell therapy, injection of cytokines and short peptides to rescue the degenerating IVD. We further stress that most bioreactor systems simplify the real in vivo conditions providing a useful proof of concept. Limitations are that certain aspects of the immune host response and pain assessments cannot be addressed with ex vivo systems. Coccygeal animal disc models are commonly used because of their availability and similarity to human IVDs. Although in vitro loading environments are not identical to the human in vivo situation, 3D ex vivo organ culture models of large animal coccygeal and human lumbar IVDs should be seen as valid alternatives for screening and feasibility testing to augment existing small animal, large animal, and human clinical trial experiments.

  2. Requirements for an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; van Donkelaar, CC; Veldhuizen, AG; van Horn, [No Value; Huyghe, JM; Verkerke, GJ

    Intervertebral disc degeneration is an important social and economic problem. Presently available artificial intervertebral discs (AIDs) are insufficient and the main surgical intervention is still spinal fusion. The objective of the present study is to present a list of requirements for the

  3. Interleukin 1 Polymorphisms Contribute to Intervertebral Disc Degeneration Risk: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Zheng Wang

    Full Text Available We performed a meta-analysis to assess association between interleukin 1 (IL-1 polymorphisms and the risk of Intervertebral Disc Degeneration (IDD.A series of studies have investigated the association between common single nucleotide polymorphisms in IL-1 and IDD risk; however, the overall results are inconclusive.Two independent investigators conducted a systematic search for relevant available studies. Allele frequencies were extracted from each study. The association between the IL-1α (+889C/T or IL-1β (+3954C/T polymorphism and IDD risk was measured by odds ratios (OR with 95% confidence intervals (95% CI.Five and six studies, respectively, were ultimately included in the meta-analysis for the IL-1α (+889C/T and IL-1β (+3954C/T polymorphism. The combined results showed that the IL-1α (+889C/T polymorphism was significantly associated with increased susceptibility to IDD, particularly in Caucasians (TT versus CC: OR = 2.95, 95% CI: 1.45, 6.04; Pheterogeneity = 0.82; TT versusOR = 2.29, 95% CI: 1.18, 4.47; Pheterogeneity = 0.20. In contrast, the IL-1β (+3954C/T polymorphism showed a trend towards increased risk in Caucasians but no association in Asians.This meta-analysis suggested that the IL-1α (+889C/T polymorphism is significantly associated with risk of IDD, especially in Caucasian populations.

  4. Vitamin D Receptor Gene, Matrix Metalloproteinase 3 Polymorphisms and the Risk of Intervertebral Disc Degeneration Susceptibility: Meta-Analysis

    Science.gov (United States)

    Huang, Yongjing; Zhao, Shujie; Xu, Nanwei

    2016-01-01

    Several studies have evaluated the association between vitamin D receptor, matrix metalloproteinase 3 (MMP-3) polymorphisms and the risk of intervertebral disc degeneration susceptibility. The findings were inconsistent. This meta-analysis aimed to systematically assess the association between vitamin D receptor, MMP-3 polymorphisms and the risk of intervertebral disc degeneration susceptibility. A search of various databases was done covering all papers published until December 31th, 2014. Eight, 4, 3 studies were finally included that addressed the risk of intervertebral disc degeneration susceptibility and vitamin D receptor FokI (rs2228570), ApaI (rs7975232), and MMP-3 (rs731236) polymorphisms, respectively. FokI (f vs. F: summary odds ratio [OR], 1.13; 95% confidence interval [CI], 0.76–1.69; ff vs. FF: OR, 1.02; 95% CI, 0.59–1.77; ff vs. Ff/FF: OR, 1.05; 95% CI, 0.70–1.58), ApaI (a vs. A: OR, 0.73; 95% CI, 0.45–1.19; aa vs. AA: OR, 0.53; 95% CI, 0.22–1.25 p=0.14; aa vs. AA/Aa: OR, 0.69; 95% CI, 0.53–0.89) in the vitamin D receptor gene and MMP3 polymorphisms (5A vs. 6A: OR, 1.92; 95% CI, 0.77–4.80; 5A5A vs. 6A6A: OR, 2.17; 95% CI, 0.75–6.24; 5A5A vs. 5A6A/6A6A: OR, 1.58; 95% CI, 0.72–3.44) were not obviously associated with risk of intervertebral disc degeneration susceptibility. FokI, ApaI polymorphisms in the vitamin D receptor gene and MMP-3 polymorphism are not obvious risk factors for intervertebral disc degeneration susceptibility.

  5. Human MMP28 expression is unresponsive to inflammatory stimuli and does not correlate to the grade of intervertebral disc degeneration

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    Klawitter Marina

    2011-07-01

    Full Text Available Abstract Background MMP28 (epilysin is a recently discovered member of the MMP (matrix metalloproteinase family that is, amongst others, expressed in osteoarthritic cartilage and intervertebral disc (IVD tissue. In this study the hypothesis that increased expression of MMP28 correlates with higher grades of degeneration and is stimulated by the presence of proinflammatory molecules was tested. Gene expression levels of MMP28 were investigated in traumatic and degenerative human IVD tissue and correlated to the type of disease and the degree of degeneration (Thompson grade. Quantification of MMP28 gene expression in human IVD tissue or in isolated cells after stimulation with the inflammatory mediators lipopolysaccharide (LPS, interleukin (IL-1β, tumor necrosis factor (TNF-α or the histondeacetylase inhibitor trichostatin A was performed by real-time RT PCR. Results While MMP28 expression was increased in individual cases with trauma or disc degeneration, there was no significant correlation between the grade of disease and MMP28 expression. Stimulation with LPS, IL-1β, TNF-α or trichostatin A did not alter MMP28 gene expression at any investigated time point or any concentration. Conclusions Our results demonstrate that gene expression of MMP28 in the IVD is not regulated by inflammatory mechanisms, is donor-dependent and cannot be positively or negatively linked to the grade of degeneration and only weakly to the occurrence of trauma. New hypotheses and future studies are needed to find the role of MMP28 in the intervertebral disc.

  6. Hydrogen sulfide protects against endoplasmic reticulum stress and mitochondrial injury in nucleus pulposus cells and ameliorates intervertebral disc degeneration.

    Science.gov (United States)

    Xu, Daoliang; Jin, Haiming; Wen, Jianxia; Chen, Jiaoxiang; Chen, Deheng; Cai, Ningyu; Wang, Yongli; Wang, Jianle; Chen, Yu; Zhang, Xiaolei; Wang, Xiangyang

    2017-03-01

    It has been suggested that excessive apoptosis in intervertebral disc cells induced by inflammatory cytokines, such as interleukin (IL)-1β, is related to the process of intervertebral disc degeneration (IVDD). Hydrogen sulfide (H2S), a gaseous signaling molecule, has drawn attention for its anti-apoptosis role in various pathophysiological processes in degenerative diseases. To date, there has been no investigation of the correlation of H2S production and IVDD or of the effects of H2S on IL-1β-induced apoptosis in nucleus pulposus (NP) cells. Here, we found that the expression levels of cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE), two key enzymes in the generation of H2S, were significantly decreased in human degenerate NP tissues as well as in IL-1β-treated NP cells. NaHS (H2S donor) administration showed a protective effect by inhibiting the endoplasmic reticulum (ER) stress response and mitochondrial dysfunction induced by IL-1β stimulation in vitro, the effect was related to activation of the PI3K/Akt and ERK1/2 signaling pathways. Suppression of these pathways by specific inhibitors, LY294002 and PD98059, partially reduced the protective effect of NaHS. Moreover, in the percutaneous needle puncture disc degeneration rat tail model, disc degeneration was partially reversed by NaHS administration. Taken together, our results suggest that H2S plays a protective role in IVDD and the underlying mechanism involves PI3K/Akt and ERK1/2 signaling pathways-mediated suppression of ER stress and mitochondrial dysfunction in IL-1β-induced NP cells.

  7. Rabbit model of intervertebral disc degeneration by external compression device characterized by X-ray, MRI, histology, and cell viability

    Directory of Open Access Journals (Sweden)

    Ismail Ismail

    2006-12-01

    Full Text Available Appropriate experimental animal models, which mimic the degenerative process occurring in human intervertebral disc (IVD breakdown and can be used for new treatment studies such as tissue engineering or disc distraction are lacking. We studied the external compression device that used by Kroeber et al to create intervertebral disc degeneration in rabbit model characterized by X-ray, MRI, Histology, and Cell Viability. Ten NZW rabbit were randomly assigned to one of five groups. Intervertebral disc VL4-L5 are compressed using an external loading device, 1.9 MPa. First group rabbit are loaded for 14 days, second loaded for 28 days, thirth group are loaded for 14 days, and unloaded for 14 days, fourth group loaded for 28 days and unloaded for 28 days. The fifth group, rabbits underwent a sham operation. Additional, rabbits were used as sample for cell viability study. In disc height : sample in group one have biggest decreasing of disc height, that is 23.9 unit. In MRI assessment, the worst grade is grade 3. In histological score, the worst group is group three (58.69, and the best is group 4 (45.69. Group one have the largest dead cell, that are 403.5, and the smallest is group four (124.75. Trypan blue staining showed that group four have better viable cell (91.1 compare than group three (86.4. The study conclude disc degeneration can be created by external axial loading for 14 days in rabbit intervertebral disc. Duration of 28 days unloading gave better result for cells to recover. (Med J Indones 2006; 15:199-207  Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Keywords: Rabbit model –intervertebral disc degeneration- external compression device-X-ray, MRI, Histology, and Cell viabilty /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso

  8. Growth factor expression in degenerated intervertebral disc tissue. An immunohistochemical analysis of transforming growth factor beta, fibroblast growth factor and platelet-derived growth factor.

    Science.gov (United States)

    Tolonen, Jukka; Grönblad, Mats; Vanharanta, Heikki; Virri, Johanna; Guyer, Richard D; Rytömaa, Tapio; Karaharju, Erkki O

    2006-05-01

    Degenerated intervertebral disc has lost its normal architecture, and there are changes both in the nuclear and annular parts of the disc. Changes in cell shape, especially in the annulus fibrosus, have been reported. During degeneration the cells become more rounded, chondrocyte-like, whereas in the normal condition annular cells are more spindle shaped. These chondrocyte-like cells, often forming clusters, affect extracellular matrix turnover. In previous studies transforming growth factor beta (TGFbeta) -1 and -2, basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) have been highlighted in herniated intervertebral disc tissue. In the present study the same growth factors are analysed immunohistochemically in degenerated intervertebral disc tissue. Disc material was obtained from 16 discs operated for painful degenerative disc disease. Discs were classified according to the Dallas Discogram Description. Different disc regions were analysed in parallel. As normal control disc tissue material from eight organ donors was used. Polyclonal antibodies against different growth factors and TGFbeta receptor type II were used, and the immunoreaction was detected by the avidin biotin complex method. All studied degenerated discs showed immunoreactivity for TGFbeta receptor type II and bFGF. Fifteen of 16 discs were immunopositive for TGFbeta-1 and -2, respectively, and none showed immunoreaction for PDGF. Immunopositivity was located in blood vessels and in disc cells. In the nucleus pulposus the immunoreaction was located almost exclusively in chondrocyte-like disc cells, whereas in the annular region this reaction was either in chondrocyte-like disc cells, often forming clusters, or in fibroblast-like disc cells. Chondrocyte-like disc cells were especially prevalent in the posterior disrupted area. In the anterior area of the annulus fibrosus the distribution was more even between these two cell types. bFGF was expressed in the anterior annulus

  9. Herb formula "Fufangqishe-Pill" prevents upright posture-induced intervertebral disc degeneration at the lumbar in rats.

    Science.gov (United States)

    Liang, Qian-Qian; Xi, Zhi-Jie; Bian, Qin; Cui, Xue-Jun; Li, Chen-Guang; Hou, Wei; Shi, Qi; Wang, Yong-Jun

    2010-01-01

    Degeneration of the lumbar spine plays an important role in most chronic low back pain. Prevention of lumbar intervertebral disc (IVD) degeneration is therefore a high research priority. Both our previous multicenter clinical trials and pharmacological research showed that Fufangqishe-Pill (FFQSP), a newly patented traditional Chinese medicine, could effectively relieve the symptoms of neck pain and prevent cervical degeneration. To clarify the effect of FFQSP on lumbar IVD degeneration, we applied a lumbar IVD degeneration rat model induced by prolonged upright posture. Pretreatment of FFQSP for one month prevented the histological changes indicating IVD disorganization; increased type II-collagen level, decreased type X-collagen protein level, and increased Col2alpha1 mRNA expression at all time points; and decreased Col10alpha1, matrix metalloproteinase (MMP)-3, MMP13, and Interleukin (IL)-1beta mRNA expression induced by upright posture for 7 and 9 months. These results suggest that FFQSP prevents lumbar IVD degeneration induced by upright posture. FFQSP is a promising medicine for lumbar IVD degeneration disease.

  10. Construction of recombinant baculovirus Ac-CMV-hSox9 for gene therapy of intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    LIU Xiao-yun; YANG Shu-hua; LIANG Chang-yong; SONG Jian-hua; LI Kang-hua; CHEN Xin-wen

    2007-01-01

    Objective: To construct the recombinant baculovirus Ac-cytomegalovirus (CMV)-hSox9 for gene therapy of intervertebral disc degeneration. Methods: Bac-to-Bac system was used for the construction of baculovirus Ac-CMV-hSox9. The cDNA of hSox9 was first cloned into a plasmid vector under the control of CMV promotor to generate the donor plasmid pFastBacDul-green fluorescene protein (GFP)-CMV (pFGC)-hSox9.The resultant plasmid was transformed into DH10Bac cells and then the transformation mixture was spread on Luria-Bertani (LB) agarose culture medium containing isopropyl-β-D-thiogalactoside (IPTG), X-gal, gentamicin, kanamycin and tetracycline.The white colonies were selected and cultured for amplification, and the hSox9Bacmid DNA was extracted. After verification, recombinant baculovirus Ac-CMV-hSox9 was obtained through transfecting Sf 21 cells.The expression of hSox9 gene in the intervertebral disc cells in rabbits was determined by Western blotting and immunohistochemical staining.Results: Polymerase chain reaction (PCR) confirmed the presence of hSox9 gene in the recombinant baculovirus and the Sf 21 cells transfected by the baculovirus showed the expression of fluorescence protein.Western blotting and immunohistochemical staining analysis indicated that exogenous hSox9 gene was expressed in the disc cells.Conclusions: The successful construction of the recombinant baculovirus Ac-CMV-hSox9 and the confirmation of the target gene expression provides a novel expression vector system for basic research and clinical treatment of intervertebral degenerative disc disease.

  11. Does elite swimming accelerate lumbar intervertebral disc degeneration and increase low back pain?

    DEFF Research Database (Denmark)

    Folkvardsen, Steffen; Magnussen, Erland; Karppinen, Jaro

    2016-01-01

    PURPOSE: The aim was to elucidate elite swimming's possible influence on lumbar disc degeneration (DD) and low back pain (LBP). METHODS: Lumbar spine MRI was performed on a group of elite swimmers and compared to a matched Finnish population-based no-sport group. RESULTS: One hundred elite swimmers...

  12. Stem Cell Therapies for Intervertebral Disc Degeneration: Immune Privilege Reinforcement by Fas/FasL Regulating Machinery.

    Science.gov (United States)

    Ma, Chi-Jiao; Liu, Xu; Che, Lu; Liu, Zhi-Heng; Samartzis, Dino; Wang, Hai-Qiang

    2015-01-01

    As a main contributing factor to low back pain, intervertebral disc degeneration (IDD) is the fundamental basis for various debilitating spinal diseases. The pros and cons of current treatment modalities necessitate biological treatment strategies targeting for reversing or altering the degeneration process in terms of molecules or genes. The advances in stem cell research facilitate the studies aiming for possible clinical application of stem cell therapies for IDD. Human NP cells are versatile with cell morphology full of variety, capable of synthesizing extracellular matrix components, engulfing substances by autophagy and phagocytosis, mitochondrial vacuolization indicating dysfunction, expressing Fas and FasL as significant omens of immune privileged sites. Human discs belong to immune privilege organs with functional FasL expression, which can interact with invasive immune cells by Fas-FasL regulatory machinery. IDD is characterized by decreased expression level of FasL with dysfunctional FasL, which in turn unbalances the interaction between NP cells and immune cells. Certain modulation factors might play a role in the process, such as miR-155. Accumulating evidence indicates that Fas-FasL network expresses in a variety of stem cells. Given the expression of functional FasL and insensitive Fas in stem cells (we term as FasL privilege), transplantation of stem cells into the disc may regenerate the degenerative disc by not only differentiating into NP-like cells, increasing extracellular matrix, but also reinforce immune privilege via interaction with immune cells by Fas-FasL network.

  13. 2D segmentation of intervertebral discs and its degree of degeneration from T2-weighted magnetic resonance images

    Science.gov (United States)

    Castro-Mateos, Isaac; Pozo, José Maria; Lazary, Aron; Frangi, Alejandro F.

    2014-03-01

    Low back pain (LBP) is a disorder suffered by a large population around the world. A key factor causing this illness is Intervertebral Disc (IVD) degeneration, whose early diagnosis could help in preventing this widespread condition. Clinicians base their diagnosis on visual inspection of 2D slices of Magnetic Resonance (MR) images, which is subject to large interobserver variability. In this work, an automatic classification method is presented, which provides the Pfirrmann degree of degeneration from a mid-sagittal MR slice. The proposed method utilizes Active Contour Models, with a new geometrical energy, to achieve an initial segmentation, which is further improved using fuzzy C-means. Then, IVDs are classified according to their degree of degeneration. This classification is attained by employing Adaboost on five specific features: the mean and the variance of the probability map of the nucleus using two different approaches and the eccentricity of the fitting ellipse to the contour of the IVD. The classification method was evaluated using a cohort of 150 intervertebral discs assessed by three experts, resulting in a mean specificity (93%) and sensitivity (83%) similar to the one provided by every expert with respect to the most voted value. The segmentation accuracy was evaluated using the Dice Similarity Index (DSI) and Root Mean Square Error (RMSE) of the point-to-contour distance. The mean DSI ± 2 standard deviation was 91:7% ±5:6%, the mean RMSE was 0:82mm and the 95 percentile was 1:36mm. These results were found accurate when compared to the state-of-the-art.

  14. Intervertebral disc degeneration and bone density in degenerative lumbar scoliosis: a comparative study between patients with degenerative lumbar scoliosis and patients with lumbar stenosis

    Institute of Scientific and Technical Information of China (English)

    DING Wen-yuan; YANG Da-long; CAO Lai-zhen; SUN Ya-peng; ZHANG Wei; XU Jia-xin; ZHANG Ying-ze; SHEN Yong

    2011-01-01

    Background Degenerative lumbar scoliosis is common in older patients.Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis.A means of quantifying the relative signal intensity for degenerative disc disease has not been previously discussed.The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study.Methods From January 2001 to August 2010,96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls.Cobb angle,height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides,the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group.The height of L2/L3,L3/L4,L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group.The grade of intervertebral disc degeneration was evaluated using T2WI sagittal images in both groups.The bone density of lumbar vertebrae was measured with dual-energy X-ray.Results In scoliosis group,the intervertebral disc height on the convex side was greater than the height on the concave side (P <0.001 ).The vertebral body height on the convex side was greater than the height on the concave side (P=0.016).There was a significant difference between the scoliosis group and the control group (P=0.003),and between T-value and the rate of osteoporosis between the two groups (both P <0.001).Results were verified using multiple linear regression analysis.Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces.There is a positive correlation between the angle of scoliosis and

  15. [Controlled distraction as a therapeutic option in moderate degeneration of the intervertebral disc -- an in vivo study in the rabbit-spine model].

    Science.gov (United States)

    Unglaub, F; Guehring, T; Omlor, G; Lorenz, H; Carstens, C; Kroeber, M W

    2006-01-01

    The aim of this study was to investigate the effects of temporary distraction on a degenerated intervertebral disc to characterize regenerative changes associated with disc distraction. New Zealand white rabbits (n = 32) were used for this experimental animal study. The rabbits were randomly assigned to one of five groups. 6 animals were loaded for 28 days using a custom-made external loading device to stimulate disc degeneration (G2). In 6 animals the discs were first loaded for 28 days and after 28 days loading time the discs in six animals were treated as dynamic distraction with an external distraction device (G1). In six animals the discs were distracted for 28 days without previous loading (G5) and in six animals the discs were loaded for 28 days and afterwards the loading device was removed for 28 days for recovery without distraction (G3). Six animals were sham operated (G4) without application of axial load. After 28 to 56 days loading and distraction time, the animals were sacrificed and the lumbar spine was harvested for histological and radiographic analysis. Histology was performed according to a degeneration score and disc height was calculated radiographically. For the cell viability examination, the number of apoptotic cells was determined. After 28 days of loading (G2), the discs showed a significant decrease in disc space of the treated segment. Histologically, a disorganization of the architecture of the annulus occurred. The number of dead cells increased significantly in the annulus and cartilage endplate. These changes were reversible after 28 days of distraction (G1). The disc thickness increased significantly to physiological levels as compared to the specimens from the 28 days loading group without distraction. Histologically, the discs showed signs of tissue regeneration after 28 days of distraction (G1). The number of apoptotic cells decreased significantly in comparison to the loaded discs without distraction (G2). The results of this

  16. The role of TGF-β1/Smad2/3 pathway in platelet-rich plasma in retarding intervertebral disc degeneration.

    Science.gov (United States)

    Yang, Huilin; Yuan, Chenxi; Wu, Chunshen; Qian, Jiale; Shi, Qing; Li, Xuefeng; Zhu, Xuesong; Zou, Jun

    2016-08-01

    Recent studies have suggested that platelet-rich plasma (PRP) injections are an effective way to retard intervertebral disc degeneration, but the mechanism of action is unclear. Activated platelets release some growth factors, such as transforming growth factor-β1 (TGF-β1), which positively modulate the extracellular matrix of nucleus pulposus cells. The purpose of this study was to explore the mechanism underlying the PRP-mediated inhibition of intervertebral disc degeneration. In an in vitro study, we found that the proliferation of nucleus pulposus cells was greatly enhanced with 2.5% PRP treatment. The TGF-β1 concentration was much higher after PRP treatment. PRP administration effectively increased the collagen II, aggrecan and sox-9 mRNA levels and decreased collagen X levels. However, Western blotting demonstrated that specifically inhibiting TGF-β1 signalling could significantly prevent nucleus pulpous cellular expression of Smad2/3 and matrix protein. In a rabbit study, magnetic resonance imaging revealed significant recovery signal intensity in the intervertebral discs of the PRP injection group compared with the very low signal intensity in the control groups. Histologically, the PRP plus inhibitor injection group had significantly lower expression levels of Smad2/3 and collagen II than the PRP group. These results demonstrated that a high TGF-β1 content in the platelets retarded disc degeneration in vitro and in vivo. Inhibiting the TGF-β1/Smad2/3 pathway could prevent this recovery by inactivating Smad2/3 and down-regulating the extracellular matrix. Therefore, the TGF-β1/Smad2/3 pathway might play a critical role in the ability of PRP to retard intervertebral disc degeneration.

  17. Lumbar intervertebral disc degeneration associated with axial and radiating low back pain in ageing SPARC-null mice.

    Science.gov (United States)

    Millecamps, Magali; Tajerian, Maral; Naso, Lina; Sage, E Helene; Stone, Laura S

    2012-06-01

    Chronic low back pain (LBP) is a complex, multifactorial disorder with unclear underlying mechanisms. In humans and rodents, decreased expression of secreted protein acidic rich in cysteine (SPARC) is associated with intervertebral disc (IVD) degeneration and signs of LBP. The current study investigates the hypothesis that IVD degeneration is a risk factor for chronic LBP. SPARC-null and age-matched control mice ranging from 6 to 78 weeks of age were evaluated in this study. X-ray and histologic analysis revealed reduced IVD height, increased wedging, and signs of degeneration (bulging and herniation). Cutaneous sensitivity to cold, heat, and mechanical stimuli were used as measures of referred (low back and tail) and radiating pain (hind paw). Region specificity was assessed by measuring icilin- and capsaicin-evoked behaviour after subcutaneous injection into the hind paw or upper lip. Axial discomfort was measured by the tail suspension and grip force assays. Motor impairment was determined by the accelerating rotarod. Physical function was evaluated by voluntary activity after axial strain or during ambulation with forced lateral flexion. SPARC-null mice developed (1) region-specific, age-dependent hypersensitivity to cold, icilin, and capsaicin (hind paw only), (2) axial discomfort, (3) motor impairment, and (4) reduced physical function. Morphine (6 mg/kg, i.p.) reduced cutaneous sensitivity and alleviated axial discomfort in SPARC-null mice. Ageing SPARC-null mice mirror many aspects of the complex and challenging nature of LBP in humans and incorporate both anatomic and functional components of the disease. The current study supports the hypothesis that IVD degeneration is a risk factor for chronic LBP.

  18. Spectroscopic Parameters of Lumbar Intervertebral Disc Material

    Science.gov (United States)

    Terbetas, G.; Kozlovskaja, A.; Varanius, D.; Graziene, V.; Vaitkus, J.; Vaitkuviene, A.

    2009-06-01

    needle can give additional information of needle position, assuring the needle tip is directed into intervertebral disc material. Spectroscopic analysis of intervertebral disc removed during open surgery, creates background for further investigation on intervertebral disc degeneration spectral classification.

  19. Population average T2 MRI maps reveal quantitative regional transformations in the degenerating rabbit intervertebral disc that vary by lumbar level.

    Science.gov (United States)

    Martin, John T; Collins, Christopher M; Ikuta, Kensuke; Mauck, Robert L; Elliott, Dawn M; Zhang, Yeija; Anderson, D Greg; Vaccaro, Alexander R; Albert, Todd J; Arlet, Vincent; Smith, Harvey E

    2015-01-01

    Magnetic resonance imaging (MRI) with T2-weighting is routinely performed to assess intervertebral disc degeneration. Standard clinical evaluations of MR images are qualitative, however, and do not focus on region-specific alterations in the disc. Utilizing a rabbit needle puncture model, T2 mapping was performed on injured discs to develop a quantitative description of the degenerative process following puncture. To do so, an 18G needle was inserted into four discs per rabbit (L3/L4 to L6/L7) and T2 maps were generated pre- and 4 weeks post-injury. Individual T2 maps were normalized to a disc-specific coordinate system and then averaged for pre- and post-injury population composite T2 maps. We also developed a method to automatically segment the nucleus pulposus by fitting the NP region of the T2 maps with modified 2-D and 3-D Gaussian distribution functions. Puncture injury produced alterations in MR signal intensity in a region-specific manner mirroring human degeneration. Population average T2 maps provided a quantitative representation of the injury response, and identified deviations of individual degenerate discs from the pre-injury population. We found that the response to standardized injury was modest at lower lumbar levels, likely as a result of increased disc dimensions. These tools will be valuable for the quantitative characterization of disc degeneration in future clinical and pre-clinical studies. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  20. Genetic Polymorphisms of Interleukin-1 Alpha and the Vitamin D Receptor in Mexican Mestizo Patients with Intervertebral Disc Degeneration

    Science.gov (United States)

    Cervin Serrano, Salvador; González Villareal, Dalia; Aguilar-Medina, Maribel; Romero-Navarro, Jose Guillermo; Romero Quintana, Jose Geovanni; Arámbula Meraz, Eliakym; Osuna Ramírez, Ignacio; Picos-Cárdenas, Veronica; Granados, Julio; Estrada-García, Iris; Sánchez-Schmitz, Guzman; Ramos-Payán, Rosalío

    2014-01-01

    Intervertebral disc degeneration (IDD) is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T) of interleukin-1 alpha (IL1A) and rs2228570 (c.2T>V) and rs731236 (c.1056T>C) of vitamin D receptor (VDR) gene polymorphisms and the development of IDD in northwestern Mexican Mestizo population. Gene polymorphisms were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism, in two groups matched by age and gender: patients with symptomatic lumbar IDD (n = 100) and subjects with normal lumbar-spine MRI-scans (n = 100). Distribution of the mutated alleles in patients and controls was 27.0% versus 28.0% (P = 0.455) for T of rs1800587 (IL1A); 53.0% versus 58.0% (P = 0.183) for V of rs2228570 (VDR); and 18.0% versus 21.0% (P = 0.262) for C of rs731236 (VDR). Our results showed no association between the studied polymorphisms and IDD in this population. This is the first report on the contribution of gene polymorphisms on IDD in a Mexican population. PMID:25506053

  1. Genetic Polymorphisms of Interleukin-1 Alpha and the Vitamin D Receptor in Mexican Mestizo Patients with Intervertebral Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Salvador Cervin Serrano

    2014-01-01

    Full Text Available Intervertebral disc degeneration (IDD is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T of interleukin-1 alpha (IL1A and rs2228570 (c.2T>V and rs731236 (c.1056T>C of vitamin D receptor (VDR gene polymorphisms and the development of IDD in northwestern Mexican Mestizo population. Gene polymorphisms were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism, in two groups matched by age and gender: patients with symptomatic lumbar IDD n=100 and subjects with normal lumbar-spine MRI-scans n=100. Distribution of the mutated alleles in patients and controls was 27.0% versus 28.0% P=0.455 for T of rs1800587 (IL1A; 53.0% versus 58.0% P=0.183 for V of rs2228570 (VDR; and 18.0% versus 21.0% P=0.262 for C of rs731236 (VDR. Our results showed no association between the studied polymorphisms and IDD in this population. This is the first report on the contribution of gene polymorphisms on IDD in a Mexican population.

  2. Genetic polymorphisms of interleukin-1 alpha and the vitamin d receptor in mexican mestizo patients with intervertebral disc degeneration.

    Science.gov (United States)

    Cervin Serrano, Salvador; González Villareal, Dalia; Aguilar-Medina, Maribel; Romero-Navarro, Jose Guillermo; Romero Quintana, Jose Geovanni; Arámbula Meraz, Eliakym; Osuna Ramírez, Ignacio; Picos-Cárdenas, Veronica; Granados, Julio; Estrada-García, Iris; Sánchez-Schmitz, Guzman; Ramos-Payán, Rosalío

    2014-01-01

    Intervertebral disc degeneration (IDD) is the most common diagnosis in patients with back pain, a leading cause of musculoskeletal disability worldwide. Several conditions, such as occupational activities, gender, age, and obesity, have been associated with IDD. However, the development of this disease has strong genetic determinants. In this study, we explore the possible association between rs1800587 (c.-949C>T) of interleukin-1 alpha (IL1A) and rs2228570 (c.2T>V) and rs731236 (c.1056T>C) of vitamin D receptor (VDR) gene polymorphisms and the development of IDD in northwestern Mexican Mestizo population. Gene polymorphisms were analyzed by polymerase chain reaction followed by restriction fragment length polymorphism, in two groups matched by age and gender: patients with symptomatic lumbar IDD (n = 100) and subjects with normal lumbar-spine MRI-scans (n = 100). Distribution of the mutated alleles in patients and controls was 27.0% versus 28.0% (P = 0.455) for T of rs1800587 (IL1A); 53.0% versus 58.0% (P = 0.183) for V of rs2228570 (VDR); and 18.0% versus 21.0% (P = 0.262) for C of rs731236 (VDR). Our results showed no association between the studied polymorphisms and IDD in this population. This is the first report on the contribution of gene polymorphisms on IDD in a Mexican population.

  3. Collagen turnover in normal and degenerate human intervertebral discs as determined by the racemization of aspartic acid

    NARCIS (Netherlands)

    Sivan, S.-S.; Wachtel, E.; Tsitron, E.; Sakkee, N.; Ham, F. van der; Groot, J.de; Roberts, S.; Maroudas, A.

    2008-01-01

    Knowledge of rates of protein turnover is important for a quantitative understanding of tissue synthesis and catabolism. In this work, we have used the racemization of aspartic acid as a marker for the turnover of collagen obtained from healthy and pathological human intervertebral disc matrices. We

  4. Collagen turnover in normal and degenerate human intervertebral discs as determined by the racemization of aspartic acid

    NARCIS (Netherlands)

    Sivan, S.-S.; Wachtel, E.; Tsitron, E.; Sakkee, N.; Ham, F. van der; Groot, J.de; Roberts, S.; Maroudas, A.

    2008-01-01

    Knowledge of rates of protein turnover is important for a quantitative understanding of tissue synthesis and catabolism. In this work, we have used the racemization of aspartic acid as a marker for the turnover of collagen obtained from healthy and pathological human intervertebral disc matrices. We

  5. Kaempferol slows intervertebral disc degeneration by modifying LPS-induced osteogenesis/adipogenesis imbalance and inflammation response in BMSCs.

    Science.gov (United States)

    Zhu, Jun; Tang, Haoyu; Zhang, Zhenhua; Zhang, Yong; Qiu, Chengfeng; Zhang, Ling; Huang, Pinge; Li, Feng

    2017-02-01

    Intervertebral disc (IVD) degeneration is a common disease that represents a significant cause of socio-economic problems. Bone marrow-derived mesenchymal stem cells (BMSCs) are a potential autologous stem cell source for the nucleus pulposus regeneration. Kaempferol has been reported to exert protective effects against both osteoporosis and obesity. This study explored the effect of kaempferol on BMSCs differentiation and inflammation. The results demonstrated that kaempferol did not show any cytotoxicity at concentrations of 20, 60 and 100μM. Kaempferol enhanced cell viability by counteracting the lipopolysaccharide (LPS)-induced cell apoptosis and increasing cell proliferation. Western blot analysis of mitosis-associated nuclear antigen (Ki67) and proliferation cell nuclear antigen (PCNA) further confirmed the increased effect of kaempferol on LPS-induced decreased viability of BMSCs. Besides, kaempferol elevated LPS-induced reduced level of chondrogenic markers (SOX-9, Collagen II and Aggrecan), decreased the level of matrix-degrading enzymes, i.e., matrix metalloprotease (MMP)-3 and MMP-13, suggesting the osteogenesis of BMSC under kaempferol treatment. On the other hand, kaempferol enhanced LPS-induced decreased expression of lipid catabolism-related genes, i.e., carnitine palmitoyl transferase-1 (CPT-1). Kaempferol also suppressed the expression of lipid anabolism-related genes, i.e., peroxisome proliferators-activated receptor-γ (PPAR-γ). The Oil red O staining further convinced the inhibition effect of kaempferol on BMSCs adipogenesis. In addition, kaempferol alleviated inflammatory by reducing the level of pro-inflammatory cytokines (i.e., interleukin (IL)-6) and increasing anti-inflammatory cytokine (IL-10) via inhibiting the nucleus translocation of nuclear transcription factor (NF)-κB p65. Taken together, our research indicated that kaempferol may serve as a novel target for treatment of IVD degeneration.

  6. 椎间盘退变生物治疗进展%The recent advances in biological therapy for intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    石志远; 张超; 阮狄克

    2012-01-01

    @@ 临床上椎间盘退行性疾病在保守治疗基础上,大多数需要通过外科干预达到长期缓解局部疼痛的目的.但由于椎间盘生物力学上的特殊地位,使得如何在保持椎间盘完整性的基础上,促进椎间盘细胞外基质再生的生物治疗方法成为椎间盘退变预防和治疗的研究热点.椎间盘髓核基质数量和成分的改变被认为是椎间盘退变的一个重要原因,目前许多学者试图通过引入各种外源性生长因子、种子细胞、基因以及基因转染的细胞,以期增加髓核细胞外基质含量,恢复II型胶原和蛋白多糖比例,逆转或延缓椎间盘退变的发展进程.%With the continuous exploration of basic research for the pathogeny of intervertebral disc degenerative disease, the causes of intervertebral disc degeneration (the anabolic imbalance initiated by cells, extracellular matrix, growth factors and inflammatory factors) have gradually become explicit. Combining with the ceaseless extending of tissue engineering in the field of orthopedics, more and more clinical and basic researchers attempt to treat the discogenic disease through the exogenous interference in the process of intervertebral disc degeneration, including molecular therapy, cell therapy and gene therapy. In molecular therapy, stimulating endogenous cell activity and delaying the process of intervertebral disc degeneration, researchers attempt to increase the anabolic growth factors through reducing the inflammatory factors such as TNF-a, IL-8 and so on. Exogenous growth factors BMP7, BMP2 and BM14 (GDF5) have also been proved to have the effects of restraining intervertebral disc degeneration. In cell therapy, the researches are mainly on the introduction of exogenous cells and the expansion and replantation of autologous nucleus pulposus cells in vitro. A randomized controlled trial in clinic preliminarily confirms that the transplantation of autologous nucleus pulposus cells plays a role

  7. Influence of degenerative changes of intervertebral disc

    Directory of Open Access Journals (Sweden)

    WANG Yi

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principles of reliability, advancement and efficiency, the obtained data were primarily examined, and the original source was retrieved to read the full-text. Repetitive articles were excluded. The data of material properties of normal and degenerated IVDs were summarized and analyzed by meta-analysis. Results: The data of Young's modulus, Poisson's ratio, shear modulus, hydraulic permeability and intradiscal pres-sure of normal and degenerated IVDs were obtained. Com-pared with normal IVDs, the Young's modulus and shear modulus of annulus fibrosus and nucleus pulposus were higher in degenerated IVDs, the Poisson's ratio was lower while the hydraulic permeability and intradiscal pressure were higher. Besides, the degeneration-related alterations in IVDs had an influence both on itself and other spinal structures, leading to diseases such as bulging disc, discogenic pain and spinal stenosis. Meanwhile, the heavy mechanical loading and injury indicated important pathways to IVD degeneration. Conclusions: To a certain extent, the degenerative changes of IVD influence its material properties. And the degeneration-related alterations of composition can cause structural failure of IVDs, leading to injuries and diseases. Key words: Intervertebral disc; Mechanical phenomena; Degeneration; Elastic modulus; Permeability; Pathology

  8. Fatores genéticos e ambientais envolvidos na degeneração do disco intervertebral Genetic and environmental factors involved on intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Francine Teresa Brioni Nunes

    2007-01-01

    Full Text Available A etiologia da degeneração do disco intervertebral (DDI ainda não está totalmente esclarecida. O gene do receptor da vitamina D (VDR tem sido apontado como um dos possíveis envolvidos no surgimento das discopatias. Por outro lado, este estudo relaciona pela primeira vez, a participação dos genes das glutatião transferases M1 e T1 (GSTT1 e GSTM1, responsáveis pela inativação dos componentes do cigarro, na DDI. Foi extraído DNA de leucócitos de 66 pacientes e 88 controles, pareados por gênero e idade. O polimorfismo VDR-FokI foi amplificado por reação em cadeia da polimerase (PCR seguido de restrição com a enzima FokI. Os polimorfismos das GSTT1/M1 foram determinados por meio da PCR multiplex. A história familial e a gravidade da doença se destacaram nos pacientes portadores do alelo f do gene VDR-FokI (P=0,000 e 0,0012, respectivamente. A idade de surgimento da doença mostrou-se precoce nos indivíduos com genótipo _/f (média de 26 anos. Foi encontrada associação do polimorfismo FokI com a degeneração precoce e gravidade da DDI, sendo que o hábito de fumar também interferiu nesse processo, independente da presença ou não do genótipo favorável para GSTT1/M1.The etiology of intervertebral disc degeneration (IDD has not been fully clarified yet. Vitamin D receptor’s gene (VDR has been suggested as one of the potential entities involved in disc pathologies onset. On the other hand, this study correlates, for the first time, glutathione transferases M1 and T1 genes (GSTT1 and GSTM1 participation, which are responsible for cigarette components’ inactivation, in IDD. DNA was extracted from leukocytes of 66 patients and 88 controls, paired by gender and age. The VDR-Fokl polymorphism was amplified by polymerase chain reaction (PCR followed by restriction with Fokl enzyme. GSTT1/M1 polymorphisms were determined by means of PCR multiplex. Family history and disease severity were highlighted in patients carrying the f

  9. Stem cells sources for intervertebral disc regeneration

    Institute of Scientific and Technical Information of China (English)

    Gianluca; Vadalà; Fabrizio; Russo; Luca; Ambrosio; Mattia; Loppini; Vincenzo; Denaro

    2016-01-01

    Intervertebral disc regeneration field is rapidly growing since disc disorders represent a major health problem in industrialized countries with very few possible treatments.Indeed, current available therapies are symptomatic, and surgical procedures consist in disc removal and spinal fusion, which is not immune to regardable concerns about possible comorbidities, cost-effectiveness, secondary risks and long-lasting outcomes. This review paper aims to share recent advances in stem cell therapy for the treatment of intervertebral disc degeneration. In literature the potential use of different adult stem cells for intervertebral disc regeneration has already been reported. Bone marrow mesenchymal stromal/stem cells, adipose tissue derived stem cells, synovial stem cells, muscle-derived stem cells, olfactory neural stem cells, induced pluripotent stem cells, hematopoietic stem cells, disc stem cells, and embryonic stem cells have been studied for this purpose either in vitro or in vivo. Moreover, several engineered carriers(e.g., hydrogels), characterized by full biocompatibility and prompt biodegradation, have been designed and combined with different stem cell types in order to optimize the local and controlled delivery of cellular substrates in situ. The paper overviews the literature discussing the current status of our knowledge of the different stem cells types used as a cell-based therapy for disc regeneration.

  10. Finite element simulation of the healthy and degenerated lumbar spine : interplay between muscle activity and intervertebral disc multiphysics

    OpenAIRE

    Toumanidou, Themis

    2016-01-01

    The human spine provides mechanical support to the trunk while it protects the spinal cord and nerves from the external loads transferred during daily activities. Such loads are largely controlled by the spine muscles and influence the biophysical regulation of the intervertebral discs (IVD). Numerical models have been important tools for the translation of the external forces into internal loads that otherwise cannot be easily measured directly. This PhD thesis used the predictive ability of...

  11. Cells and Biomaterials for Intervertebral Disc Regeneration

    CERN Document Server

    Grad, Sibylle

    2010-01-01

    Disorders related to the intervertebral disc (IVD) are common causes of morbidity and of severe life quality deterioration. IVD degeneration, although in many cases asymptomatic, is often the origin of painful neck and back diseases. In Western societies IVD related pain and disability account for enormous health care costs as a result of work absenteeism and thus lost production, disability benefits, medical and insurance expenses. Although only a small percentage of patients with disc disorders finally will undergo surgery, spinal surgery has been one of the fastest growing disciplines in th

  12. The effect of training on lumbar spine posture and intervertebral disc degeneration in active-duty Marines.

    Science.gov (United States)

    Rodriguez-Soto, Ana E; Berry, David B; Jaworski, Rebecca; Jensen, Andrew; Chung, Christine B; Niederberger, Brenda; Qadir, Aziza; Kelly, Karen R; Ward, Samuel R

    2017-08-01

    Military training aims to improve load carriage performance and reduce risk of injuries. Data describing the lumbar spine (LS) postural response to load carriage throughout training are limited. We hypothesised that training would reduce the LS postural response to load. The LS posture of 27 Marines was measured from upright MR images: with and without load (22.6 kg) at the beginning, middle, and end of School of Infantry (SOI) training. Disc degeneration was graded at L5-S1. No changes in posture and disc degeneration were found throughout training. During load carriage the LS became less lordotic and the sacrum more horizontal. Marines with disc degeneration had larger sacral postural perturbations in response to load. Our findings suggest that the postural response to load is defined more by the task needs than by the physical condition of the Marine. Practitioner Summary: The effect of military training on lumbar spine posture is unknown. The lumbar posture of 27 Marines was measured from upright MR images, with and without load throughout infantry training. No changes in posture or IVD degeneration were found across training. Marines with degeneration at the L5-S1 level had larger sacral postural perturbations in response to load.

  13. On the development of an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, Marcus Franciscus

    2002-01-01

    Degenerative disc disease is one of the causes of low back pain. There are two major surgical interventions: spinal fusion and implantation of an artificial intervertebral disc. Spinal fusion alters the biomechanics of the spine, which may lead to further degeneration of the surrounding tissues and

  14. Intervertebral disc calcifications in children.

    Science.gov (United States)

    Beluffi, G; Fiori, P; Sileo, C

    2009-03-01

    This study was done to assess the presence of both asymptomatic and symptomatic intervertebral disc calcifications in a large paediatric population. We retrospectively reviewed the radiographs taken during the past 26 years in children (age 0-18 years) undergoing imaging of the spine or of other body segments in which the spine was adequately depicted, to determine possible intervertebral disc calcifications. The following clinical evaluation was extrapolated from the patients' charts: presence of spinal symptoms, history of trauma, suspected or clinically evident scoliosis, suspected or clinically evident syndromes, bone dysplasias, and pre- or postoperative chest or abdominal X-rays. We detected intervertebral disc calcifications in six patients only. Five calcifications were asymptomatic (one newborn baby with Patau syndrome; three patients studied to rule out scoliosis, hypochondroplasia and syndromic traits; one for dyspnoea due to sunflower seeds inhalation). Only one was symptomatic, with acute neck pain. Calcifications varied in number from one in one patient to two to five in the others. Apart from the calcification in the patient with cervical pain, all calcifications were asymptomatic and constituted an incidental finding (particularly those detected at the thoracic level in the patient studied for sunflower-seed inhalation). Calcification shapes were either linear or round. Our series confirms that intervertebral disc calcifications are a rare finding in childhood and should not be a source of concern: symptomatic calcifications tend to regress spontaneously within a short time with or without therapy and immobilisation, whereas asymptomatic calcifications may last for years but disappear before the age of 20 years. Only very few cases, such as those of medullary compression or severe dysphagia due to anterior herniation of cervical discs, may require surgical procedures.

  15. Histological analysis of surgical lumbar intervertebral disc tissue provides evidence for an association between disc degeneration and increased body mass index

    Directory of Open Access Journals (Sweden)

    Weiler Christoph

    2011-11-01

    Full Text Available Abstract Background Although histopathological grading systems for disc degeneration are frequently used in research, they are not yet integrated into daily care routine pathology of surgical samples. Therefore, data on histopathological changes in surgically excised disc material and their correlation to clinical parameters such as age, gender or body mass index (BMI is limited to date. The current study was designed to correlate major physico-clinical parameters from a population of orthopaedic spine center patients (gender, age and BMI with a quantitative histologic degeneration score (HDS. Methods Excised lumbar disc material from 854 patients (529 men/325 women/mean age 56 (15-96 yrs. was graded based on a previously validated histologic degeneration score (HDS in a cohort of surgical disc samples that had been obtained for the treatment of either disc herniation or discogenic back pain. Cases with obvious inflammation, tumor formation or congenital disc pathology were excluded. The degree of histological changes was correlated with sex, age and BMI. Results The HDS (0-15 points showed significantly higher values in the nucleus pulposus (NP than in the annulus fibrosus (AF (Mean: NP 11.45/AF 7.87, with a significantly higher frequency of histomorphological alterations in men in comparison to women. Furthermore, the HDS revealed a positive significant correlation between the BMI and the extent of histological changes. No statistical age relation of the degenerative lesions was seen. Conclusions This study demonstrated that histological disc alterations in surgical specimens can be graded in a reliable manner based on a quantitative histologic degeneration score (HDS. Increased BMI was identified as a positive risk factor for the development of symptomatic, clinically significant disc degeneration.

  16. Quantitative T2 magnetic resonance imaging compared to morphological grading of the early cervical intervertebral disc degeneration: an evaluation approach in asymptomatic young adults.

    Directory of Open Access Journals (Sweden)

    Chun Chen

    Full Text Available OBJECTIVE: The objective of this study was to evaluate the efficacy of quantitative T2 magnetic resonance imaging (MRI for quantifying early cervical intervertebral disc (IVD degeneration in asymptomatic young adults by correlating the T2 value with Pfirrmann grade, sex, and anatomic level. METHODS: Seventy asymptomatic young subjects (34 men and 36 women; mean age, 22.80±2.11 yr; range, 18-25 years underwent 3.0-T MRI to obtain morphological data (one T1-fast spin echo (FSE and three-plane T2-FSE, used to assign a Pfirrmann grade (I-V and for T2 mapping (multi-echo spin echo. T2 values in the nucleus pulposus (NP, n = 350 and anulus fibrosus (AF, n = 700 were obtained. Differences in T2 values between sexes and anatomic level were evaluated, and linear correlation analysis of T2 values versus degenerative grade was conducted. FINDINGS: Cervical IVDs of healthy young adults were commonly determined to be at Pfirrmann grades I and II. T2 values of NPs were significantly higher than those of AF at all anatomic levels (P0.05. T2 values decreased linearly with degenerative grade. Linear correlation analysis revealed a strong negative association between the Pfirrmann grade and the T2 values of the NP (P = 0.000 but not the T2 values of the AF (P = 0.854. However, non-degenerated discs (Pfirrmann grades I and II showed a wide range of T2 relaxation time. T2 values according to disc degeneration level classification were as follows: grade I (>62.03 ms, grade II (54.60-62.03 ms, grade III (<54.60 ms. CONCLUSIONS: T2 quantitation provides a more sensitive and robust approach for detecting and characterizing the early stage of cervical IVD degeneration and to create a reliable quantitative in healthy young adults.

  17. The species-specific regenerative effects of notochordal cell-conditioned medium on chondrocyte-like cells derived from degenerated human intervertebral discs

    NARCIS (Netherlands)

    Bach, F C; de Vries, S A; Krouwels, A; Creemers, L B; Ito, K; Meij, B P; Tryfonidou, M A

    2015-01-01

    During intervertebral disc (IVD) maturation, the main cell type shifts from notochordal cells (NCs) to chondrocyte-like cells (CLCs). NCs secrete factors with regenerative potential, making them an interesting focus for regenerative treatments. During initial development, these strategies preferably

  18. The species-specific regenerative effects of notochordal cell-conditioned medium on chondrocyte-like cells derived from degenerated human intervertebral discs.

    NARCIS (Netherlands)

    Bach, FC; de Vries, S A H; Krouwels, A; Creemers, L B; Ito, K; Meij, B P; Tryfonidou, M A

    2015-01-01

    During intervertebral disc (IVD) maturation, the main cell type shifts from notochordal cells (NCs) to chondrocyte-like cells (CLCs). NCs secrete factors with regenerative potential, making them an interesting focus for regenerative treatments. During initial development, these strategies preferably

  19. Design and fabrication of 3D-printed anatomically shaped lumbar cage for intervertebral disc (IVD) degeneration treatment.

    Science.gov (United States)

    Serra, T; Capelli, C; Toumpaniari, R; Orriss, I R; Leong, J J H; Dalgarno, K; Kalaskar, D M

    2016-07-19

    Spinal fusion is the gold standard surgical procedure for degenerative spinal conditions when conservative therapies have been unsuccessful in rehabilitation of patients. Novel strategies are required to improve biocompatibility and osseointegration of traditionally used materials for lumbar cages. Furthermore, new design and technologies are needed to bridge the gap due to the shortage of optimal implant sizes to fill the intervertebral disc defect. Within this context, additive manufacturing technology presents an excellent opportunity to fabricate ergonomic shape medical implants. The goal of this study is to design and manufacture a 3D-printed lumbar cage for lumbar interbody fusion. Optimisations of the proposed implant design and its printing parameters were achieved via in silico analysis. The final construct was characterised via scanning electron microscopy, contact angle, x-ray micro computed tomography (μCT), atomic force microscopy, and compressive test. Preliminary in vitro cell culture tests such as morphological assessment and metabolic activities were performed to access biocompatibility of 3D-printed constructs. Results of in silico analysis provided a useful platform to test preliminary cage design and to find an optimal value of filling density for 3D printing process. Surface characterisation confirmed a uniform coating of nHAp with nanoscale topography. Mechanical evaluation showed mechanical properties of final cage design similar to that of trabecular bone. Preliminary cell culture results showed promising results in terms of cell growth and activity confirming biocompatibility of constructs. Thus for the first time, design optimisation based on computational and experimental analysis combined with the 3D-printing technique for intervertebral fusion cage has been reported in a single study. 3D-printing is a promising technique for medical applications and this study paves the way for future development of customised implants in spinal

  20. Disc distraction shows evidence of regenerative potential in degenerated intervertebral discs as evaluated by protein expression, magnetic resonance imaging, and messenger ribonucleic acid expression analysis.

    Science.gov (United States)

    Guehring, Thorsten; Omlor, Georg W; Lorenz, Helga; Engelleiter, Karl; Richter, Wiltrud; Carstens, Claus; Kroeber, Markus

    2006-07-01

    An animal model of degeneration was used to determine the effects of disc distraction, and was evaluated with magnetic resonance imaging (MRI) as well as gene and protein expression levels. To investigate gene expression and MRI effects of distraction. Disc degeneration can result from hyper-physiologic loading. Distracted discs with degeneration showed histologic signs of tissue recovery. There were 18 rabbits that underwent 28 days of compression (200 N) to induce moderate disc degeneration followed by 28 days of distraction (120 N; attached and loaded distraction device) or sham distraction (attached but unloaded distraction device). Comparison was performed with 56 days of compressed discs without distraction. Quantitative outcome measures were MRI signal intensity and gene expression analysis to determine: messenger ribonucleic acid levels for extracellular matrix genes, including collagen 1, collagen 2, biglycan, decorin, aggrecan, fibromodulin, and osteonectin; and matrix-regulative genes, including matrix metalloproteinase-13, tissue-inhibitor of matrix metalloproteinase-1, and bone morphogenetic protein (BMP)-2. Immunohistology was performed for collagen 2 and BMP-2 to label cells semiquantitatively by staining of the cell-surrounding matrix. A total of 28 days of compression decreased signal intensity. Distraction over the same period reestablished physiologic signal intensity, however, a persistent reduction was found in sham distraction. Distraction resulted in gene expression up-regulation of collagen 1 (5.4-fold), collagen 2 (5.5-fold), biglycan (7.7-fold), and decorin (3.4-fold), while expression of fibromodulin (0.16-fold), tissue-inhibitor of matrix metalloproteinase-1 (0.05-fold), and BMP-2 (0.15-fold) was decreased, as compared with 56 days compression. Distracted discs showed more BMP-2 (19.67 vs. 3.67 in 56 days compression) and collagen 2 (18.67 vs. 11.33 in 56 days compression) positive cells per field. Distraction results in disc rehydration

  1. 白细胞介素-17与椎间盘退变相关性的研究进展%Progress of correlation between interleukin-17 and intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    罗元一; 殷明; 何丁文; 魏强强

    2013-01-01

    The mechanism of intervertebral disc degeneration is very complex and related to many factors.In recent years,studies have indicated that intervertebral disc degeneration is closely related to immune inflammation,in which immune cells and many kinds of inflammatory cytokines are involved.As proinflammatory cytokine,interleukin-17 plays a very important role in autoimmune disease and chronic inflammation,which is associated with inflammatory cytokines and cells apoptosis.These secreted inflammation cytokines and increased intervertebral disc cells apoptosis will promote the intervertebral disc degeneration.In the disc cells,IL-17 will promote synthesis of inflammation mediator,thereby induce extracellular matrix metabolic imbalances and accelerate apoptosis.These factors further interacted with each other and promote the intervertebral disc degeneration.This article reviews the biological characteristics of interleukin-17 and its role in the intervertebral disc degeneration.%椎间盘退变机制非常复杂与多种因素相关,近年来研究认为椎间盘退变与免疫炎症密切相关,椎间盘退变机制中有免疫细胞和多种炎症介质的参与,炎症细胞因子在椎间盘的退变中扮演者重要角色,而白细胞介素-17(interleukin-17,IL-17)在自身免疫性疾病和慢性炎症中发挥着重要作用,是非常重要的促炎细胞因子,与许多炎症介质有关,也与细胞凋亡等有很大关系.在椎间盘细胞中,IL-17将促进椎间盘细胞合成炎症介质、椎间盘细胞外基质代谢失衡和椎间盘细胞的过快凋亡.这些因素相互作用从而加速了椎间盘的退变 本文主要对IL-17的生物学特性及在椎间盘退变中的作用进行综述.

  2. Dysregulated miR-127-5p contributes to type II collagen degradation by targeting matrix metalloproteinase-13 in human intervertebral disc degeneration.

    Science.gov (United States)

    Hua, Wen-Bin; Wu, Xing-Huo; Zhang, Yu-Kun; Song, Yu; Tu, Ji; Kang, Liang; Zhao, Kang-Cheng; Li, Shuai; Wang, Kun; Liu, Wei; Shao, Zeng-Wu; Yang, Shu-Hua; Yang, Cao

    2017-08-01

    Intervertebral disc degeneration (IDD) is a chronic disease associated with the degradation of extracellular matrix (ECM). Matrix metalloproteinase (MMP)-13 is a major enzyme that mediates the degradation of ECM components. MMP-13 has been predicted to be a potential target of miR-127-5p. However, the exact function of miR-127-5p in IDD is still unclear. We designed this study to evaluate the correlation between miR-127-5p level and the degeneration of human intervertebral discs and explore the potential mechanisms. miR-127-5p levels and MMP-13 mRNA levels were detected by quantitative real-time polymerase chain reaction (qPCR). To determine whether MMP-13 is a target of miR-127-5p, dual luciferase reporter assays were performed. miR-127-5p mimic and miR-127-5p inhibitor were used to overexpress or downregulate miR-127-5p expression in human NP cells, respectively. Small interfering RNA (siRNA) was used to knock down MMP-13 expression in human NP cells. Type II collagen expression in human NP cells was detected by qPCR, western blotting, and immunofluorescence staining. We confirmed that miR-127-5p was significantly downregulated in nucleus pulposus (NP) tissue of degenerative discs and its expression was inversely correlated with MMP-13 mRNA levels. We reveal that MMP-13 may act as a target of miR-127-5p. Expression of miR-127-5p was inversely correlated with type II collagen expression in human NP cells. Moreover, suppression of MMP-13 expression by siRNA blocked downstream signaling and increased type II collagen expression. Dysregulated miR-127-5p contributed to the degradation of type II collagen by targeting MMP-13 in human IDD. Our findings highlight that miR-127-5p may serve as a new therapeutic target in IDD. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

  3. Does elite swimming accelerate lumbar intervertebral disc degeneration and increase low back pain? A cross-sectional comparison.

    Science.gov (United States)

    Folkvardsen, Steffen; Magnussen, Erland; Karppinen, Jaro; Auvinen, Juha; Larsen, Rasmus Hertzum; Wong, Christian; Bendix, Tom

    2016-09-01

    The aim was to elucidate elite swimming's possible influence on lumbar disc degeneration (DD) and low back pain (LBP). Lumbar spine MRI was performed on a group of elite swimmers and compared to a matched Finnish population-based no-sport group. One hundred elite swimmers and 96 no-sport adults, mean age 18.7/20.8, respectively, participated. Overall, the two groups had similar prevalence of DD. Swimmers had more DD in the upper lumbar spine but tended to have less DD at the lowest level. Prevalence of bulges and disc herniations were similar, but swimmers had significantly more bulges at L4-5. The swimmers reported less LBP, although not significantly (N.S.). If degenerative findings were present, the association between them and LBP was stronger in the no-sport group. Elite swimmers and controls had similar prevalence of DD and LBP, although the pattern of DD differed between the groups. In case of DD, swimmers reported less LBP, although N.S.

  4. Advances in Susceptibility Genetics of Intervertebral Degenerative Disc Disease

    Directory of Open Access Journals (Sweden)

    Yin'gang Zhang, Zhengming Sun, Jiangtao Liu, Xiong Guo

    2008-01-01

    Full Text Available The traditional view that the etiology of lumbar disc herniation is primarily due to age, gender, occupation, smoking and exposure to vehicular vibration dominated much of the last century. Recent research indicates that heredity may be largely responsible for the degeneration as well as herniation of intervertebral discs. Since 1998, genetic influences have been confirmed by the identification of several genes forms associated with disc degeneration. These researches are paving the way for a better understanding of the biologic mechanisms. Now, many researchers unanimously agree that lumbar disc herniation appears to be similar to other complex diseases, whose etiology has both environmental and hereditary influence, each with a part of contribution and relative risk. Then addressing the etiological of lumbar disc herniation, it is important to integrate heredity with the environment factors. For the purpose of this review, we have limited our discussion to several susceptibility genes associated with disc degeneration.

  5. The presence of local mesenchymal progenitor cells in human degenerated intervertebral discs and possibilities to influence these in vitro: a descriptive study in humans.

    Science.gov (United States)

    Brisby, Helena; Papadimitriou, Nikolaos; Brantsing, Camilla; Bergh, Peter; Lindahl, Anders; Barreto Henriksson, Helena

    2013-03-01

    Low back pain is common and degenerated discs (DDs) are believed to be a major cause. In non-degenerated intervertebral discs (IVDs) presence of stem/progenitor cells was recently reported in different mammals (rabbit, rat, pig). Understanding processes of disc degeneration and regenerative mechanisms within DDs is important. The aim of the study was to examine the presence of local stem/progenitor cells in human DDs and if these cell populations could respond to paracrine stimulation in vitro. Tissue biopsies from the IVD region (L3-S1) were collected from 15 patients, age 34-69 years, undergoing surgery (spinal fusion) and mesenchymal stem cells (MSCs) (iliac crest) from 2 donors. Non-DD cells were collected from 1 donor (scoliosis) and chordoma tissue was obtained from (positive control, stem cell markers) 2 donors. The IVD biopsies were investigated for gene and protein expression of: OCT3/4, CD105, CD90, STRO-1, and NOTCH1. DD cell cultures (pellet mass) were performed with conditioned media from MSCs and non-degenerated IVD cells. Pellets were investigated after 7, 14, 28 days for the same stem cell markers as above. Gene expression of OCT3/4 and STRO-1 was detected in 13/15 patient samples, CD105 in 14/15 samples, and CD90 and NOTCH1 were detected 15/15 samples. Immunohistochemistry analysis supported findings on the protein level, in cells sparsely distributed in DDs tissues. DDs cell cultures displayed more undifferentiated appearance with increased expression of CD105, CD90, STRO-1, OCT3/4, NOTCH1, and JAGGED1, which was observed when cultured in conditioned cell culture media from MSCs compared to cell cultures cultured with conditioned media from non-DD cells. Expression of OCT3/4 (multipotency marker) and NOTCH1 (regulator of cell fate), MSC-markers, CD105, CD90, and STRO-1, indicate that primitive cell populations are present within DDs. Furthermore, the possibility to influence cells from DDs by paracrine signaling /soluble factors from MSCs and from

  6. Effects of single injection of local anesthetic agents on intervertebral disc degeneration: ex vivo and long-term in vivo experimental study.

    Directory of Open Access Journals (Sweden)

    Koji Iwasaki

    Full Text Available Analgesic discography (discoblock can be used to diagnose or treat discogenic low back pain by injecting a small amount of local anesthetics. However, recent in vitro studies have revealed cytotoxic effects of local anesthetics on intervertebral disc (IVD cells. Here we aimed to investigate the deteriorative effects of lidocaine and bupivacaine on rabbit IVDs using an organotypic culture model and an in vivo long-term follow-up model.For the organotypic culture model, rabbit IVDs were harvested and cultured for 3 or 7 days after intradiscal injection of local anesthetics (1% lidocaine or 0.5% bupivacaine. Nucleus pulposus (NP cell death was measured using confocal microscopy. Histological and TUNEL assays were performed. For in vivo study, each local anesthetic was injected into rabbit lumbar IVDs under a fluoroscope. Six or 12 months after the injection, each IVD was prepared for magnetic resonance imaging (MRI and histological analysis.In the organotypic culture model, both anesthetic agents induced time-dependent NP cell death; when compared with injected saline solution, significant effects were detected within 7 days. Compared with the saline group, TUNEL-positive NP cells were significantly increased in the bupivacaine group. In the in vivo study, MRI analysis did not show any significant difference. Histological analysis revealed that IVD degeneration occurred to a significantly level in the saline- and local anesthetics-injected groups compared with the untreated control or puncture-only groups. However, there was no significant difference between the saline and anesthetic agents groups.In the in vivo model using healthy IVDs, there was no strong evidence to suggest that discoblock with local anesthetics has the potential of inducing IVD degeneration other than the initial mechanical damage of the pressurized injection. Further studies should be performed to investigate the deteriorative effects of the local injection of analgesic agents

  7. Effect of Degeneration on Fluid-Solid Interaction within Intervertebral Disc under Cyclic Loading – A Meta-Model Analysis of Finite Element Simulations

    Directory of Open Access Journals (Sweden)

    Mohammad eNikkhoo

    2015-01-01

    Full Text Available The risk of low back pain resulted from cyclic loadings is greater than that resulted from prolonged static postures. Disc degeneration results in degradation of disc solid structures and decrease of water contents, which is caused by activation of matrix digestive enzymes. The mechanical responses resulted from internal solid-fluid interactions of degenerative discs to cyclic loadings are not well studied yet. The fluid-solid interactions in discs can be evaluated by mathematical models, especially the poroelastic finite element models. We developed a robust disc poroelastic FE model to analyze the effect of degeneration on solid-fluid interactions within disc subjected to cyclic loadings at different loading frequencies. A backward analysis combined with in-vitro experiments were used to find the elastic modulus and hydraulic permeability of intact and enzyme-induced degenerated porcine discs. The results showed that the averaged peak-to-peak disc deformations during the in-vitro cyclic tests were well fitted with limited FE simulations and a quadratic response surface regression for both disc groups. The results showed that higher loading frequency increased the intradiscal pressure, decreased the total fluid loss, and slightly increased the maximum axial stress within solid matrix. Enzyme-induced degeneration decreased the intradiscal pressure and total fluid loss, and barely changed the maximum axial stress within solid matrix. The increase of intradiscal pressure and total fluid loss with loading frequency was less sensitive after the frequency elevated to 0.1 Hz for the enzyme-induced degenerated disc. Based on this study, it is found that enzyme-induced degeneration decreases energy attenuation capability of disc, but less change the strength of disc.

  8. MECHANICAL DESIGN CRITERIA FOR INTERVERTEBRAL DISC TISSUE ENGINEERING

    Science.gov (United States)

    Nerurkar, Nandan L.; Elliott, Dawn M.; Mauck, Robert L.

    2009-01-01

    Due to the inability of current clinical practices to restore function to degenerated intervertebral discs, the arena of disc tissue engineering has received substantial attention in recent years. Despite tremendous growth and progress in this field, translation to clinical implementation has been hindered by a lack of well-defined functional benchmarks. Because successful replacement of the disc is contingent upon replication of some or all of its complex mechanical behaviour, it is critically important that disc mechanics be well characterized in order to establish discrete functional goals for tissue engineering. In this review, the key functional signatures of the intervertebral disc are discussed and used to propose a series of native tissue benchmarks to guide the development of engineered replacement tissues. These benchmarks include measures of mechanical function under tensile, compressive and shear deformations for the disc and its substructures. In some cases, important functional measures are identified that have yet to be measured in the native tissue. Ultimately, native tissue benchmark values are compared to measurements that have been made on engineered disc tissues, identifying measures where functional equivalence was achieved, and others where there remain opportunities for advancement. Several excellent reviews exist regarding disc composition and structure, as well as recent tissue engineering strategies; therefore this review will remain focused on the functional aspects of disc tissue engineering. PMID:20080239

  9. Research progress of mesenchymal stem cell therapy for regeneration of degenerated intervertebral discs%间充质干细胞治疗椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    毕松超; 杨建东; 冯新民; 陈涛; 黄泽楠; 张亮

    2016-01-01

    Intervertebral disc degeneration (IVD) represents the main cause of the low-back pain that affects the majority of the adult population, and causes major social and economic costs. Physical therapy and spinal fusion as the major treatment for IVD degeneration only can relieve symptoms, but can not reverse IVD degeneration. People had begun to pay attention to the number and functional recovery of intervertebral disc cells, to achieve the goal of reversing the degeneration of intervertebral disc. Adult mesenchymal stem cells (MSC) can be differentiated into nucleus pulposus like cells, which provide seed cells for the treatment of IVD. MSC and intervertebral disc cells co-culture technology also provides a feasible method. At present, the use of MSC for IVD degeneration is limited to pre-clinical research, and many problems need to be solved. For example, how to determine the phenotype of nucleus pulposus cells, how to avoid the leakage of stem cells and tumor formation.%下腰痛已严重影响了人们的工作和生活,带来了严重的经济负担和社会负担。下腰痛主要是由椎间盘退变性疾病引起,保守治疗和手术治疗是目前临床上治疗椎间盘退变的常用方法,但这些方法仅限于缓解症状,而无法从根本上扭转椎间盘退变。人们已经开始关注通过恢复椎间盘细胞的数量和功能,从而实现生物学修复椎间盘退变的目的。间充质干细胞可分化为髓核样细胞,这为利用干细胞治疗椎间盘退变提供了种子细胞。间充质干细胞与椎间盘细胞的共培养技术也为此提供了可行的方法。目前这种方法也仅限于临床前研究,还有许多问题需要解决,例如:如何确定髓核细胞表型、如何避免干细胞的渗漏和肿瘤形成等。

  10. Exosomes as potential alternatives to stem cell therapy for intervertebral disc degeneration: in-vitro study on exosomes in interaction of nucleus pulposus cells and bone marrow mesenchymal stem cells.

    Science.gov (United States)

    Lu, Kang; Li, Hai-Yin; Yang, Kuang; Wu, Jun-Long; Cai, Xiao-Wei; Zhou, Yue; Li, Chang-Qing

    2017-05-10

    The stem cell-based therapies for intervertebral disc degeneration have been widely studied. However, the mechanisms of mesenchymal stem cells interacting with intervertebral disc cells, such as nucleus pulposus cells (NPCs), remain unknown. Exosomes as a vital paracrine mechanism in cell-cell communication have been highly focused on. The purpose of this study was to detect the role of exosomes derived from bone marrow mesenchymal stem cells (BM-MSCs) and NPCs in their interaction with corresponding cells. The exosomes secreted by BM-MSCs and NPCs were purified by differential centrifugation and identified by transmission electron microscope and immunoblot analysis of exosomal marker proteins. Fluorescence confocal microscopy was used to examine the uptake of exosomes by recipient cells. The effects of NPC exosomes on the migration and differentiation of BM-MSCs were determined by transwell migration assays and quantitative RT-PCR analysis of NPC phenotypic genes. Western blot analysis was performed to examine proteins such as aggrecan, sox-9, collagen II and hif-1α in the induced BM-MSCs. Proliferation and the gene expression profile of NPCs induced by BM-MSC exosomes were measured by Cell Counting Kit-8 and qRT-PCR analysis, respectively. Both the NPCs and BM-MSCs secreted exosomes, and these exosomes underwent uptake by the corresponding cells. NPC-derived exosomes promoted BM-MSC migration and induced BM-MSC differentiation to a nucleus pulposus-like phenotype. BM-MSC-derived exosomes promoted NPC proliferation and healthier extracellular matrix production in the degenerate NPCs. Our study indicates that the exosomes act as an important vehicle in information exchange between BM-MSCs and NPCs. Given a variety of functions and multiple advantages, exosomes alone or loaded with specific genes and drugs would be an appropriate option in a cell-free therapy strategy for intervertebral disc degeneration.

  11. Anisotropic ion diffusivity in intervertebral disc: an electrical conductivity approach.

    Science.gov (United States)

    Jackson, Alicia; Yao, Hai; Brown, Mark D; Yong Gu, Wei

    2006-11-15

    Investigation of the transport behavior of ions in intervertebral disc using an electrical conductivity method. To determine the electrical conductivity and ion diffusivity of nucleus pulposus and anulus fibrosus in 3 major directions (axial, circumferential, and radial). Knowledge of diffusivity of small molecules is important for understanding nutrition supply in intervertebral disc and disc degeneration. However, little is known on the anisotropic behaviors of ion diffusivity and of electrical conductivity in intervertebral disc. Electrical conductivity measurement was performed on 24 axial, circumferential, and radial anulus fibrosus specimens and 24 axial nucleus pulposus specimens from bovine coccygeal discs. The diffusivity of Na and Cl were estimated by the analysis of conductivity data. The electrical conductivity (mean +/- standard deviation; n = 24) of the bovine anulus fibrosus was 4.70 +/- 1.08 mS/cm in the axial, 2.86 +/- 0.83 mS/cm in the radial, and 4.38 +/- 1.25 mS/cm in the circumferential direction. For nucleus pulposus, the electrical conductivity (mean +/- standard deviation; n = 24) was 8.95 +/- 0.89 mS/cm. The mean value for nucleus pulposus was significantly higher than that of anulus fibrosus (t test, P conductivity in the radial direction was significantly lower than in axial or circumferential directions. Similar trends were found for both Na and Cl diffusivities. Both electrical conductivity and ion diffusivity were highly sensitive to water content. Electrical conductivity and ion diffusivity of anulus fibrosus are anisotropic.

  12. Genome-Wide Association Study in Dachshund: Identification of a Major Locus Affecting Intervertebral Disc Calcification

    DEFF Research Database (Denmark)

    Mogensen, Mette Sloth; Karlskov-Mortensen, Peter; Proschowsky, Helle Friis;

    2011-01-01

    Intervertebral disc calcification and herniation commonly affects Dachshund where the predisposition is caused by an early onset degenerative process resulting in disc calcification. A continuous spectrum of disc degeneration is seen within and among clog breeds, suggesting a multifactorial...... with intervertebral disc calcification in Dachshund through a genome-wide association (GWA) study. Based on thorough radiographic examinations, 48 cases with >= 6 disc calcifications or surgically treated for disc herniation and 46 controls with 0-1 disc calcifications were identified. GWA using the Illumina Canine......HD BeadChip identified a locus on chromosome 12 from 36.8 to 38.6 Mb with 36 markers reaching genome-wide significance (P-genome = 0.00001-0.026). This study suggests that a major locus on chromosome 12 harbors genetic variations affecting the development of intervertebral disc calcification in Dachshund....

  13. Intervertebral Disc Herniation Treated by Comprehensive Therapy

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; HUANG Guo-qi

    2007-01-01

    In the treatment of 169 cases of the patients sick with intervertebral disc hemiation by integrated application of acupuncture therapy,Chinese massage therapy and herbal fumigation method.the results showed cure in 129 cases.improvement in 33 cases and failure in 7 cases,and the total effective rate was 95.9%.

  14. 大鼠颈椎间盘退行性变后软骨细胞凋亡及形态学改变%Chondrocyte apoptosis and morphological changes of degenerated cervical intervertebral disc in rats

    Institute of Scientific and Technical Information of China (English)

    王拥军; 施杞; 李家顺; 贾连顺; 周重建; 刘梅; 周泉

    2004-01-01

    背景:椎间盘软骨终板是椎间盘营养渗透的主要途径,又是维持脊柱生物力学的重要结构之一.对其重要性的认识及相关研究日益深入,但对椎间盘退行性变的确切原因仍不清楚.目的:动态观察大鼠颈部动静力失去平衡后颈椎间盘软骨细胞凋亡的形态学改变以及凋亡率.设计:采用完全随机对照设计.地点和对象:实验在上海中医药大学脊柱病研究所完成,对象为8月龄清洁级SD大鼠60只,雌雄各30只.干预:将雌雄大鼠分别按随机数字表法分为3,5,7月对照组与模型组,每组10只,雌雄各5只.取大鼠颈背部正中纵向切口,切开皮肤后,充分游离各层肌肉,横向切断深群颈夹肌和头、颈、寰最长肌,完全切除颈髂肋肌与头半棘肌,然后再依次切断C2~C7棘上和棘间韧带,建立的动静力失衡性颈椎间盘退行性变模型.主要观察指标:3,5,7月后椎间盘软骨细胞凋亡程度.结果:退行性变椎间盘内有典型凋亡的软骨细胞.与对照组比较,各个模型组软骨细胞凋亡指数明显升高(P<0.01);模型组间比较,TUNEL法5,7月软骨细胞凋亡指数分别为36.59±5.93和36 36±5.13较3月(27.73±4.12)明显升高(P<0.01),流式细胞仪PI法5,7月细胞凋亡指数分别为37.56±3.82和28.02±3.48较3月(21.45±2.23)明显升高(P<0.01).结论:退行性变椎间盘软骨终板内软骨细胞凋亡数目增多,这可能是椎间盘退行性变的重要机制之一.%BACKGROUND: The cartilage endplate of intervertebral disc, the main way of the nutrition pervasion in intervertebral disc, is also one of the important structures in maintaining the biodynamics of spine. Though its importance and related researches were recognized further, the actual reasons for degeneration of intervertebral disc still remains unclear.OBJECTIVE: To dynamically observe the morphological changes of the chondyrocyte apoptosis and the apoptotic rate of chondyrocytes in the degenerated

  15. 艾灸对兔退变颈椎间盘蛋白多糖含量的影响%Effect of Moxibustion on the Contents of Proteoglycan of Rabbits with Degeneration of Cervical Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    蔡洁; 彭锐; 熊勇

    2011-01-01

    Objective:To observe the effect of moxibustion on the contents of proteoglycan of rabbits with degeneration of cervical in-tervertebral disc, and to explore its potential mechanism. Methods: Twenty-four Japanese white rabbits were divided into three groups at random: moxibustion group, model group and normal group, 8 in each group. Model of degeneration of cervical interver-tebral disc was established with modified fixation in sixty-degree flexion, and intervention was used at the beginning of model preparation. Animals in the moxibustion group were treated with moxibustion applied on cervical paravertebral point (EX-B 2) (each acupoint for 15minutes, once a day); animals in the nomal group with nothing. The intervertebral disc tissues were harvested three months after model preparation, and the proteoglycan contents were measured. Results:The contents of proteoglycan in the model group were significantly decreased (P0. 05). Conclusion: Moxibustion can prevent depression of the contents of proteoglycan, which may contribute to the therapeutic effect of moxibustion on degeneration of cervical intervertebral disc.%目的:观察艾灸对兔退变颈椎间盘蛋白多糖的影响,探讨艾灸防治颈椎间盘退变的作用及可能机制.方法:24只日本大耳白兔随机分为艾灸组、模型组和正常组,每组8只,采用颈椎曲位固定法制备兔颈椎间盘退变模型,造模后立即干预.艾灸组温和灸颈部夹脊穴,每穴15min,1次/d.造模3月后,各组取出退变椎间盘组织,测量其蛋白多糖含量.结果:模型组椎间盘蛋白多糖含量明显减少(P0.05).结论:艾灸可防止兔颈椎间盘蛋白多糖含童过度减少,对兔颈椎间盘退变有一定延缓作用.

  16. Histologic observation of intervertebral disc degeneration in lack-leptin mice%瘦素缺乏小鼠椎间盘退变的组织学观察

    Institute of Scientific and Technical Information of China (English)

    郭震; 李新锋; 戴力扬

    2012-01-01

    目的 探讨瘦素在椎间盘退变中的可能作用.方法 采用HE染色观察6月龄雄性ob/ob小鼠(瘦素缺乏小鼠)和野生型小鼠(C57BL小鼠)椎间盘的形态学;免疫组织化学检测Ⅱ型胶原、蛋白聚糖的表达;Real-time PCR检测Ⅱ型胶原、Ⅹ型胶原及蛋白聚糖的基因表达.结果 与野生型小鼠相比,ob/ob小鼠椎间盘HE染色表现为椎间盘组织的胶原结构紊乱、髓核碎裂、椎间盘高度降低,免疫组化检测显示Ⅱ型胶原、蛋白聚糖表达减少,Real-time PCR检测显示Ⅱ型胶原、蛋白聚糖基因表达下调而Ⅹ型胶原基因表达上调,差异有统计学意义(P<0.05).结论活体内瘦素缺乏可能加速小鼠椎间盘退变.%Objective To explore the possible role of leptin in intervertebral disc degeneration. Methods The interver-tebral discs of 6-month-old male ob/ob mice ( lack-leptin mice ) and wild type mice ( C57BL mice ) were histologically observed by HE staining. The expression of collagen II and aggrecan were detected by immunohistochemistry. And the gene expression of collagen II , collagen X and aggrecan were measured by Real-time PCR. Results HE staining results showed collagen disorders, fragmentation of nucleus pulposus, and decreased height of intervertebral disc in ob/ob mice. Compare with the wild type mice, there were decreased protein level of collagen II and aggrecan, downregulated mRNA expression of collagen II and aggrecan, and upregulated mRNA expression of collagen X in ob/ob mice. There was significant difference of the changes between wild type mice and ob/ob mice ( P<0.05 ). Conclusion In vivo, lack of leptin may accelerate intervertebral disc degeneration in mice.

  17. Genetic Alterations in Intervertebral Disc Disease

    Directory of Open Access Journals (Sweden)

    Nikolay L. Martirosyan

    2016-11-01

    Full Text Available Background: Intervertebral disc degeneration (IVDD is considered a multifactorial disease. The last two decades of research strongly demonstrate that genetic factors contribute about 75% of the IVDD etiology. Recent total genome sequencing studies have shed light on the various single nucleotide polymorphisms (SNPs that are associated with IVDD.Aim: This review explores and presents updated information about the diversity of genetic factors in the inflammatory, degradative, homeostatic, and structural systems involved in the IVDD.Results: SNPs in the genes coding for structural proteins linked with IVDD or disc bulging include the Sp1 polymorphism of COL1A1, Trp3 polymorphism of COL9A3, several polymorphisms of COL11A1 and COL11A2, and a variable number tandem repeat polymorphism of ACAN. The rs4148941 SNP of CHST3 coding for an aggrecan sulfation enzyme is also associated with IVDD. The FokI, TaqI, and ApaI SNPs of the vitamin D receptor gene that is involved in chondrocyte functioning are also associated with IVDD. SNPs relevant to cytokine imbalance in IVDD include 889C/T of IL1a and 15T/A, as well as other SNPs (rs1800795, rs1800796, and rs1800797, of IL6, with effects limited to certain genders and populations. SNPs in collagenase genes include -1605G/D (guanine insertion/deletion of MMP1, -1306C/T of MMP2, -1562C/T and a 5-adenosine (5A variant (in the promotor region of MMP3, -1562C/T of MMP9, and -378T/C of MMP-14. SNPs in aggrecanase genes include 1877T/U of ADAMTS-4 and rs162509 of ADAMTS-5. Among the apoptosis-mediating genes, 1595T/C of the caspase 9 gene, 1525A/G and 1595T/C of the TRAIL gene, and 626C/G of the death receptor 4 gene (DR4 are SNPs associated with IVDD. Among the growth factors involved in disc homeostasis, the rs4871857 SNP of GDF5 was associated with IVDD. VEGF SNPs -2578C/A and -634G/C could foster neovascularization observed in IVDD.Conclusion: Improved understanding of the numerous genetic variants behind various

  18. A method for quantitative measurement of lumbar intervertebral disc structures

    DEFF Research Database (Denmark)

    Tunset, Andreas; Kjær, Per; Samir Chreiteh, Shadi

    2013-01-01

    There is a shortage of agreement studies relevant for measuring changes over time in lumbar intervertebral disc structures. The objectives of this study were: 1) to develop a method for measurement of intervertebral disc height, anterior and posterior disc material and dural sac diameter using MRI...

  19. Mechanisms for mechanical damage in the intervertebral disc annulus fibrosus.

    Science.gov (United States)

    Iatridis, J C James C; ap Gwynn, Iolo

    2004-08-01

    Intervertebral disc degeneration results in disorganization of the laminate structure of the annulus that may arise from mechanical microfailure. Failure mechanisms in the annulus were investigated using composite lamination theory and other analyses to calculate stresses in annulus layers, interlaminar shear stress, and the region of stress concentration around a fiber break. Scanning electron microscopy (SEM) was used to evaluate failure patterns in the annulus and evaluate novel structural features of the disc tissue. Stress concentrations in the annulus due to an isolated fiber break were localized to approximately 5 microm away from the break, and only considered a likely cause of annulus fibrosus failure (i.e., radial tears in the annulus) under extreme loading conditions or when collagen damage occurs over a relatively large region. Interlaminar shear stresses were calculated to be relatively large, to increase with layer thickness (as reported with degeneration), and were considered to be associated with propagation of circumferential tears in the annulus. SEM analysis of intervertebral disc annulus fibrosus tissue demonstrated a clear laminate structure, delamination, matrix cracking, and fiber failure. Novel structural features noted with SEM also included the presence of small tubules that appear to run along the length of collagen fibers in the annulus and a distinct collagenous structure representative of a pericellular matrix in the nucleus region.

  20. Effect of collagen fibre orientation on intervertebral disc torsion mechanics.

    Science.gov (United States)

    Yang, Bo; O'Connell, Grace D

    2017-07-21

    The intervertebral disc is a complex fibro-cartilaginous material, consisting of a pressurized nucleus pulposus surrounded by the annulus fibrosus, which has an angle-ply structure. Disc injury and degeneration are noted by significant changes in tissue structure and function, which significantly alters stress distribution and disc joint stiffness. Differences in fibre orientation are thought to contribute to changes in disc torsion mechanics. Therefore, the objective of this study was to evaluate the effect of collagen fibre orientation on internal disc mechanics under compression combined with axial rotation. We developed and validated a finite element model (FEM) to delineate changes in disc mechanics due to fibre orientation from differences in material properties. FEM simulations were performed with fibres oriented at [Formula: see text] throughout the disc (uniform by region and fibre layer). The initial model was validated by published experimental results for two load conditions, including [Formula: see text] axial compression and [Formula: see text] axial rotation. Once validated, fibre orientation was rotated by [Formula: see text] or [Formula: see text] towards the horizontal plane, resulting in a decrease in disc joint torsional stiffness. Furthermore, we observed that axial rotation caused a sinusoidal change in disc height and radial bulge, which may be beneficial for nutrient transport. In conclusion, including anatomically relevant fibre angles in disc joint FEMs is important for understanding stress distribution throughout the disc and will be important for understanding potential causes for disc injury. Future models will include regional differences in fibre orientation to better represent the fibre architecture of the native disc.

  1. A method for quantifying intervertebral disc signal intensity on T2-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nagashima, Masaki [Dept. of Orthopaedic Surgery, Keio Univ. School of Medicine, Tokyo (Japan); Dept. of Orthopaedic Surgery, Kitasato Univ. Kitasato Inst. Hospital, Tokyo (Japan); Abe, Hitoshi [Dept. of Orthopaedic Surgery, Kitasato Univ. Kitasato Inst. Hospital, Tokyo (Japan)], E-mail: hit-abe@insti.kitasato-u.ac.jp; Amaya, Kenji [Graduate School of Information Science and Engineering, Tokyo Inst. of Technology, Tokyo (Japan); Matsumoto, Hideo [Inst. for Integrated Sports Medicine, Keio Univ. School of Medicine, Tokyo (Japan); Yanaihara, Hisashi [Dept. of Diagnostic Radiology, Kitasato Univ. Kitasato Inst. Hospital, Tokyo (Japan); Nishiwaki, Yuji [Dept. of Environmental and Occupational Health, Toho Univ. School of Medicine, Tokyo (Japan); Toyama, Yoshiaki; Matsumoto, Morio [Dept. of Orthopaedic Surgery, Keio Univ. School of Medicine, Tokyo (Japan)

    2012-11-15

    Background Quantification of intervertebral disc degeneration based on intensity of the nucleus pulposus in magnetic resonance imaging (MRI) often uses the mean intensity of the region of interest (ROI) within the nucleus pulposus. However, the location and size of ROI have varied in different reports, and none of the reported methods can be considered fully objective. Purpose To develop a more objective method of establishing ROIs for quantitative evaluation of signal intensity in the nucleus pulposus using T2-weighted MRI. Material and Methods A 1.5-T scanner was used to obtain T2-weighted mid-sagittal images. A total of 288 intervertebral discs from 48 patients (25 men, 23 women) were analyzed. Mean age was 47.4 years (range, 17-69 years). All discs were classified into five grades according to Pfirrmann et al. Discs in grades I and II were defined as bright discs, and discs in grades IV and V were defined as dark discs. Eight candidate methods of ROI determination were devised. The method offering the highest degree of discrimination between bright and dark discs was investigated among these eight methods. Results The method with the greatest degree of discrimination was as follows. The quadrangle formed by anterior and posterior edges of the upper and lower end plates in contact with the intervertebral disc to be measured was defined as the intervertebral area. A shape similar to the intervertebral area but with one-quarter the area was drawn. The geometrical center of the shape was matched to the center of intensity, and this shape was then used as the ROI. Satisfactory validity and reproducibility were obtained using this method. Conclusion The present method offers adequate discrimination and could be useful for longitudinal tracking of intervertebral disc degeneration with sufficient reproducibility.

  2. Classification of the lumbar disc degeneration using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Hirotoshi; Shinomiya, Kenichi; Okamoto, Akihiko; Muto, Naoko; Furuya, Kotaro (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1992-11-01

    Magnetic resonance (MR) imaging has been performed in consecutive 114 patients with a chief complaint of lumbar pain. A retrospective review of MR images of a total of 570 lumbar vertebrae from these patients were done to examine lumbar disc degeneration. According to the MR intensity of nucleus pulposus on T2-wighted sagittal images, lumbar disc degeneration was graded on a scale of 0-4: 0=uniform hyperintensity; 1=slight hypointensity; 2=centrally band-like hypointensity with marginal hyperintensity; 3=irregular hypointensity in both the central and marginal sites; 4=uniform hypointensity. Lumbar disc degeneration was observed in 76%; and it was rapidly increased in frequency in the 30 or older age groups. Of 570 vertebrae, 51 (8.9%) had narrowing of intervertebral cavity. For these vertebrae, a mean score of lumbar disc degeneration was 3.1. Lumbar disc herniation was seen in 93 vertebrae, with a mean score of lumbar disc degeneration being 3.07. Changes in vertebral body marrow were seen in 14 vertebrae (2.5%), in which a mean score of intervertebral disc degeneration was 3.71. (N.K.).

  3. Aquaporin-1 and Aquaporin-3 Expressions in the Intervertebral Disc of Rats with Aging

    Directory of Open Access Journals (Sweden)

    Mustafa Sarsılmaz

    2012-12-01

    Full Text Available Objective: The intervertebral disc (IVD undergoes biochemical and morphologic degenerative changes during the process of aging. Aquaporins (AQPs are a family of water channel proteins that facilitate water and small solute movement in tissues and may have a potential role in the aging degeneration of IVDs. One of the important problems in understanding disc degeneration is to find cellular molecules which contribute to the pathogenesis of IVDs. XThe aim of this study was to demonstrate the expression of aquaporin 1 and 3 in nucleus pulposus (NP, annulus fibrosus (AF cells of rat lumbar intervertebral discs from both young and aged animals using immunohistochemistry.Material and Methods: Twenty Wistar-albino rats were included in the study. The rats were separated into two groups: 2-month-old rats (n=10 as the young group, 18-month-old rats (n=10 as the old group. The intervertebral disc tissues obtained from the lumbar spine (L1–L4, 4 discs were used for immunohistochemical staining of AQP-1 and 3. Results: This study demonstrated that AQP-1 and AQP-3 immunoreactivity significantly decreased in NP and AF of aged rats compared to the young rats. Conclusion: We suggest that AQP-1 and 3 may contribute to the age related degeneration of the intervertebral disc.

  4. Treatment of intervertebral disc degeneration by bone marrow mesenchymal stem cell transplantation%骨髓间充质干细胞治疗椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    赵泽; 张洋; 王娟; 陈长青

    2015-01-01

    Objective To review the research and progress of treating intervertebral disc degeneration ( IDD) by using BMSCs transplantation, and provide theoretical basis for further basic researches. Methods CNKI database and ISI Web of Knowledge database from 2000 to 2014 were retrieved by the first author with the key words of " bone marrow mesenchymal stem cells (BMSCs), cell therapy, intervertebral disc degeneration ( IDD )" in Chinese and in English, respectively. The biological characteristics and cultivation of BMSCs, the influence factors of BMSCs differentiate into intervertebral disc cells and cell therapy for IDD by BMSCs transplantation in vivo were summarized. Results We can obtain enough amount of BMSCs. BMSCs has low immunogenicity and good differentiation potential, and these make BMSCs a very good seed cell source for cell therapy of IDD. Under the condition of improving the micro environment of IDD, or a special support material system for cell cultivation, or the induction of cytokines, or co-cultured with intervertebral disc cell, BMSCs can differentiate into nucleus pulposus cells, express proteoglycan and collagen-Ⅱ. Whether autograft or allograft, even heterogeneous, BMSCs can survive and propagate in degenerative intervertebral disc for long-term, promote the secretion of intervertebral disc cells matrix. Conclusions As the study of BMSCs and cellular therapy, a lot of work has been done on treating IDD by using BMSCs transplantation and we have made some achievements. Although using BMSCs transplantation in the treatment of IDD also shows huge application prospect, there are still many problems need to be solved before applying it in clinical treatment.%目的:总结骨髓间充质干细胞(BMSCs)治疗椎间盘退变(IDD)的相关研究成果,为BMSCs 治疗 IDD 的临床应用提供理论基础。方法计算机检索 CNKI 数据库和 ISI Web of Knowledge数据库,限定时间为2000—2014年,中英文检索词分别为“骨髓间充质干

  5. Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

    Directory of Open Access Journals (Sweden)

    SCW Chan

    2010-06-01

    Full Text Available Severe intervertebral disc (IVD degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of the behaviour of disc cells during cryopreservation, as well as how to maximize their survival, such that disc graft properties can be preserved. Here, we report on the effect of alterations in cooling rates, cryoprotective agents (CPAs, and duration of pre-cryopreservation incubation in CPA on cellular activity in whole porcine lumbar discs. Our results indicated that cooling rates of -0.3°C/min and -0.5°C /min resulted in the least loss of metabolic activity in nucleus pulposus (NP and annulus fibrosus (AF respectively, while metabolic activity is best maintained by using a combination of 10% dimethylsulphoxide (DMSO and 10% propylene-glycol (PG as CPA. By the use of such parameters, metabolic activity of the NP and the AF cells could be maintained at 70% and 45%, respectively, of that of the fresh tissue. Mechanical testing and histological evaluation showed no significant differences in mechanical properties or alterations in disc structure compared to fresh discs. Despite the limitations of the animal model, our findings provide a framework for establishing an applicable cryopreservation protocol for human disc allografts or tissue-engineered disc constructs.

  6. Prognosis of intervertebral disc loss from diagnosis of degenerative disc disease

    Science.gov (United States)

    Li, S.; Lin, A.; Tay, K.; Romano, W.; Osman, Said

    2015-03-01

    Degenerative Disc Disease (DDD) is one of the most common causes of low back pain, and is a major factor in limiting the quality of life of an individual usually as they enter older stages of life, the disc degeneration reduces the shock absorption available which in turn causes pain. Disc loss is one of the central processes in the pathogenesis of DDD. In this study, we investigated whether the image texture features quantified from magnetic resonance imaging (MRI) could be appropriate markers for diagnosis of DDD and prognosis of inter-vertebral disc loss. The main objective is to use simple image based biomarkers to perform prognosis of spinal diseases using non-invasive procedures. Our results from 65 subjects proved the higher success rates of the combination marker compared to the individual markers and in the future, we will extend the study to other spine regions to allow prognosis and diagnosis of DDD for a wider region.

  7. Matrix-assisted cell transfer for intervertebral disc cell therapy.

    Science.gov (United States)

    Bertram, Helge; Kroeber, Markus; Wang, Haili; Unglaub, Frank; Guehring, Thorsten; Carstens, Claus; Richter, Wiltrud

    2005-06-17

    Cell therapy seems to be a promising way to reconstitute degenerated discs. We elucidate the basic aspects of intervertebral disc (IVD) cell therapy to estimate its potential in disc regeneration. Cell transfer efficiency and survival was quantified by luciferase expression after injection of recombinant cells into healthy, nucleotomized or mechanically degenerated rabbit IVDs in vitro, in situ or in vivo. A two-component fibrin matrix was adapted to allow injection of a fluid cell suspension that quickly polymerizes in IVDs. Thirty-five to fifty percent of matrix injected cells remained in the nucleus and transition zone in contrast to a rapid loss of medium-injected cells. Nucleotomy, which reduces intradiscal pressure, was crucial to the survival of the transferred cells over 3 days and nutritional enrichment of the fibrin matrix with potent biomolecules from serum significantly enhanced cell viability. In conclusion, advanced matrix substitutes are needed for efficient transfer and improved cell survival in the low-nutrient intradiscal environment to further improve disc cell therapy.

  8. A biochemical/biophysical 3D FE intervertebral disc model.

    Science.gov (United States)

    Schroeder, Y; Huyghe, J M; van Donkelaar, C C; Ito, K

    2010-10-01

    Present research focuses on different strategies to preserve the degenerated disc. To assure long-term success of novel approaches, favorable mechanical conditions in the disc tissue are essential. To evaluate these, a model is required that can determine internal mechanical conditions which cannot be directly measured as a function of assessable biophysical characteristics. Therefore, the objective is to evaluate if constitutive and material laws acquired on isolated samples of nucleus and annulus tissue can be used directly in a whole-organ 3D FE model to describe intervertebral disc behavior. The 3D osmo-poro-visco-hyper-elastic disc (OVED) model describes disc behavior as a function of annulus and nucleus tissue biochemical composition, organization and specific constituent properties. The description of the 3D collagen network was enhanced to account for smaller fibril structures. Tissue mechanical behavior tests on isolated nucleus and annulus samples were simulated with models incorporating tissue composition to calculate the constituent parameter values. The obtained constitutive laws were incorporated into the whole-organ model. The overall behavior and disc properties of the model were corroborated against in vitro creep experiments of human L4/L5 discs. The OVED model simulated isolated tissue experiments on confined compression and uniaxial tensile test and whole-organ disc behavior. This was possible, provided that secondary fiber structures were accounted for. The fair agreement (radial bulge, axial creep deformation and intradiscal pressure) between model and experiment was obtained using constitutive properties that are the same for annulus and nucleus. Both tissue models differed in the 3D OVED model only by composition. The composition-based modeling presents the advantage of reducing the numbers of material parameters to a minimum and to use tissue composition directly as input. Hence, this approach provides the possibility to describe internal

  9. Biomaterials for intervertebral disc regeneration : Past performance and possible future strategies

    NARCIS (Netherlands)

    Schutgens, E. M.; Tryfonidou, M. A.; Smit, T. H.; Cumhur Öner, F.; Krouwels, A.; Ito, K.; Creemers, L. B.

    2015-01-01

    Intervertebral disc (IVD) degeneration is associated with most cases of cervical and lumbar spine pathologies, amongst which chronic low back pain has become the number one cause of loss of quality-adjusted life years. In search of alternatives to the current less than optimal and usually highly inv

  10. Biomaterials for intervertebral disc regeneration : Past performance and possible future strategies

    NARCIS (Netherlands)

    Schutgens, E. M.; Tryfonidou, M. A.; Smit, T. H.; Cumhur Öner, F.; Krouwels, A.; Ito, K.; Creemers, L. B.

    2015-01-01

    Intervertebral disc (IVD) degeneration is associated with most cases of cervical and lumbar spine pathologies, amongst which chronic low back pain has become the number one cause of loss of quality-adjusted life years. In search of alternatives to the current less than optimal and usually highly

  11. [Stimulation of degenerative changes in the intervertebral disc through axial compression. Radiologic, histologic and biomechanical research in an animal model].

    Science.gov (United States)

    Unglaub, F; Lorenz, H; Nerlich, A; Richter, W; Kroeber, M W

    2003-01-01

    Degeneration of the intervertebral disc is a common disease in the adults, especially at advanced age. A causal therapy is not known, but the progress in new therapeutic strategies, for example in tissue engineering, shows new possibilities. The goal of our study was to develop a new animal model that stimulates a load induced degeneration of the disc. We used the New Zealand rabbit, because morphology is similar to the human intervertebral disc. The degeneration was induced by axial compression of the disc L4 - L5 with an external fixateur. After different loading intervals, the animals were sacrified and the discs examined by radiology, histology, apoptosis and biomechanical testing. Radiography showed a significant decrease of the disc thickness in all loaded groups. Morphologically the intervertebral discs of loaded rabbits showed degenerative changes which were comparable to those in humans. A significantly increased number of dead cells in the annulus occurred after 14 and 28 days loading compared to the controls. The bending stress measured as the load to failure was not significantly different between the unloaded discs and the 28 days loaded discs. The results show that our animal modell can create degeneration. Four weeks compression leads to significant degeneration. Degeneration of the discs persisted in animals that were allowed a recovery time of 28 days after 28 days of loading.

  12. Magnetic resonance imaging of the cervical spine: Frequency of degenerative changes in the intervertebral disc with relation to age

    Energy Technology Data Exchange (ETDEWEB)

    Abdulkarim, J.A.; Dhingsa, R.; Finlay, D.B.L

    2003-12-01

    AIM: To ascertain the level at which intervertebral disc degeneration of the cervical spine most commonly occurs in each decade from 20-79 years. MATERIALS AND METHODS: Using computer analysis, we retrospectively assessed the mean signal intensity from each cervical disc from T2-weighted spin-echo images in 60 symptomatic patients (10 per decade from the third to eighth inclusive). RESULTS: Age, disc level and interaction between age and level were highly significant predictors for the magnetic resonance imaging (MRI) mean signal intensity from intervertebral discs (p<0.0001 for all three terms). The MRI signals were generally lower as age increased and also for the higher discs (C2-C3, etc). CONCLUSION: In our study we have shown that in younger patients the higher discs are more frequently affected by degeneration than the lower ones. As age increases, the process of degeneration becomes more generalized with less variability between discs.

  13. RESEARCH PROGRESS OF CELLULAR SENESCENCE AND SENESCENT SECRETARY PHENOTYPE IN INTERVERTEBRAL DISC DEGENERATION%细胞老化及老化表型改变在椎间盘退行性变中的研究进展

    Institute of Scientific and Technical Information of China (English)

    王锋; 郑陈静美; 吴小涛

    2012-01-01

    Objective To summarize the role of cellular senescence and senescent secretary phenotype in the intervertebral disc (IVD) degeneration. Methods Relevant articles that discussed the roles of cellular senescence in the IVD degeneration were extensively reviewed, and retrospective and comprehensive analysis was performed. The senescent phenomenon during IVD degeneration, senescent secretary phenotype of the disc cells, senescent pathways within the IVD microenvironment, as well as the anti-senescent approaches for IVD regeneration were systematically reviewed. Results During aging and degeneration, IVD cells gradually and/or prematurely undergo senescence by activating p53-p21-retinoblastoma (RB) or pl6INK4A-RB senescent pathways. The accumulation of senescent cells not only decreases the self-renewal ability of IVD, but also deteriorates the disc microenvironment by producing more inflammatory cytokines and matrix degrading enzymes. More specific senescent biomarkers are required to fully understand the phenotype change of senescent disc cells during IVD degeneration. Molecular analysis of the senescent disc cells and their intracellular signaling pathways are needed to get a safer and more efficient anti-senescence strategy for IVD regeneration. Conclusion Cellular senescence is an important mechanism by which IVD cells decrease viabil ity and degenerate biological behaviors, which provide a new thinking to understand the pathogenesis of IVD degeneration.%目的 综述细胞老化及老化表型改变在椎间盘退行性变中的研究进展. 方法 查阅椎间盘退行性变领域细胞老化相关的国内外文献并回顾分析,综述椎间盘细胞的老化现象、老化表型改变、老化信号激活与椎间盘退行性变的相互关系,评价抗老化治疗对椎间盘退行性变的修复作用. 结果 随着机体衰老与椎间盘退行性变,椎间盘细胞通过选择性地激活p53-p21-视网膜母细胞瘤(retinoblastoma,RB)或p16INK4A-RB信号

  14. Acute pyogenic discitis in a degenerative intervertebral disc in an adult

    Directory of Open Access Journals (Sweden)

    Masamitsu Tanaka

    2010-08-01

    Full Text Available Masamitsu Tanaka1,2, Hiroshi Shimizu2, Yoshiyuki Yato1, Takashi Asazuma1, Koichi Nemoto11Department of Orthopedic Surgery, National Defense Medical College, Tokorozawa, Saitama; 2Department of Orthopedic Surgery, Self Defense Force Fukuoka Hospital, Kasuga, Fukuoka, JapanAbstract: A 35-year-old male who had been receiving conservative treatment for L4 isthmic spondylolisthesis suffered from pyogenic spondylodiscitis in the degenerative L4/L5 intervertebral disc space, which could be identified by comparison with previous images. Symptoms improved with conservative antibiotic treatment. Neovascularization may occur in the annulus fibrosus of a degenerative intervertebral disc, which may increase the risk of hematogenous infection, leading to “discitis” even in adults.Keywords: spondylodiscitis, spondylitis, discitis, isthmic spondylolisthesis, spondylolysis, intervertebral disc degeneration

  15. Biomechanical analysis of the camelid cervical intervertebral disc

    Directory of Open Access Journals (Sweden)

    Dean K. Stolworthy

    2015-01-01

    Full Text Available Chronic low back pain (LBP is a prevalent global problem, which is often correlated with degenerative disc disease. The development and use of good, relevant animal models of the spine may improve treatment options for this condition. While no animal model is capable of reproducing the exact biology, anatomy, and biomechanics of the human spine, the quality of a particular animal model increases with the number of shared characteristics that are relevant to the human condition. The purpose of this study was to investigate the camelid (specifically, alpaca and llama cervical spine as a model of the human lumbar spine. Cervical spines were obtained from four alpacas and four llamas and individual segments were used for segmental flexibility/biomechanics and/or morphology/anatomy studies. Qualitative and quantitative data were compared for the alpaca and llama cervical spines, and human lumbar specimens in addition to other published large animal data. Results indicate that a camelid cervical intervertebral disc (IVD closely approximates the human lumbar disc with regard to size, spinal posture, and biomechanical flexibility. Specifically, compared with the human lumbar disc, the alpaca and llama cervical disc size are approximately 62%, 83%, and 75% with regard to area, depth, and width, respectively, and the disc flexibility is approximately 133%, 173%, and 254%, with regard to range of motion (ROM in axial-rotation, flexion-extension, and lateral-bending, respectively. These results, combined with the clinical report of disc degeneration in the llama lower cervical spine, suggest that the camelid cervical spine is potentially well suited for use as an animal model in biomechanical studies of the human lumbar spine.

  16. Determination of the intervertebral disc space from CT images of the lumbar spine

    Science.gov (United States)

    Korez, Robert; Å tern, Darko; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2014-03-01

    Degenerative changes of the intervertebral disc are among the most common causes of low back pain, where for individuals with significant symptoms surgery may be needed. One of the interventions is the total disc replacement surgery, where the degenerated disc is replaced by an artificial implant. For designing implants with good bone contact and continuous force distribution, the morphology of the intervertebral disc space and vertebral body endplates is of considerable importance. In this study we propose a method for the determination of the intervertebral disc space from three-dimensional (3D) computed tomography (CT) images of the lumbar spine. The first step of the proposed method is the construction of a model of vertebral bodies in the lumbar spine. For this purpose, a chain of five elliptical cylinders is initialized in the 3D image and then deformed to resemble vertebral bodies by introducing 25 shape parameters. The parameters are obtained by aligning the chain to the vertebral bodies in the CT image according to image intensity and appearance information. The determination of the intervertebral disc space is finally achieved by finding the planes that fit the endplates of the obtained parametric 3D models, and placing points in the space between the planes of adjacent vertebrae that enable surface reconstruction of the intervertebral disc space. The morphometric analysis of images from 20 subjects yielded 11:3 +/- 2:6, 12:1 +/- 2:4, 12:8 +/- 2:0 and 12:9 +/- 2:7 cm3 in terms of L1-L2, L2-L3, L3-L4 and L4-L5 intervertebral disc space volume, respectively.

  17. Parametric T2 and T2* mapping techniques to visualize intervertebral disc degeneration in patients with low back pain: initial results on the clinical use of 3.0 Tesla MRI

    Energy Technology Data Exchange (ETDEWEB)

    Welsch, Goetz Hannes [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); University of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Trattnig, Siegfried; Goed, Sabine; Stelzeneder, David [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); Paternostro-Sluga, Tatjana [Medical University of Vienna, Department of Physical Therapy, Vienna (Austria); Bohndorf, Klaus [Klinikum Augsburg, Department of Radiology, Augsburg (Germany); Mamisch, Tallal Charles [Medical University of Vienna, MR Center - High Field MR, Department of Radiology, Vienna (Austria); University of Berne, Department of Orthopedic Surgery, Berne (Switzerland)

    2011-05-15

    To assess, compare and correlate quantitative T2 and T2* relaxation time measurements of intervertebral discs (IVDs) in patients suffering from low back pain, with respect to the IVD degeneration as assessed by the morphological Pfirrmann Score. Special focus was on the spatial variation of T2 and T2* between the annulus fibrosus (AF) and the nucleus pulposus (NP). Thirty patients (mean age: 38.1 {+-} 9.1 years; 20 female, 10 male) suffering from low back pain were included. Morphological (sagittal T1-FSE, sagittal and axial T2-FSE) and biochemical (sagittal T2- and T2* mapping) MRI was performed at 3 Tesla covering IVDs L1-L2 to L5-S1. All IVDs were morphologically classified using the Pfirrmann score. Region-of-interest (ROI) analysis was performed on midsagittal T2 and T2* maps at five ROIs from anterior to posterior to obtain information on spatial variation between the AF and the NP. Statistical analysis-of-variance and Pearson correlation was performed. The spatial variation as an increase in T2 and T2* values from the AF to the NP was highest at Pfirmann grade I and declined at higher Pfirmann grades II-IV (p < 0.05). With increased IVD degeneration, T2 and T2* revealed a clear differences in the NP, whereas T2* was additionally able to depict changes in the posterior AF. Correlation between T2 and T2* showed a medium Pearson's correlation (0.210 to 0.356 [p < 0.001]). The clear differentiation of IVD degeneration and the possible quantification by means of T2 and fast T2* mapping may provide a new tool for follow-up therapy protocols in patients with low back pain. (orig.)

  18. Propionibacterium acnes, Coagulase-Negative Staphylococcus, and the “Biofilm-like” Intervertebral Disc

    Science.gov (United States)

    Coscia, Michael F.; Denys, Gerald A.; Wack, Matthew F.

    2016-01-01

    Study Design. Patients scheduled for spinal surgery were screened prospectively for a microbial presence associated with intervertebral disc specimens. Inclusion was limited to patients requiring surgery for any of five conditions: study patients with cervical spine intervertebral herniation (IVH), lumbar spine IVH, lumbar spine discogenic pain, and control patients with idiopathic scoliosis/Scheurermann's kyphosis or trauma/neuromuscular deformity. Exclusion criteria included ongoing systemic infection, abnormal pre-operative white cell counts, documented or suspected spinal infection, or previous surgery to the involved disc. Objective. The aim of this study was to test for an association between the presence of a bacterial entity in operated discs and a diagnosis of pathologic disc disease. Summary of Background Data. An association has been described between microbial colonization and progressive intervertebral disc degeneration in 36 herniation patients undergoing microdiscectomies. A total of 19 patients had positive cultures on long-term incubation, with Propionibacterium acnes present in 84% of discs. Materials and Methods. Discs were harvested during surgery, using strict sterile technique. Each disc was divided, with half the sample sealed in a sterile, commercially prepared anaerobic culture transport container, and half fixed in formalin. Live specimens were cultured for bacteria at a university-affiliated laboratory in a blinded fashion. Fixed pathologic specimens were gram-stained and read by a board-certified pathologist. Results. A total of 169 intervertebral discs from 87 patients were evaluated (46 males, 41 females). Positive cultures were noted in 76 of 169 discs (45%), with 34 discs positive for P. acnes and 30 discs positive for Staphylococcus. No pathologic evidence was seen of microorganisms, acute or chronic inflammation, or infection. Pooling the IVH and discogenic pain patients and contrasting them with control patients showed a

  19. Mesenchymal stem cell regeneration of degenerated intervertebral discs:current status%间充质干细胞移植修复椎间盘退变的研究进展

    Institute of Scientific and Technical Information of China (English)

    王彦强; 张光武

    2014-01-01

    Low back pain, strongly associated with intervertebral disc (IVD) degeneration, affects a large proportion of the population and has major social and economic costs. Current first-line therapies for IVD degeneration such as physical therapy and spinal fusion address symptoms, but do not treat the underlying degeneration. As such, efforts are being directed towards development of therapies aimed at alleviating pain through the restoration of the IVD function. The use of tissue engineering to treat IVD degeneration provides an opportunity to correct the pathological process. Adult mesenchymal stem cells (MSCs), capable of differentiating down the discogenic lineage, have shown promise as a suitable cell source for IVD tissue engineering. However, the use of MSCs for IVD degeneration is still at the stage of preclinical and Phase 1 studies, a number of factors remain to be addressed, including understanding whether and how the MSCs survive and thrive in the hostile microenvironment of the degenerated IVD, identification of suitable biomaterials for cell implantation, and ensuring the safety of MSCs implantation.%下腰痛影响了不少人的生活和工作,造成沉重的社会、经济负担。下腰痛最主要的原因是椎间盘退变,目前临床上治疗椎间盘退变的方法有保守治疗和椎体融合等手术治疗,这些方法可以缓解症状但是不针对退变的原因。通过恢复椎间盘功能来缓解疼痛的方法受到人们关注,利用组织工程学方法逆转椎间盘退变已经实现。成体间充质干细胞可以分化为髓核样细胞为椎间盘组织工程提供了种子细胞。目前这种方法初步应用于临床前研究,但是许多问题有待进一步解决,例如间充质干细胞在宿主椎间盘中如何生存和增殖,移植过程中是否需要生物支架以及移植的安全性等。

  20. Innervation of ''painful'' lumbar discs

    NARCIS (Netherlands)

    Coppes, MH; Marani, E; Thomeer, RTWM; Groen, GJ

    1997-01-01

    Study Design. The authors investigated the innervation of discographically confirmed degenerated and ''painful'' human intervertebral discs. Objective. To determine the type and distribution patterns of nerve fibers present in degenerated human intervertebral discs. Summary of Background Data. The i

  1. Evaluation of apoptotic cell death in normal and chondrodystrophic canine intervertebral discs

    Directory of Open Access Journals (Sweden)

    Marie Klauser

    2012-02-01

    Full Text Available Disc degeneration occurs commonly in dogs. A variety of factors is thought to contribute an inappropriate disc matrix that isolate cells in the disc and lead to apoptosis. Disc herniation with radiculopathy and discogenic pain are the results of the degenerative process. The objective of this prospective study was to determine the extent of apoptosis in intact and herniated intervertebral discs of chondrodystrophic dogs and non-chondrodystrophic dogs. In addition, the nucleus pulposus (NP was histologically compared between non-chondrodystrophic and chondrodystrophic dogs. Thoracolumbar intervertebral discs and parts of the extruded nucleus pulposus were harvested from 45 dogs. Samples were subsequently stained with haematoxylin-eosin and processed to detect cleaved caspase-3 and poly(ADP-ribose polymerase. A significant greater degree of apoptosis was observed in herniated NPs of chondrodystrophic dogs compared to non- chondrodystrophic dogs with poly (ADP-ribose polymerase and cleaved caspase- 3 detection. Within the group of chondrodystrophic dogs, dogs with an intact disc and younger than 6 years showed a significant lower incidence of apoptosis in the NP compared to the herniated NP of chondrodystrophic dogs. The extent of apoptosis in the annulus fibrosus was not different between the intact disc from chondrodystrophic and non- chondrodystrophic dogs. An age-related increase of apoptotic cells in NP and annulus fibrosus was found in the intact non-herniated intervertebral discs. Histologically, absence of notochordal cells and occurrence of chondroid metaplasia were observed in the nucleus pulposus of chondrodystrophic dogs. As a result, we found that apoptosis plays a role in disc degeneration in chondrodystrophic dogs.

  2. MRI and discography in traumatic intervertebral disc lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ghanem, Nadir; Uhl, Markus; Elgeti, Florian; Pache, Gregor; Kotter, Elmar; Langer, Mathias [University Hospital Freiburg, Departments of Diagnostic Radiology, Freiburg (Germany); Mueller, Christoph; Markmiller, Max [University Hospital Freiburg, Traumatology, Freiburg (Germany)

    2006-11-15

    In this study we evaluated magnetic resonance imaging (MRI) in trauma patients for assessing traumatised adjacent discs of fractured vertebrae before dorsoventral stabilisation. In a prospective study, MRI of 54 discs was performed with a 1.5-T MRI unit. The preoperative MRI with sagittal T1-W-SE and T2-W-TSE was compared to intraoperative discography, which was carried out on both intervertebral discs adjacent to the fractured vertebrae. Signal alterations, morphological changes in the adjacent discs, fractured vertebrae and associated ligament injuries were evaluated. In 47/54 (87%) of the intervertebral discs, the results of both imaging findings were concordant. The discs adjoining vertebral fractures were normal in 18 cases. Regarding the positive concordant imaging findings, MRI and discography revealed traumatised adjacent cranial and caudal discs in 22 discs. In 7 cases, only the cranial adjacent disc was affected. Moreover, 17 cases of intradiscal bleeding, 13 intraosseous herniations into the fractured vertebrae and 20 anuluar tears were visualised in MRI. Associated ligament injuries were detected in 18 cases. Findings were discordant in eight discs. In six discs, MRI was abnormal, demonstrating signal alterations suggestive of positive imaging findings, whereas discography demonstrated no disc injury. MRI failed to detect disc injury in two discs, whereas discography was positive, showing an irregular intradiscal contrast media distribution. MRI, as a non-invasive method for assessing fractures of the thoraco-lumbar spine, may detect traumatised adjacent intervertebral discs. MRI is superior to intraoperative discography. The performance of MRI of the thoraco-lumbar spine is recommended before dorsoventral stabilisation in trauma patients, as it can reveal additional preoperative information such as fractures, disc and associated ligament injuries. (orig.)

  3. Intervertebral disc repair with activated nucleus pulposus cell transplantation: a three-year, prospective clinical study of its safety

    Directory of Open Access Journals (Sweden)

    J Mochida

    2015-03-01

    Full Text Available Degeneration of the lumbar intervertebral discs is irreversible, with no treatment currently available. Building upon experimental studies that demonstrated the importance of the nucleus pulposus (NP in preserving disc structure, we demonstrated that reinsertion of NP cells slowed further disc degeneration and that direct cell-to-cell contact co-culture with mesenchymal stromal cells (MSCs significantly upregulated the viability of NP cells in basic and pre-clinical studies in vitro and in vivo using animal models and human cells. Here, we report a 3-year result of a prospective clinical study, aimed to assess the safety and efficacy of activated NP cell transplantation in the degenerate lumbar intervertebral disc. Candidates were 9 patients aged 20-29 years who had Pfirrmann’s grade III disc degeneration at the level adjacent to the level scheduled for posterior lumbar intervertebral fusion. Viable NP cells from the fused disc were co-cultured in direct contact with autologous bone marrow-derived MSCs. One million activated NP cells were transplanted into the degenerated disc adjacent to the fused level at 7 d after the first fusion surgery. No adverse effects were observed during the 3-year follow-up period. Magnetic resonance imaging did not show any detrimental effects to the transplanted discs and revealed a mild improvement in 1 case. No cases reported any low back pain. Our clinical study confirmed the safety of activated NP cell transplantation, and the findings suggest the minimal efficacy of this treatment to slow the further degeneration of human intervertebral discs.

  4. Mesenchymal stem cell tracking in the intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    Charles Handley; Tony Goldschlager; David Oehme; Peter Ghosh; Graham Jenkin

    2015-01-01

    Low back pain is a common clinical problem, whichleads to significant social, economic and public healthcosts. Intervertebral disc (IVD) degeneration is acceptedas a common cause of low back pain. Initially, thisis characterized by a loss of proteoglycans from thenucleus pulposus resulting in loss of tissue hydrationand hydrostatic pressure. Conservative management,including analgesia and physiotherapy often fails andsurgical treatment, such as spinal fusion, is required. Stemcells offer an exciting possible regenerative approachto IVD disease. Preclinical research has demonstratedpromising biochemical, histological and radiological resultsin restoring degenerate IVDs. Cell tracking provides anopportunity to develop an in-depth understanding ofstem cell survival, differentiation and migration, enablingoptimization of stem cell treatment. Magnetic ResonanceImaging (MRI) is a non-invasive, non-ionizing imagingmodality with high spatial resolution, ideally suited for stemcell tracking. Furthermore, novel MRI sequences have thepotential to quantitatively assess IVD disease, providingan improved method to review response to biologicaltreatment. Superparamagnetic iron oxide nanoparticleshave been extensively researched for the purpose of celltracking. These particles are biocompatible, non-toxicand act as excellent MRI contrast agents. This review willexplore recent advances and issues in stem cell trackingand molecular imaging in relation to the IVD.

  5. Trauma induces apoptosis in human thoracolumbar intervertebral discs

    Directory of Open Access Journals (Sweden)

    Ertel Wolfgang

    2006-05-01

    Full Text Available Abstract Background Vertebral fractures resulting from high energy trauma often comprise the risk of posttraumatic degenerative changes in the affected intervertebral discs (IVD. Particularly in conservatively treated patients, or in cases after implant removal of an exclusively posterior stabilization, consecutive disc degeneration and the associated functional losing of the spinal segment clearly represent detrimental treatment results. In this regard, apoptosis of IVD cells has been suggested to be involved in the critical changes of the extracellular matrix. Methods To investigate whether fractures of the vertebrae induce apoptosis in the affected IVD, disc tissue from patients (n = 17 undergoing open reduction and internal fixation of thoracolumbar spine fractures were analysed in regards to caspase activity, apoptosis-receptor expression levels and gene expression of apoptosis-regulating proteins such as Bax and Bcl-2. Healthy IVD tissue (n = 3 obtained from patients undergoing surgical resection of adjacent vertebrae were used as control samples. Results In contrast to healthy control IVD tissues, samples from traumatic thoracolumbar IVD showed positive TUNEL staining and a significant increase of caspase-3/7 activity. Interestingly, analyses of the initiator caspase-8 and -9 revealed significantly increased activation levels compared to control values, suggesting the coexistent activation of both the extrinsic (receptor-mediated and intrinsic (mitochondria-mediated apoptosis pathway. Accordingly, expression levels of the Fas receptor (FasR mRNA were significantly increased. Although the TNF receptor I (TNFR I was only slightly upregulated, corresponding TNFα from trauma IVD presented significantly increased mRNA expression values. Furthermore, traumatic IVD cells demonstrated significantly reduced expression of the mitochondria-bound anti-apoptotic Bcl-2, thereby maintaining baseline transcriptional levels of the pro-apoptotic Bax

  6. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  7. Development of Ultrasound to Measure In-vivo Dynamic Cervical Spine Intervertebral Disc Mechanics

    Science.gov (United States)

    2015-01-01

    Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Neck pain is pervasive problems in military population...especially in those working in vibrating environments. Previous studies show neck pain is strongly associated with degeneration of Intervertebral Disc (IVD...The capability of dual US to measure C-spine properties in-vivo in simulation environment is currently being tested. Biomechanics finite element(FE

  8. Intervertebral disc extrusion and spinal decompression in a binturong (Arctictis binturong).

    Science.gov (United States)

    Spriggs, Maria; Arble, Jason; Myers, Gwen

    2007-03-01

    A 10-yr-old binturong (Arctictis binturong) developed an acute onset of hind limb paralysis. Neurological examination revealed sensorimotor paraplegia. Myelography and computed tomography demonstrated a ventrolateral extradural compression of the spinal cord centered over the L3-L4 intervertebral disc space. Spinal decompression was performed via hemilaminectomy and excision of degenerate nucleus pulposus, confirmed by histopathologic examination. The binturong regained slight motor function by day 8 postoperatively but succumbed to pancreatitis 19 days postoperatively.

  9. Comparison of two methods for RNA extraction from the nucleus pulposus of intervertebral discs.

    Science.gov (United States)

    Gan, M F; Yang, H L; Qian, J L; Wu, C S; Yuan, C X; Li, X F; Zou, J

    2016-06-03

    RNA extraction from the nucleus pulposus of intervertebral discs has been extensively used in orthopedic studies. We compared two methods for extracting RNA from the nucleus pulposus: liquid nitrogen grinding and enzyme digestion. The RNA was detected by agarose gel electrophoresis, and the purity was evaluated by absorbance ratio using a spectrophotometer. Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) expression was assayed by reverse transcription-polymerase chain reaction (RT-PCR). Thirty human lumbar intervertebral discs were used in this study. The liquid nitrogen-grinding method was used for RNA extraction from 15 samples, and the mean RNA concentration was 491.04 ± 44.16 ng/mL. The enzyme digestion method was used on 15 samples, and the mean RNA concentration was 898.42 ± 38.64 ng/mL. The statistical analysis revealed that there was a significant difference in concentration between the different methods. Apparent 28S, 18S, and 5S bands were detectable in RNA extracted using the enzyme digestion method, whereas no 28S or 18S bands were detected in RNA extracted using the liquid nitrogen-grinding method. The GAPDH band was visible, and no non-specific band was detected in the RT-PCR assay by the enzyme digestion method. Therefore, the enzyme digestion method is an efficient and easy method for RNA extraction from the nucleus pulposus of intervertebral discs for further intervertebral disc degeneration-related studies.

  10. Piperine mediates LPS induced inflammatory and catabolic effects in rat intervertebral disc.

    Science.gov (United States)

    Li, Yan; Li, Kang; Hu, Yiqin; Xu, Bo; Zhao, Jie

    2015-01-01

    Piperine is an exact of the active phenolic component from Black pepper. It has been reported to have many biological activities including anti-oxidant, anti-inflammatory and anti-tumor effects. Intervertebral disc degeneration (IDD) is a degenerative disease closely relate to inflammation of nucleus pulposus (NP) cells. This study aimed to assess the anti-inflammatory and anti-catabolic effects of piperine in rat intervertebral disc using in vitro and ex vivo analyzes. We demonstrated that piperine could inhibit LPS induced expression and production of inflammatory factors and catabolic proteases in NP cells culture model. It significantly inhibited multiple inflammatory factors and oxidative stress-associated genes (IL-1β, TNF-α, IL-6, iNOS), MMPs (MMP-3, MMP-13), ADAMTS (ADAMTS-4, ADAMTS-5) mRNA expression and NO production in a concentration-dependent manner. Moreover, piperine could reverse the LPS-induced inhibition of gene expression of aggrecan and collagen-II. Histologic and dimethylmethylene blue analysis indicated piperine could also against LPS induced proteoglycan (PG) depletion in a rat intervertebral disc culture model. Western blot results showed that piperine inhibited the LPS-mediated phosphorylation of JNK and activation of NF-κB. Finally, our results demonstrated the ability of piperine to antagonize LPS-mediated inflammation of NP cells and suppression of PG in rat intervertebral disc, suggesting a potential agent for treatment of IDD in future.

  11. Tuina Therapy for Prolapsed Lumbar Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    ZHANG Bi-meng; WU Huan-gan; SHEN Jian; XIAO Yuan-chun

    2004-01-01

    Recurrent low back pain and reflex sciatica of lower limbs are the two leading symptoms of prolapsed lumbar intervertebral disc, which can be confirmed in the history, symptoms, signs and imaging examination such as CT scan and MRI. It should be differentiated from those conditions characterized by lumbago and/or possible sciatica. Tuina was performed mostly on the Bladder Meridian,Gallbladder Meridian and Governor Vessel, as well as their acupoints such as Jiaji (Ex-B 2) points,Shenshu (BL 23), Dachangshu (BL 25), Yaoyangguan (GV 3), Huantiao (GB 30), Weizhong (BL 40),Chengshan (BL 57), Yanglingquan (GB 34) and Ashi points. Thumb-massaging manipulation, rolling manipulation, pulling manipulation, pressing manipulation, kneading manipulation and grasping manipulation are often performed.%反复下腰痛和下肢反射性坐骨神经痛是腰椎间盘突出症的两大症状.根据病史、症状、体征以及影像学(包括CT、MRI等)结果,可以确诊.需与以腰痛为主要表现的疾病,以腰痛伴坐骨神经痛为主要表现的疾病和以坐骨神经痛为主要表现的疾病相鉴别.推拿保守治疗多以足太阳膀胱经、足少阳胆经及督脉为主,取相应的夹脊穴、肾俞、大肠俞、腰阳关、环跳、委中、承山、阳陵泉及阿是穴等以一指禅推法、滚法、扳法、按法、揉法和拿法等进行治疗.

  12. 移植骨髓间充质干细胞对兔退变椎间盘髓核细胞凋亡的影响%Effects of mesenchymal stem cells transplantation on the apoptosis after rabbit intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    樊守刚; 吴小涛; 王运涛; 庄苏阳; 李果

    2010-01-01

    Objective To investigate the effects of the mesenchymal stem cells (MSCs) transplantation on the apoptosis of nucleus pulposus cells after rabbit intervertebral disc degeneration. Methods New Zealand white rabbits were used to stimulate allograft. Harvested rabbit MSCs and fibroblasts were cultured , proliferated and labeled in vitro. At the same time, degenerated intervertebral disc models were set up using 21-gauge needle to puncture the annulus. Four weeks later, 2 X 106 MSCs and fibroblasts were injected into the respective disc segments. After 1,2,4 and 8 weeks, specimens from degenerated models were obtained in order. The number of apoptotic nucleus pulposus cells and the expression of Caspase-3 were detected under laser scanning confocal microscopy in every disc from the experimental group and the control groups of the rabbits. The bcl-2 and bax mRNA expression of all discs was assayed by real time reverse transcription-polymerase chain reaction (RT-PCR). Results The transmission electron microscopy revealed that part of the nucleus pulposus cells became apoptosis in the initial stage in ultramicrostructure. Apoptosis rate was (16.75 ±2. 14)% and (31. 87 ±4. 16)% in the experimental group and the degenerated group, as well as Caspase-3 expression ratio was (20. 34 ± 1. 03)% and (31. 50 ±3. 78)% respectively , demonstrating that MSCs could relieve apoptosis after rabbit intervertebral disc degeneration. The levels of bcl-2 mRNA expression in experimental group were higher than in the degenerated group (P0.05).MSCs移植治疗组细胞凋亡率和Caspase-3表达率均高于正常组[细胞凋亡率分别为(16.75±2.14)%和(6.86±1.08)%;Caspase-3表达率分别为[(20.34±1.03)%和(6.09±0.77)%](P<0.05),低于退变组和SFs移植对照组[细胞凋亡率分别为(31.87±4.16)%和(29.02±2.16)%;Caspase-3表达率分别为(31.50±3.78)%和(30.20±4.93)%](P<0.05).结论 髓核细胞凋亡在椎间盘退变过程中起重要作用.MSCs移植能有效抑制

  13. The Natural Polyphenol Epigallocatechin Gallate Protects Intervertebral Disc Cells from Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Olga Krupkova

    2016-01-01

    Full Text Available Oxidative stress-related phenotypic changes and a decline in the number of viable cells are crucial contributors to intervertebral disc degeneration. The polyphenol epigallocatechin 3-gallate (EGCG can interfere with painful disc degeneration by reducing inflammation, catabolism, and pain. In this study, we hypothesized that EGCG furthermore protects against senescence and/or cell death, induced by oxidative stress. Sublethal and lethal oxidative stress were induced in primary human intervertebral disc cells with H2O2 (total n=36. Under sublethal conditions, the effects of EGCG on p53-p21 activation, proliferative capacity, and accumulation of senescence-associated β-galactosidase were tested. Further, the effects of EGCG on mitochondria depolarization and cell viability were analyzed in lethal oxidative stress. The inhibitor LY249002 was applied to investigate the PI3K/Akt pathway. EGCG inhibited accumulation of senescence-associated β-galactosidase but did not affect the loss of proliferative capacity, suggesting that EGCG did not fully neutralize exogenous radicals. Furthermore, EGCG increased the survival of IVD cells in lethal oxidative stress via activation of prosurvival PI3K/Akt and protection of mitochondria. We demonstrated that EGCG not only inhibits inflammation but also can enhance the survival of disc cells in oxidative stress, which makes it a suitable candidate for the development of novel therapies targeting disc degeneration.

  14. Simulating the sensitivity of cell nutritive environment to composition changes within the intervertebral disc

    Science.gov (United States)

    Wills, C. Ruiz; Malandrino, A.; van Rijsbergen, MM.; Lacroix, D.; Ito, K.; Noailly, J.

    2016-05-01

    Altered nutrition in the intervertebral disc affects cell viability and can generate catabolic cascades contributing to extracellular matrix (ECM) degradation. Such degradation is expected to affect couplings between disc mechanics and nutrition, contributing to accelerate degenerative processes. However, the relation of ECM changes to major biophysical events within the loaded disc remains unclear. A L4-L5 disc finite element model including the nucleus (NP), annulus (AF) and endplates was used and coupled to a transport-cell viability model. Solute concentrations and cell viability were evaluated along the mid-sagittal plane path. A design of experiment (DOE) was performed. DOE parameters corresponded to AF and NP biochemical tissue measurements in discs with different degeneration grades. Cell viability was not affected by any parameter combinations defined. Nonetheless, the initial water content was the parameter that affected the most the solute contents, especially glucose. Calculations showed that altered NP composition could negatively affect AF cell nutrition. Results suggested that AF and NP tissue degeneration are not critical to nutrition-related cell viability at early-stage of disc degeneration. However, small ECM degenerative changes may alter significantly disc nutrition under mechanical loads. Coupling disc mechano-transport simulations and enzyme expression studies could allow identifying spatiotemporal sequences related to tissue catabolism.

  15. 椎间盘退变患者血清及髓核组织中基质金属蛋白酶1及抑制剂1的表达%Serum and tissue levels of matrix metalloproteinase-1 and its tissue inhibitor in patients with intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    邓斌; 王叶新; 孟纯阳

    2016-01-01

    BACKGROUND:Matrix metaloproteinases are now generaly considered to be able to degrade al extracelular matrices. Hypersecretion of matrix metaloproteinases or reduction in tissue inhibitors of matrix metaloproteinases leads to destruction of the dynamic balance of extracelular matrix. OBJECTIVE: To elucidate the role of matrix metaloproteinase-1 and tissue inhibitor of matrix metaloproteinase-1 in the pathogenesis and progression of intervertebral disc degeneration. METHODS:A total of 60 patients with intervertebral disc degeneration were included. Mild, moderate, and severe degeneration signals appeared on MRI imaging of the patients. Meanwhile, 20 patients with vertebral fracture, mainly cervical spine fracture, were selected as the control group. Venous blood samples were colected before the surgery; the intervertebral disc specimens were sequentialy colected. RESULTS AND CONCLUSION: Serum and tissue levels of matrix metaloproteinase-1 in patients with intervertebral disc degeneration were significantly increased compared with the control group (P 0.05). These results indicate that hypersecretion of matrix metaloproteinase-1 occurs in patients with intervertebral disc degeneration; however, the expression of tissue inhibitor of matrix metaloproteinase-1 is not correlated with intervertebral disc degeneration.%背景:基质金属蛋白酶现被公认为能降解所有的细胞外基质,基质金属蛋白酶分泌过多或金属蛋白酶抑制剂的分泌减少能破坏细胞外基质的动态平衡。目的:试图阐明基质金属蛋白酶1和金属蛋白酶抑制剂1在椎间盘退变的发病机制。方法:选择60例椎间盘退变患者,根据磁共振(MRI)检查结果分为椎间盘有轻度的退变信号、椎间盘中度抑制信号及椎间盘严重的退变信号3个亚组;对照组20例椎体骨折(颈椎为主)但椎间盘正常的患者。在术前收集静脉血液样品,随后收集病变的椎间盘组织。结果与结论:①椎

  16. Robust local intervertebral disc alignment for spinal MRI

    Science.gov (United States)

    Reisman, James; Höppner, Jan; Huang, Szu-Hao; Zhang, Li; Lai, Shang-Hong; Odry, Benjamin; Novak, Carol L.

    2006-03-01

    Magnetic resonance (MR) imaging is frequently used to diagnose abnormalities in the spinal intervertebral discs. Owing to the non-isotropic resolution of typical MR spinal scans, physicians prefer to align the scanner plane with the disc in order to maximize the diagnostic value and to facilitate comparison with prior and follow-up studies. Commonly a planning scan is acquired of the whole spine, followed by a diagnostic scan aligned with selected discs of interest. Manual determination of the optimal disc plane is tedious and prone to operator variation. A fast and accurate method to automatically determine the disc alignment can decrease examination time and increase the reliability of diagnosis. We present a validation study of an automatic spine alignment system for determining the orientation of intervertebral discs in MR studies. In order to measure the effectiveness of the automatic alignment system, we compared its performance with human observers. 12 MR spinal scans of adult spines were tested. Two observers independently indicated the intervertebral plane for each disc, and then repeated the procedure on another day, in order to determine the inter- and intra-observer variability associated with manual alignment. Results were also collected for the observers utilizing the automatic spine alignment system, in order to determine the method's consistency and its accuracy with respect to human observers. We found that the results from the automatic alignment system are comparable with the alignment determined by human observers, with the computer showing greater speed and consistency.

  17. Clinical Impact of Sagittal Spinopelvic Parameters on Disc Degeneration in Young Adults.

    Science.gov (United States)

    Oh, Young-Min; Eun, Jong-Pil

    2015-10-01

    The sagittal balance plays an important role in the determination of shear and compressive forces applied on the anterior (vertebral bodies and intervertebral discs) and posterior (facet joints) elements of the lumbar vertebral column. Many studies have also examined the effect of structural changes in the disc on the biomechanical characteristics of the spinal segment. Nevertheless, the relationship between sagittal balance and the degree of disc degeneration has not been extensively explored. Thus, here we investigated the relationships between various sagittal spinopelvic parameters and the degree of disc degeneration in young adults.A total of 278 young adult male patients were included in this study (age range: 18-24 years old). Multiple sagittal spinopelvic parameters, including pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sacral inclination (SI), lumbosacral angle (LSA), and sacral table angle (STA), were measured from standing lateral lumbosacral radiographs. The degree of intervertebral disc degeneration was classified using a modified Pfirrmann scale. To assess the pain intensity of each patient, the visual analogue scale (VAS) score for low back pain (LBP) was obtained from all the patients. Finally, the relationships between these spinopelvic parameters and the degree of disc degeneration in young adults were analyzed. Also, we performed multiple logistic regression study.Out of all the spinopelvic parameters measured in this study, a low STA and a low SI were the only significant risk factors that were associated with disc degeneration in young adults. It means that patients with disc degeneration tend to have more severe sacral kyphosis and vertical sacrum.We found that patients with disc degeneration showed a lower SI and lower STA compared with patients without disc degeneration in young adults. Therefore, we suggest that the patients with disc degeneration tend to have more vertical sacrum, more sacral kyphosis

  18. Regional variations in the compressive properties of lumbar vertebral trabeculae. Effects of disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Keller, T.S.; Hansson, T.H.; Abram, A.C.; Spengler, D.M.; Panjabi, M.M. (Orthopaedic Biomechanics Lab, Nashville, TN (USA))

    1989-09-01

    The compressive mechanical properties of human lumbar vertebral trabeculae were examined on the basis of anatomic origin, bone density, and intervertebral disc properties. Trabecular bone compressive strength and stiffness increased with increasing bone density, the latter proportional to strength and stiffness to the one-half power. Regional variations within each segment were found, the most prevalent differences occurring in regions of bone overlying the disc nucleus in comparison with bone overlying the disc anulus. For normal discs, the ratio of strength of bone overlying the disc nucleus to bone overlying the disc anulus was 1.25, decreasing to 1.0 for moderately degenerated discs. These results suggest that an interdependency of trabecular bone properties and intervertebral disc properties may exist.

  19. Improving the fixation of an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; Hayen, J; Veldhuizen, AG; Van Horn, [No Value; Verkerke, GJ

    2002-01-01

    The fixation of an artificial intervertebral disc has been studied especially with respect to the dimensions, the convexity of the endplates and the size of the fixation elements. From literature and cadaveric vertebrae, the dimensions and shape of the lumbar vertebral endplates were determined and

  20. Reduced nucleus pulposus glycosaminoglycan content alters intervertebral disc dynamic viscoelastic mechanics.

    Science.gov (United States)

    Boxberger, John I; Orlansky, Amy S; Sen, Sounok; Elliott, Dawn M

    2009-08-25

    The intervertebral disc functions over a range of dynamic loading regimes including axial loads applied across a spectrum of frequencies at varying compressive loads. Biochemical changes occurring in early degeneration, including reduced nucleus pulposus glycosaminoglycan content, may alter disc mechanical behavior and thus may contribute to the progression of degeneration. The objective of this study was to determine disc dynamic viscoelastic properties under several equilibrium loads and loading frequencies, and further, to determine how reduced nucleus glycosaminoglycan content alters dynamic mechanics. We hypothesized that (1) dynamic stiffness would be elevated with increasing equilibrium load and increasing frequency, (2) the disc would behave more elastically at higher frequencies, and finally, (3) dynamic stiffness would be reduced at low equilibrium loads under all frequencies due to nucleus glycosaminoglycan loss. We mechanically tested control and chondroitinase ABC injected rat lumbar motion segments at several equilibrium loads using oscillatory loading at frequencies ranging from 0.05 to 5Hz. The rat lumbar disc behaved non-linearly with higher dynamic stiffness at elevated compressive loads irrespective of frequency. Phase angle was not affected by equilibrium load, although it decreased as frequency was increased. Reduced glycosaminoglycan decreased dynamic stiffness at low loads but not at high equilibrium loads and led to increased phase angle at all loads and frequencies. The findings of this study demonstrate the effect of equilibrium load and loading frequencies on dynamic disc mechanics and indicate possible mechanical mechanisms through which disc degeneration can progress.

  1. Training for motor function after removal of nucleus pulposus in protrusion of lumbar intervertebral discs%腰椎间盘突出症髓核摘除术后运动功能训练

    Institute of Scientific and Technical Information of China (English)

    王媛

    2003-01-01

    @@ INTRODUCIION Protrusion of lumbar intervertebral discs is a kind of disease causedby protrusion of nucleus pulposus to vertebral canal due to degen-eration and rupture of lumbar intervertebral discs and stimulationand compression on neighboring nerve roots. Therapeutic effects afteroperation has a direct relationship with postoperative rehabilitationnursing.

  2. Prolonged upright posture induces degenerative changes in intervertebral discs in rat lumbar spine.

    Science.gov (United States)

    Liang, Qian-Qian; Zhou, Quan; Zhang, Min; Hou, Wei; Cui, Xue-Jun; Li, Chen-Guang; Li, Tian-Fang; Shi, Qi; Wang, Yong-Jun

    2008-09-01

    Both forelimbs of rats were amputated, and these rats were kept in the custom-made cages that kept the rats in prolonged upright posture. Pathologic changes were observed in the lumbar spine at different time points after the surgery. To investigate the effect of upright posture on intervertebral discs of rat lumbar spine. Previous studies have shown that increased axial forces on the spine can decrease the height of the intervertebral disc, but there are no data to indicate whether or not long-term and repeated assumption of the upright posture could result in degenerative changes. The forelimbs of 30 rats were amputated when they were 1-month old. These rats were kept in the custom-made cages and were forced to stand upright on their hind-limbs and tails to obtain water and food. Normal rats of the same ages kept in regular cages were used as control. The rats were killed at 5, 7, and 9 months after the surgery, and the intervertebral discs samples of lumbar spine were harvested for histologic and immunohistochemical studies. Total RNA isolated from these samples was used for real-time PCR of type II collagen (Col2alpha1), type X collagen (Col10alpha1), matrix metalloproteinase-13 (MMP-13), aggrecan, and disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5). RESULTS.: Histologic analysis showed degenerative changes of the intervertebral discs after surgery such as disordered collagen structure of endplate cartilage, fragmentation of annulus fibrosus, and decreased height of disc. Immunostaining revealed decreased protein level of type II collagen and increased protein expression of type X collagen. Real-time PCR showed upregulated expression of MMP 13, ADAMTS-5, and Col10alpha1 mRNA and downregulated mRNA expression of Col2alpha1 and aggrecan. Long-term and repeated assumption of the upright stance accelerates disc degeneration in rats.

  3. The distribution of Schmorl's nodes in patients with low back pain or radiculopathy and their correlation with degeneration of lumbar intervertebral discs%许莫氏结节在腰腿痛患者中的分布特点及与腰椎间盘退变的相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈意磊; 周志杰; 范顺武; 赵凤东; 方向前

    2013-01-01

    Objective To evaluate the distribution of Schmorl's nodes (SN) in patients with low back pain or radiculopathy,and to analyze the correlation between SN and degeneration of lumbar intervertebral discs.Methods In 2012,1024 patients with low back pain or sciatica were examined by magnetic resonance (MR) scan and plain film.There were 448 males and 576 females,with an average age of (54.3 ± 12.7) years (range,22-90).The features distribution of SN in lumbar endplate on age,sex,segment and the type and grade of intervertebral disc degeneration were analyzed retrospectively.Results Among 5120 lumbar intervertebral segments of the 1024 patients,295 (28.8%) cases and 532 (5.2%) endplates were involved with SN,302 located in the cranial and 230 in the caudal endplate.According to percent prevalence per lumbar segment,L1,2 was the most common level (29.1%),followed by L3,4 (23.7%) and L2,3 (21.1%).The incidence of SN was positively correlated with elder age,but not with sex,body weight,height,or body mass index.SN occurred more often in bulging,extrusion,Modic changes,spondylolisthesis and osteophyte comparing with normal disc or protrusion or high intensity zone.The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent SN.Intervertebral discs with adjacent SN were more degenerated than those without adjacent SN.The number,size and volume of SN were associated with the degrade of intervertebral discs degeneration.SN was divided into two types,i.e.,"acute edematous" SN and "non-acute"SN,according to the signal type on T1-and T2-weighted MR images,and the degeneration of the corresponding intervertebral discs was more severe in the latter than the former group.Conclusion SN occurred more often in the upper lumbar spine and cranial endplate in patients with low back pain or radiculopathy.SN were correlated with elder age and the degeneration of lumbar intervertebral discs.The number

  4. Correlation research on gene polymorphism of interleukin-1α, interleukin-6 and intervertebral disc degeneration disease%白细胞介素-1α和白细胞介素-6基因多态性与椎间盘退变症相关性研究

    Institute of Scientific and Technical Information of China (English)

    段雄; 安菊霞; 赵岩; 杨学军

    2013-01-01

    Objective To research the correlation on gene polymorphism of interleukin-1α,interleukin-6 and intervertebral disc degeneration disease.Methods 42 patients with intervertebral disc degeneration disease treated by surgery from June 2009 to January 2012 in Affiliated Hospital of Wulanchabu Medical College were selected as cases group,85 patients without intervertebral disc degeneration disease treated surgery because of the fracture and trauma were chosen as control group.Gene frequency distribution of IL-1α-rs1800587 and IL-6-rs1800797 were analyzed by PCT-RFLP; influence of gene polymorphism of IL-1α-rs1800587 and IL-6-rs1800797 on intervertebral disc degeneration were analyzed by multivariable Logistic regression analysis model.Results ①Distribution percentage of C/C,C/T,T/T genotype in IL-1α-rs1800587 were 52.4%,40.5%,7.1% respectively in cases group,corresponding genotype were 55.3%,38.8%,5.9% in control group,the differences were not statistically significant (P =0.87).Distribution percentage of A/A,A/G,G/G genotype in IL-6-rs1800797 were 50.0%,33.3%,16.7% respectively in cases group,corresponding genotype were 64.7%,28.2%,7.1% in control group,the differences were not statistically significant (P =0.17).②Gene polymorphism of IL-1α-rs1800587 was found no function in increasing the probability of intervertebral disc degeneration disease,the OR (95%CI) value in C/T,T/T genotype were 1.28 (0.18-7.27) and 1.43(0.27-8.06) in IL-1α-rs1800587.Correlationship was found between A/G gene polymorphism in IL-6-rs1800797 and intervertebral disc degeneration disease according to multivariable Logistic regression analysis.Probability of intervertebral disc degeneration disease in G/G genotype of IL-6-rs1800797 was higher than that in A/A genotype of IL-6-rs1800797,the OR (95%CI) value was 5.52 (1.24-18.21).Conclusion IL-6 rs1800797 gene polymorphism has obvious influence in intervertebral disc degeneration disease,the detection of gene

  5. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjaer, Per

    2012-01-01

    Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans....

  6. Hygroviscoelasticity of the Human Intervertebral Disc.

    Science.gov (United States)

    1980-07-01

    hernia - tion with age depends on the biochemical changes that occur in the material of the disc during its maturation process. However, a careful machanics...EFFORT One of the recurring pieces of information required in disc response is the intra- discal pressure when the spine is loaded axially. This

  7. Protective effect of calcitonin on lumbar fusion-induced adjacent-segment disc degeneration in ovariectomized rat

    OpenAIRE

    Liu, Chang-Cheng; Tian, Fa-Ming; Zhou, Zhuang; Wang, Peng; Gou, Yu; Zhang, Heng; Wang, Wen-Ya; Shen, Yong; Zhang, Ying-Ze; Zhang, Liu

    2015-01-01

    Background Intervertebral disc (IVD) degeneration and pathological changes in the spinal cord are major causes of back pain. In addition to its well-established anti-resorptive effect on bone, calcitonin (CT) potentially exerts protective effects on IVD degeneration in ovariectomized rats. However, possible therapeutic effects of CT on lumbar fusion-induced adjacent-segment disc degeneration (ASDD) have not been investigated yet. In this study, we examined the effects of CT on IVD degeneratio...

  8. Contribuição das projeções oblíquas em mielografias de pequenos animais para a localização de lesões medulares causadas por processo degenerativo do disco intervertebral Contribution of oblique projections in small animals myelography to the localization of spinal lesions caused by intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Karen Maciel Zardo

    2010-11-01

    Full Text Available Mielografia é uma técnica radiográfica na qual se administra meio de contraste no espaço subaracnóideo para avaliar a medula espinhal. Múltiplas projeções radiográficas fornecem uma exploração circunferencial da medula, auxiliando na localização mais precisa de compressões nesta região. Objetivou-se demonstrar a contribuição das projeções oblíquas, pouco exploradas em exames de mielografia, para a localização de lesões medulares extradurais em cães e gatos causadas por processo degenerativo do disco intervertebral. Foram avaliadas 116 mielografias e observou-se que em 36,2% dos casos as projeções oblíquas foram imprescindíveis para a localização exata das lesões. A associação entre as projeções ventrodorsal e oblíquas se mostraram mais úteis para a localização da lesão do que quando avaliadas isoladamente e as projeções oblíquas esquerda e direita foram igualmente importantes.Myelography is a radiographic technique in which is administered contrast in the subarachnoid space to assess the spinal cord. Multiple radiographic projections provide a circumferential view of the spinal cord, aiding in more precise localization of compression in this region. This paper aimed to demonstrate the contribution of oblique projections, little explored in myelography, for the location of extradural spinal cord injuries in dogs and cats caused by degeneration of the intervertebral disc. It was evaluated 116 myelography and it was observed that in 36.2% of cases, oblique views were essential to the exact localization of lesions. The association between the oblique and ventrodorsal projections was more effective to find the lesion´s lateralization than when taken separately, and the left and right oblique view was equally important.

  9. Insertion of PCB to treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 隰建成; 陈兴; 关长勇; 全长彬

    2002-01-01

    Objective: To evaluate the clinical effect of PCB (a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate) in treating traumatic cervical intervertebral disc herniation. Methods: Anterior decompression and PCB internal fixation were used in 22 patients with traumatic cervical intervertebral disc herniation. They were followed up from 3 to 16 months and analyzed by symptom and image data. Among them, 16 patients underwent fixation at one level and 6 patients at two levels. Results: This technique did not cause intraoperative complications. After surgery no screw backout or device failure was found. Based on the JOA grade, 20 patients improved clinically and 2 gently because of serious cervical stenosis. The general excellent rate was 90.9%. Conclusions: PCB internal fixation is stable. Morbidity of donor and acceptor sites is less. No collars are needed after surgery.

  10. Insertion of PCBto treat traumatic cervical intervertebral disc herniation

    Institute of Scientific and Technical Information of China (English)

    马远征; 陈兴; 等

    2002-01-01

    Objective:To evaluate the clinical effect of PCB(a new anterior cervical instrumental system combining an intradiscal cage with an integrated plate)in treating taunatic cervical intervertebral disc herniation.Methods:Anterior decompression and PCB internal fixation were used in 22patients with traumatic cervical intervertebral disc herniation.They were followed up from3to16months and analyzed by symptom and imape data.Among them,16 patients underwent fixation at one level and 6patients at two levels.Results:This technique did not cause intraoperative complications.After surgery on screw backout or device failure was found.Based on the JOAgrade,20 patients improved clinically and 2gently because of serious cervical stenosis.The general excellent rate was90.9%.Conclusions:PCB internal fixation is stable.Morbidity of donor and acceptor sites is less.No collars are needed after surgery.

  11. Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy.

    Science.gov (United States)

    Capoor, Manu N; Ruzicka, Filip; Schmitz, Jonathan E; James, Garth A; Machackova, Tana; Jancalek, Radim; Smrcka, Martin; Lipina, Radim; Ahmed, Fahad S; Alamin, Todd F; Anand, Neel; Baird, John C; Bhatia, Nitin; Demir-Deviren, Sibel; Eastlack, Robert K; Fisher, Steve; Garfin, Steven R; Gogia, Jaspaul S; Gokaslan, Ziya L; Kuo, Calvin C; Lee, Yu-Po; Mavrommatis, Konstantinos; Michu, Elleni; Noskova, Hana; Raz, Assaf; Sana, Jiri; Shamie, A Nick; Stewart, Philip S; Stonemetz, Jerry L; Wang, Jeffrey C; Witham, Timothy F; Coscia, Michael F; Birkenmaier, Christof; Fischetti, Vincent A; Slaby, Ondrej

    2017-01-01

    In previous studies, Propionibacterium acnes was cultured from intervertebral disc tissue of ~25% of patients undergoing microdiscectomy, suggesting a possible link between chronic bacterial infection and disc degeneration. However, given the prominence of P. acnes as a skin commensal, such analyses often struggled to exclude the alternate possibility that these organisms represent perioperative microbiologic contamination. This investigation seeks to validate P. acnes prevalence in resected disc cultures, while providing microscopic evidence of P. acnes biofilm in the intervertebral discs. Specimens from 368 patients undergoing microdiscectomy for disc herniation were divided into several fragments, one being homogenized, subjected to quantitative anaerobic culture, and assessed for bacterial growth, and a second fragment frozen for additional analyses. Colonies were identified by MALDI-TOF mass spectrometry and P. acnes phylotyping was conducted by multiplex PCR. For a sub-set of specimens, bacteria localization within the disc was assessed by microscopy using confocal laser scanning and FISH. Bacteria were cultured from 162 discs (44%), including 119 cases (32.3%) with P. acnes. In 89 cases, P. acnes was cultured exclusively; in 30 cases, it was isolated in combination with other bacteria (primarily coagulase-negative Staphylococcus spp.) Among positive specimens, the median P. acnes bacterial burden was 350 CFU/g (12 - ~20,000 CFU/g). Thirty-eight P. acnes isolates were subjected to molecular sub-typing, identifying 4 of 6 defined phylogroups: IA1, IB, IC, and II. Eight culture-positive specimens were evaluated by fluorescence microscopy and revealed P. acnes in situ. Notably, these bacteria demonstrated a biofilm distribution within the disc matrix. P. acnes bacteria were more prevalent in males than females (39% vs. 23%, p = 0.0013). This study confirms that P. acnes is prevalent in herniated disc tissue. Moreover, it provides the first visual evidence of P

  12. Cervical intervertebral disc calcification combined with ossification of posterior longitudinal ligament in an-11-year old girl: case report and review of literature.

    Science.gov (United States)

    Wang, Guoqiang; Kang, Yijun; Chen, Fei; Wang, Bing

    2016-02-01

    To present the clinical feature, radiographic characteristic, treatment and prognosis of an 11 years old girl with cervical intervertebral disc calcification combined with ossification of posterior longitudinal ligament(OPLL). Calcification is the degeneration of intervertebral disc, mostly occurs in the cervical segment. The pediatric cervical intervertebral disc calcification associated with OPLL is very rare. The etiology and treatment guidelines of this complex are poorly known. An 11 years old girl experienced neck pain for 3 months,aggravated for half a month. Neurological examination revealed the limitation of cervical spine motion and numbness of the upper left extremity. The spine radiograph, computed tomography and magnetic resonance imaging confirmed the diagnosis of cervical intervertebral disc calcification accompanied with OPLL. Conservative intervention was performed, followed up with an observation for 6 months. On admission, the spine radiograph and computed tomography found the calcified intervertebral disc of C5/6 and ossified posterior longitudinal ligament at C5/6,C6 level, leading to spinal canal stenosis and spine cord compression. After a two-week in-hospital conservative treatment, the patient's neurologic symptoms were relieved. Two months later, the computed tomography confirmed the calcification of C5/6 intervertebral disc and ossified mass decreased significantly, spinal stenosis subsided. Six months later, the patient felt no discomfort, the computed tomography showed the ossified mass completely disappeared, only a small calcification remained at C5/6 intervertebral disc. Intervertebral disc calcification associated with OPLL is extremely rare in children. In this case, OPLL is a temporary condition highly related to the disease process of Intervertebral disc calcification. The patient has a satisfactory recovery after non-surgical intervention. Conservative treatment is a prospective choice.

  13. Effect of comprehensive rehabilitative treatment on prolapse of lumbar intervertebral disc in 120 cases%综合康复治疗腰椎间盘出症120例疗效分析

    Institute of Scientific and Technical Information of China (English)

    梁君

    2002-01-01

    Background:Lumbar spine connects thorax and pelvis,its physiological structure and kinetics confer susceptibility to injury and degeneration.Prolapse of lumbar intervertebral disc often coexist with other diseases or is secondary to them.

  14. Intervertebral disc biomechanics in the pathogenesis of idiopathic scoliosis.

    Science.gov (United States)

    Grivas, Theodoros B; Vasiliadis, Elias; Malakasis, Marinos; Mouzakis, Vasilios; Segos, Dimitrios

    2006-01-01

    The aim of the present study is to investigate whether the deformation of the intervertebral disc contributes to the progression of idiopathic scoliotic curves. In the standing posteroanterior x-rays of 92 scoliotic curves the following readings were obtained: Cobb angle (CA), apical vertebral rotation (AVR), apical vertebral wedging (AVW) and the adjacent to the apical vertebra Upper (UIVDW) and Lower (LIVDW) InterVertebral Discs Wedging. The statistical analyses included inter - intraobserver reliability test, descriptives, monofactorial linear regression and Pearson correlation coefficient, with p<0.05 considered statistical significant (SS). The mean thoracic CA was 13.4 degrees, lumbar CA 13.8 degrees, thoracic AVR 5.3 degrees, lumbar AVR 4.7 degrees, thoracic AVW 1.4 degrees, lumbar AVW 1.5 degrees, thoracic UIVDW 1.6 degrees, thoracic LIVDW 1 degrees, lumbar UIVDW 1.3 degrees and lumbar LIVDW 2 degrees. Both thoracic and lumbar CA regressed SS with lumbar LIVDW, lumbar UIVDW, thoracic LIVDW and thoracic AVW. Lumbar LIVDW correlates SS with thoracic CA, lumbar CA and thoracic LIVDW. An inter and intra-observer error was below 1 degrees . The eccentric intervertebral disc in the scoliotic spine, through variation in its water concentration produces asymmetrically cyclical load during the 24-hour period and an asymmetrical growth of the vertebral body (Hueter-Volkman's law). The statistical analysis revealed that AVW appears later when already CA increases, the IVDW is more important than AVW and the LIVDW, which is greater than UIVDW, is the most frequent correlated radiographic parameter. The deformation of the apical intervertebral disc seems to be an important contributory factor in the progression of a scoliotic curve.

  15. Effects of intervertebral injection of transforming growth factor beta 1 on proteoglycan expression in rabbit degenerated lumbar discs%椎间注射转化生长因子β1对兔退变腰椎间盘蛋白多糖表达的影响

    Institute of Scientific and Technical Information of China (English)

    吴彬; 张辉; 王海滨; 贾存岭; 赵益峰

    2011-01-01

    BACKGROUND: In vitro experiments have confirmed that transforming growth factor-β1 (TGF-β1) can promote proteoglycan synthesis and delay intervertebral disc degeneration, but its in vivo role remains unclear.OBJECTIVE: To study the effect of local utilization of TGF-β1 on proteoglycan expression in rabbit degenerated lumbar discs.METHODS: Thirty-six New Zealand white rabbits were divided into two groups randomly, with 6 in control group and 30 in model group. The lumbar structure was destroyed partly in the model group. After 12 weeks, the intervertebral disc degeneration was testified by X-ray in model group. Six rabbits chosen randomly from the model group and all rabbits in the control group were killed and the organizations of the intervertebral discs of L4-5 were harvested. Meanwhile, the rest rabbits in model group were divided into two groups randomly, which was injected with TGF-β1 saline. The rabbits were killed by 2 and 4 weeks after injection.The contents of proteoglycan in nucleus pulposus were tested by phloroglucinol method.RESULTS AND CONCLUSION: The content of proteoglycan in the nucleus pulposus was obviously decreased at 12 weeks after model preparation (P < 0.01). After TGF-β1 injection, the content of proteoglycan was notably increased (P < 0.01). It is suggested that intervertebral injection of TGF-β1 to rabbit can delay intervertebral disc degeneration and enhance the synthesis of proteoglycan in nucleus pulposus.%背景:体外研究证实转化生长因子β1可以促进蛋白多糖合成,延缓椎间盘退变,但体内实验鲜见报道.目的:观察局部应用转化生长因子β1对兔退变腰椎间盘髓核蛋白多糖表达的影响.方法:取30只新西兰大白兔建立兔腰椎间盘退变模型,造模12周,经X射线证实退变后,随机选择6只模型兔及6只未造模正常兔,处死取材.分别向剩余24只模型兔L4~5椎间隙注射转化生子因子β1和生理盐水.末次给药2,4周取材,间苯三酚法测

  16. Transabdominal sonography of lumbar intervertebral discs and intraspinal structures

    Energy Technology Data Exchange (ETDEWEB)

    Toelly, E.

    1984-11-01

    This paper reports a prospective study on 64 patients in whom sonography was used to diagnose pathological changes in lumbar discs and intraspinal space occupying lesions; the results were compared with myelography and computer assisted tomography (CAT). The sonography device used was a mechanical sector scanner with a medium focused transducer with a frequency of 3.5 MHz. The normal and pathological anatomy as shown by ultrasound was correlated to the known anatomy of CAT-scanning; the nerve roots, the dural sac and the intervertebral disc were recognizable in sonography and in CAT. The extent of an intraspinal lesion beyond the upper and lower limiting planes of the intervertebral discs were not demonstrable by ultrasound. The sonographic study was at least partially successful in 55 of 64 patients (86%). It failed in 14% (9 cases) because of obesity or because of diminution of the intervertebral space. The study revealed a specifity and sensitivity of transabdominal spinal sonography of 0.86 respectively 0.84.

  17. A meta-model analysis of a finite element simulation for defining poroelastic properties of intervertebral discs.

    Science.gov (United States)

    Nikkhoo, Mohammad; Hsu, Yu-Chun; Haghpanahi, Mohammad; Parnianpour, Mohamad; Wang, Jaw-Lin

    2013-06-01

    Finite element analysis is an effective tool to evaluate the material properties of living tissue. For an interactive optimization procedure, the finite element analysis usually needs many simulations to reach a reasonable solution. The meta-model analysis of finite element simulation can be used to reduce the computation of a structure with complex geometry or a material with composite constitutive equations. The intervertebral disc is a complex, heterogeneous, and hydrated porous structure. A poroelastic finite element model can be used to observe the fluid transferring, pressure deviation, and other properties within the disc. Defining reasonable poroelastic material properties of the anulus fibrosus and nucleus pulposus is critical for the quality of the simulation. We developed a material property updating protocol, which is basically a fitting algorithm consisted of finite element simulations and a quadratic response surface regression. This protocol was used to find the material properties, such as the hydraulic permeability, elastic modulus, and Poisson's ratio, of intact and degenerated porcine discs. The results showed that the in vitro disc experimental deformations were well fitted with limited finite element simulations and a quadratic response surface regression. The comparison of material properties of intact and degenerated discs showed that the hydraulic permeability significantly decreased but Poisson's ratio significantly increased for the degenerated discs. This study shows that the developed protocol is efficient and effective in defining material properties of a complex structure such as the intervertebral disc.

  18. Mechanical stress-induced apoptosis of endplate chondrocytes in organ-cultured mouse intervertebral discs: an ex vivo study.

    Science.gov (United States)

    Ariga, Kenta; Yonenobu, Kazuo; Nakase, Takanobu; Hosono, Noboru; Okuda, Shin'ya; Meng, Wenxiang; Tamura, Yuichi; Yoshikawa, Hideki

    2003-07-15

    Various amounts of static mechanical load were applied to mouse intervertebral discs in organ cultures. The apoptosis then was examined using nick end labeling. Two mitogen-activated protein kinase (MAPK) inhibitors were added to the medium. To establish an experimental model for detecting factors regulating chondrocyte apoptosis induced by mechanical stress, and to determine the role of MAPK and p38 in the stress-induced apoptotic pathway of endplate chondrocytes. The cause of degenerative change in the cartilaginous endplate (CEP) remains unclear. The authors' previous findings using a mouse model suggested that apoptosis in the cartilaginous endplate may play a role in intervertebral disc degeneration, and that mechanical stress may induce apoptosis. If apoptosis of endplate chondrocytes is involved in the cascade of intervertebral disc degeneration, then how apoptosis is induced by mechanical stress should be important in preventing disc degeneration. However, the mechanism of apoptosis induced by mechanical stress remains unclear. Mouse coccygeal discs were harvested and organ cultured. Various static compression loads (0, 0.2, 0.4, 0.8, and 1.0 MPa) were applied on intervertebral discs placed in culture bottles for 24 hours. Paraffin-embedded sections of the harvested discs were stained using Safranin-O and the nick end labeling procedure. The apoptotic cells were counted in the cartilaginous endplate and junctional anulus fibrosus of each intervertebral disc. In addition, U0126 (MAPK inhibitor) and SB202190 (p38 inhibitor) were added to the culture medium to determine their regulatory roles in the apoptosis of endplate chondrocytes induced by mechanical load. Histologically, loaded discs became bulged, and the disc space became narrow. Apoptosis was absent in discs without load, but was particularly noticeable in loaded discs (load weight, 1.0 MPa). The number of apoptotic cells increased depending on the weight of the load. The two MAPK inhibitors

  19. Molecular regulation of CCN2 in the intervertebral disc: lessons learned from other connective tissues.

    Science.gov (United States)

    Tran, Cassie M; Shapiro, Irving M; Risbud, Makarand V

    2013-08-08

    Connective tissue growth factor (CCN2/CTGF) plays an important role in extracellular matrix synthesis, especially in skeletal tissues such as cartilage, bone, and the intervertebral disc. As a result there is a growing interest in examining the function and regulation of this important molecule in the disc. This review discusses the regulation of CCN2 by TGF-β and hypoxia, two critical determinants that characterize the disc microenvironment, and discusses known functions of CCN2 in the disc. The almost ubiquitous regulation of CCN2 by TGF-β, including that seen in the disc, emphasizes the importance of the TGF-β-CCN2 relationship, especially in terms of extracellular matrix synthesis. Likewise, the unique cross-talk between CCN2 and HIF-1 in the disc highlights the tissue and niche specific mode of regulation. Taken together the current literature supports an anabolic role for CCN2 in the disc and its involvement in the maintenance of tissue homeostasis during both health and disease. Further studies of CCN2 in this tissue may reveal valuable targets for the biological therapy of disc degeneration.

  20. Adolescent prolapsed lumbar intervertebral disc: Management strategies and outcome

    Directory of Open Access Journals (Sweden)

    Pragyan Sarma

    2016-01-01

    Full Text Available Objective: Lumbar intervertebral disc herniation (LIVDH is rare in children and adolescents when compared to adults. In literature, children generally constitute around 0.5–3% of surgically treated LIVDH. Though much rarer, they are less likely to respond to conservative treatment than adults. In this study, we analyze our experience in the management of adolescent LIVDH (ALIVDH (age group 12–18 years including the demographic, clinico-radiological features; surgical management strategies and outcome. Materials and Methods: This retrospective analysis constituted all patients between 12 and 18 years, who underwent surgery for LIVDH at our institute over a period of 15 years from January 1999 to June 2014. The records of these patients were retrieved, and demographic features, clinical picture, radiological features, operative findings, and postoperative events were evaluated. Follow-up data were obtained either through direct clinical evaluation or mailed self-report questionnaire and telephone conversations. The long-term outcome was analyzed by using standardized and condition specific outcome scales in addition to routine clinical follow-up evaluation. The long-term outcome was analyzed by using the short form-36 (SF-36.Results: There were a total of 32 patients (26 males, eight females with an average age of 15.64 years. Trauma was a significant etiological factor 57.14% (n = 16/28. Vertebral anomalies were present in 35.7% (n = 10/28 cases. Majority had a neurological deficit at presentation (n = 20/28. The most commonly involved level was the L4–L5 level (n = 18/128 in this series. Multiple level disc degeneration was present in eight patients (28.6%. Immediate postoperative relief was achieved in all but one patient. At long-term follow-up twenty patients were pain-free (71.4%. At follow-up, the physical functioning scale of SF-36 was significantly lower in patients with gross motor deficit prior to surgery. Conclusions: Early

  1. Intervertebral disc calcification in a child

    Directory of Open Access Journals (Sweden)

    Ahemad Athar

    2008-01-01

    Full Text Available Disc calcification in children is a rare condition of which only approximately 200 cases have been reported worldwide and one from India and we report one such case. A five year-old boy presented with neck pain, torticollis and limitations of cervical motions following a fall while playing 3 months back. He had low grade fever cervical lymphadenopthy, paraspinal muscle spasm. His blood counts and ESR was raised. Fine needle aspiration cytology of lymph node revealed reactive lymphadenitis. His cervical radiograph slowed calcification of C 6-7. MRI scan showed hypointense signals in C6-C7 and D5-D6 disc on both T1 and T2 W images. Cerebrospinal fluid examination was normal. He improved on analgesics, bed rest and cervical traction.

  2. Finite element based nonlinear normalization of human lumbar intervertebral disc stiffness to account for its morphology.

    Science.gov (United States)

    Maquer, Ghislain; Laurent, Marc; Brandejsky, Vaclav; Pretterklieber, Michael L; Zysset, Philippe K

    2014-06-01

    Disc degeneration, usually associated with low back pain and changes of intervertebral stiffness, represents a major health issue. As the intervertebral disc (IVD) morphology influences its stiffness, the link between mechanical properties and degenerative grade is partially lost without an efficient normalization of the stiffness with respect to the morphology. Moreover, although the behavior of soft tissues is highly nonlinear, only linear normalization protocols have been defined so far for the disc stiffness. Thus, the aim of this work is to propose a nonlinear normalization based on finite elements (FE) simulations and evaluate its impact on the stiffness of human anatomical specimens of lumbar IVD. First, a parameter study involving simulations of biomechanical tests (compression, flexion/extension, bilateral torsion and bending) on 20 FE models of IVDs with various dimensions was carried out to evaluate the effect of the disc's geometry on its compliance and establish stiffness/morphology relations necessary to the nonlinear normalization. The computed stiffness was then normalized by height (H), cross-sectional area (CSA), polar moment of inertia (J) or moments of inertia (Ixx, Iyy) to quantify the effect of both linear and nonlinear normalizations. In the second part of the study, T1-weighted MRI images were acquired to determine H, CSA, J, Ixx and Iyy of 14 human lumbar IVDs. Based on the measured morphology and pre-established relation with stiffness, linear and nonlinear normalization routines were then applied to the compliance of the specimens for each quasi-static biomechanical test. The variability of the stiffness prior to and after normalization was assessed via coefficient of variation (CV). The FE study confirmed that larger and thinner IVDs were stiffer while the normalization strongly attenuated the effect of the disc geometry on its stiffness. Yet, notwithstanding the results of the FE study, the experimental stiffness showed consistently

  3. Series of spinal balance therapy in treatment of 196 cases of protrusion of intervertebral disc%脊柱系列平衡疗法治疗椎间盘突出症196例

    Institute of Scientific and Technical Information of China (English)

    高维亮; 米宏义; 任秀琴; 任秀琴

    2002-01-01

    @@ Background:Protrusion of intervertebral disc was a clinical syndrom resulted from intervertevral disc degeneration, fibrous ring rupture,protrusion of pulpiform nucleus that stimulate and compresses nerve root,and comprehensive conservative therapy was often adopted.In this group of data,196 cases of protrusion of intervertebral disc treated by series of spinal balance therapy were collected from January 2000 to December 2001.

  4. Accelerated Aging of Intervertebral Discs in a Mouse Model of Progeria

    Science.gov (United States)

    Vo, Nam; Seo, Hyoung-Yeon; Robinson, Andria; Sowa, Gwendolyn; Bentley, Douglas; Taylor, Lauren; Studer, Rebecca; Usas, Arvydas; Huard, Johnny; Alber, Sean; Watkins, Simon C.; Lee, Joon; Coehlo, Paulo; Wang, Dong; Loppini, Mattia; Robbins, Paul D.; Niedernhofer, Laura J.; Kang, James

    2012-01-01

    Intervertebral disc degeneration (IDD) is a common and debilitating disorder that results in reduced flexibility of the spine, pain, and reduced mobility. Risk factors for IDD include age, genetic predisposition, injury, and other environmental factors such as smoking. Loss of proteoglycans (PGs) contributes to IDD with advancing age. Currently there is a lack of a model for rapid investigation of disc aging and evaluation of therapeutic interventions. Here we examined progression of disc aging in a murine model of a human progeroid syndrome caused by deficiency of the DNA repair endonuclease, ERCC1–XPF (Ercc1−/Δ mice). The ERCC1-deficient mice showed loss of disc height and degenerative structural changes in their vertebral bodies similar to those reported for old rodents. Compared to their wild-type littermates, Ercc1−/Δ mice also exhibit other age-related IDD characteristics, including premature loss of disc PG, reduced matrix PG synthesis, and enhanced apoptosis and cell senescence. Finally, the onset of age-associated disc pathologies was further accelerated in Ercc1−/Δ mice following chronic treatment with the chemotherapeutic agent mechlorethamine. These results demonstrate that Ercc1−/Δ mice represent an accurate and rapid model of disc aging and provide novel evidence that DNA damage negatively impacts PG synthesis. PMID:20973062

  5. Estudo comparativo dos mecanorreceptores dos discos intervertebrais normais e degenerados da coluna lombar de humanos pela radiografia, ressonância magnética e estudo anatomopatológico Comparative study of normal and degenerated intervertebral discs' mechanoreceptors of human lumar spine X-ray, magnetic resonance and anatomopathologic study

    Directory of Open Access Journals (Sweden)

    Valdeci Manoel de Oliveira

    2007-01-01

    Full Text Available Os autores fizeram um estudo da coluna lombar de humanos, objetivando avaliar e determinar os diferentes tipos de fibras nervosas no disco intervertebral normal e no degenerado. Foram usadas dez colunas lombares de cadáveres com aproximadamente 48 a 72 horas de óbito. As peças foram submetidas a exames de radiografia simples e ressonância magnética. Após os exames, os discos foram classificados em normais e degenerados. Em seguida, foram dissecados, divididos em regiões anterior e posterior, incluídos em parafina e realizado estudo de imuno-histoquímica com a proteína S100. Com o auxílio de um programa de computador Image-Pro Plus (media cybernetics®, as fibras nervosas tiveram seu diâmetro medidos em micrômetros e classificadas em quatro tipos de fibras. Foram encontrados quatro tipos de fibras nervosas nas diferentes regiões discais. O número e o tipo de fibras variaram de acordo com a região e grau de degeneração do disco intervertebral. Concluíram que as fibras do tipo III são mais freqüentes na região anterior; as fibras dos tipos II e IV são mais freqüentes na região posterior, e as fibras do tipo I não apresentaram diferenças entre a região anterior e a posterior; além disso, o disco degenerado tem mais fibras nervosas que o disco normal.The authors conducted a study on human lumbar spine, aiming to assess and determine the different kinds of nervous fibers in normal and degenerated intervertebral discs. Ten cadaver’s lumbar spines with approximately 48 - 72 of death have been used. The pieces were submitted to simple X-ray and magnetic resonance tests. Subsequently to the tests, discs were divided into normal and degenerated. Then, they were dissected, divided into anterior and posterior according to the region, included in paraffin and an immunohistochemical study with S100 protein was performed. With the aid of Image-Pro Plus computer software (media cybernetics ®, nervous fibers’ diameters were

  6. Human Amniotic Tissue-derived Allograft, NuCel, in Posteriolateral Lumbar Fusions for Degenerative Disc Disease

    Science.gov (United States)

    2017-09-14

    Lumbar Degenerative Disc Disease; Spinal Stenosis; Spondylolisthesis; Spondylosis; Intervertebral Disk Displacement; Intervertebral Disk Degeneration; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Spondylolysis

  7. Cordycepin inhibits LPS-induced inflammatory and matrix degradation in the intervertebral disc

    Directory of Open Access Journals (Sweden)

    Yan Li

    2016-05-01

    Full Text Available Cordycepin is a component of the extract obtained from Cordyceps militaris and has many biological activities, including anti-cancer, anti-metastatic and anti-inflammatory effects. Intervertebral disc degeneration (IDD is a degenerative disease that is closely related to the inflammation of nucleus pulposus (NP cells. The effect of cordycepin on NP cells in relation to inflammation and degeneration has not yet been studied. In our study, we used a rat NP cell culture and an intervertebral disc (IVD organ culture model to examine the inhibitory effects of cordycepin on lipopolysaccharide (LPS-induced gene expression and the production of matrix degradation enzymes (MMP-3, MMP-13, ADAMTS-4, and ADAMTS-5 and oxidative stress-associated factors (nitric oxide and PGE2. We found a protective effect of cordycepin on NP cells and IVDs against LPS-induced matrix degradation and macrophage infiltration. In addition, western blot and luciferase assay results demonstrated that pretreatment with cordycepin significantly suppressed the LPS-induced activation of the NF-κB pathway. Taken together, the results of our research suggest that cordycepin could exert anti-inflammatory and anti-degenerative effects on NP cells and IVDs by inhibiting the activation of the NF-κB pathway. Therefore, cordycepin may be a potential treatment for IDD in the future.

  8. Treatment of Protrusion of the Lumbar Intervertebral Disc by TCM Massage

    Institute of Scientific and Technical Information of China (English)

    龙亚军

    2002-01-01

    @@ Protrusion of the lumbar intervertebral disc is a common disorder frequently encountered in clinic. With TCM massage and the maneuver of manual reduction, we have treated 82 cases of protrusion of the lumbar intervertebral disc, with satisfactory therapeutic results reported in the following.

  9. A minimally invasive in-fiber Bragg grating sensor for intervertebral disc pressure measurements

    Science.gov (United States)

    Dennison, Christopher R.; Wild, Peter M.; Wilson, David R.; Cripton, Peter A.

    2008-08-01

    We present an in-fiber Bragg grating (FBG) based intervertebral disc (IVD) pressure sensor that has pressure sensitivity seven times greater than that of a bare fiber, and a major diameter and sensing area of only 400 µm and 0.03 mm2, respectively. This is the only optical, the smallest and the most mechanically compliant disc pressure sensor reported in the literature. This is also an improvement over other FBG pressure sensors that achieve increased sensitivity through mechanical amplification schemes, usually resulting in major diameters and sensing lengths of many millimeters. Sensor sensitivity is predicted using numerical models, and the predicted sensitivity is verified through experimental calibrations. The sensor is validated by conducting IVD pressure measurements in porcine discs and comparing the FBG measurements to those obtained using the current standard sensor for IVD pressure. The predicted sensitivity of the FBG sensor matched with that measured experimentally. IVD pressure measurements showed excellent repeatability and agreement with those obtained from the standard sensor. Unlike the current larger sensors, the FBG sensor could be used in discs with small disc height (i.e. cervical or degenerated discs). Therefore, there is potential to conduct new measurements that could lead to new understanding of the biomechanics.

  10. ELECTROACUPUNCTURE TREATMENT OF 176 CASES OF LUMBAR INTERVERTEBRAL DISC PROTRUSION

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In the present paper,176 cases of lumbar intervertebral disc protusion are treated with electroacupuncture(EA) and topical heat irradiation.Local tender-point is used as the main acupoint ,combined with Tunzhong,Tiaoyue,Weizhong(BL40)and Yanglingquan(GB34).The treatment is conducted once daily,with 15 sessions being a therapeutic course,Following treatment,of 176 cases,46(26.1%) are cured.90(51.1%)have prominent improvement ,35(19.8%)have amelioration and 5(2.8%) have no apparent changes,with a total effective rate of 97.0%.

  11. ELECTROACUPUNCTURE TREATMENT OF 176 CASES OF LUMBAR INTERVERTEBRAL DISC PROTRUSION

    Institute of Scientific and Technical Information of China (English)

    LI Lanmin

    2002-01-01

    In the present paper, 176 cases of lumbar intervertebral disc protrusion are treated with electroacupuncture (EA) and topical heat irradiation. Local tender-point is used as the main acupoint, combined with Tunzhong, Tiaoyue, Weizhong (BL 40) and Yanglingquan (GB 34). The treatment is conducted once daily, with 15 sessions being a therapeutic course. Following treatment, of 176 cases, 46 (26. 1%) are cured, 90 (51. 1%) have prominent improvement, 35 (19.8%) have amelioration and 5 (2.8%) have no apparent changes, with a total effective rate of 97.0%.

  12. Interleukin-1 inhibits Sox9 and collagen type Ⅱ expression via nuclear factor-κB in the cultured human intervertebral disc cells

    Institute of Scientific and Technical Information of China (English)

    YU Zhan-ge; XU Ning; WANG Wen-bo; PAN Shang-ha; LI Ke-shen; LIU Jia-kun

    2009-01-01

    Background The most significant biological change in intervertebral disc degeneration is the decrease of chondrocyte specific gene and protein expression of Sox9 and collagen type Ⅱ. Interleukin-1 (IL-1) is not expressed in the normal intervertebral disc tissue but increases in the degenerated intervertebral disc tissue. This suggests that IL-1 may play a role in regulation of the expression of Sox9 and collagen type Ⅱ.Methods Human intervertebral disc cells were isolated and cultured. Sox9 and collagen type Ⅱ expression during treatment with IL-1, with or without the nuclear factor-κB (NF-κB) activity inhibitor curcumin, were detected by using reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting, and the activity of the NF-κB signaling pathway was detected by the electrophoretic mobility shift assay (EMSA).Results IL-1 lowered the mRNA level and protein expression of Sox9 and collagen type Ⅱ in the cultured intervertebral disc cells in a dose dependent manner (P 0.05). IL-1 at concentrations of 0.1 ng/ml, 1 ng/ml and 10 ng/ml could stimulate the activity of NF-κB in the intervertebral disc cells in a dose dependent manner (P <0.05) that was inhibited by curcumin.Conclusions We demonstrated the previously unknown function of IL-1 in inhibiting Sox9 and collagen type II via NF-κB in the intervertebral disc cells. This inhibition can be attenuated by curcumin, which is an effective NF-κB activity inhibitor.

  13. Material properties of bovine intervertebral discs across strain rates.

    Science.gov (United States)

    Newell, Nicolas; Grigoriadis, Grigorios; Christou, Alexandros; Carpanen, Diagarajen; Masouros, Spyros D

    2017-01-01

    The intervertebral disc (IVD) is a complex structure responsible for distributing compressive loading to adjacent vertebrae and allowing the vertebral column to bend and twist. To study the mechanical behaviour of individual components of the IVD, it is common for specimens to be dissected away from their surrounding tissues for mechanical testing. However, disrupting the continuity of the IVD to obtain material properties of each component separately may result in erroneous values. In this study, an inverse finite element (FE) modelling optimisation algorithm has been used to obtain material properties of the IVD across strain rates, therefore bypassing the need to harvest individual samples of each component. Uniaxial compression was applied to ten fresh-frozen bovine intervertebral discs at strain rates of 10(-3)-1/s. The experimental data were fed into the inverse FE optimisation algorithm and each experiment was simulated using the subject specific FE model of the respective specimen. A sensitivity analysis revealed that the IVD's response was most dependent upon the Young's modulus (YM) of the fibre bundles and therefore this was chosen to be the parameter to optimise. Based on the obtained YM values for each test corresponding to a different strain rate (ε̇), the following relationship was derived:YM=35.5lnε̇+527.5. These properties can be used in finite element models of the IVD that aim to simulate spinal biomechanics across loading rates. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Treatment of Protrusion of the Lumbar Intervertebral Disc by Massotherapy

    Institute of Scientific and Technical Information of China (English)

    程斌

    2001-01-01

    @@Clinically, there is a higher incidence of protrusion of the lumbar intervertebral disc. It can cause a terrible pain. The author has treated 66 cases by massotherapy, who were confirmatively diagnosed as having protrusion of the lumbar intervertebral disc by X-ray film and computer-aided tomography, with satisfactory results as reported in the following. Clinical Data Among the 66 cases in this series, 49 were male and 17 female, ranging in age from 26 to 59 years, averaging 36.2 years. All the patients had got lumbago and unilateral ischialgia, with the left side affected in 37 cases and the right side in 29 cases. The leg pain radiating to lateral malleolus was found in 28 cases, to dorsum of the foot in 24 cases, and to the toes in 14 cases. Intermittent claudication was present in 22 cases, numbness of the affected foot in 16 cases, pain exacerbated when coughing in 35 cases, scoliosis in 21 cases, and positive Lasegue's sign in 48 cases.

  15. Molecular mechanisms of intervertebral disc degeneration:present and future%椎间盘退化分子机制研究:现状和展望

    Institute of Scientific and Technical Information of China (English)

    张斌; 史建刚; 史国栋; 刘洋; 郑冰; 孔庆捷; 王海波; 孙璟川; 王元

    2016-01-01

    BACKGROUND:Intervertebral disc degeneration is one of the ancient and common clinical diseases. Its complex pathogenesis affected by various factors, such as environment and genes, is stil in debate. Because of the technical limitations, there is stil no deep understanding on the molecular mechanism of intervertebral disc degeneration. However, its molecular mechanism in recent years has made considerable development. OBJECTIVE: To summarize and discuss the molecular mechanism of intervertebral disc degeneration, thereby providing the basis for the effective treatment. METHODS: CNKI and Medline databases were retrieved by the first author using computer to search relevant articles published from 2005 to 2015. The key words were “intervertebral disc degeneration, molecular mechanism, environmental factors, genes, matrix, degradation enzyme,inflammatory factor, biological environment, treatment” in Chinese and English, respectively. Mechanisms of intervertebral disc degeneration, involving genes, cel senescence and apoptosis, degradation enzyme and substrate, inflammatory cytokines, were summarized to explore the pathogenesis and possible effective treatment of intervertebral disc degeneration. RESULTS AND CONCLUSION:Totaly 153 articles were initialy retrieved and finaly 52 articles were included in result analysis according to inclusive and exclusive criteria. Unique structure and biochemical properties of the intervertebral disc are easy to cause intervertebral disc degeneration. Traditionaly, environmental factors, such as occupation and smoking, are considered as the main factors inducing intervertebral disc degeneration; however, more and more studies have shown that genes have the most important influence on intervertebral disc degeneration. Declined extracelular matrix, increased degradation enzymes, and overexpression of inflammatory factors can al destroy the entire structure of intervertebral disc, and accelerate the process of intervertebral disc

  16. Signal intensity loss of the intervertebral discs in the cervical spine of young patients on fluid sensitive sequences

    Energy Technology Data Exchange (ETDEWEB)

    Bruin, F. de; Horst, S. ter; Bloem, J.L.; Reijnierse, M. [Leiden University Medical Center, Department of Radiology, C2-S, Albinusdreef 2, PO box 9600, Leiden (Netherlands); Berg, R. van den; Hooge, M. de; Gaalen, F. van; Heijde, D. van der [Leiden University Medical Center, Department of Rheumatology, Leiden (Netherlands); Fagerli, K.M. [Diakonhjemmet Hospital, Department of Rheumatology, Oslo (Norway); Landewe, R. [Amsterdam Medical Center, Department of Rheumatology, Amsterdam (Netherlands); Oosterhout, M. van [Groene Hartziekenhuis, Department of Rheumatology, Gouda (Netherlands)

    2016-03-15

    To evaluate the signal intensity (SI) of the intervertebral discs of the cervical spine on magnetic resonance (MR) fluid sensitive sequences, and correlate this to secondary signs of degeneration on MR and radiographs as well as to age. A total of 265 patients aged ≥16 with back pain (≥3-months, <2-year, onset <45-years) from the SPondyloArthritis Caught Early (SPACE) cohort were included. Sagittal 1.5 T MR images and lateral radiographs of the cervical spine were independently evaluated by two readers for: SI of the intervertebral discs using a grading system based of Pfirrmann (grade 1 normal/bright SI; 2 inhomogeneous/bright SI; 3 inhomogeneous/mildly decreased SI; 4 inhomogeneous/markedly decreased SI; 5 signal void), disc herniation and Modic changes (MRI) and disc space narrowing, osteophytes and sclerosis (radiograph). Readers were blinded for clinical information. Descriptive statistics were used for characteristics and prevalence of findings, and regression analysis was used for age and grades. Of 265 patients (36 % male, mean age 30), 221 (83 %) patients had 1 to 6 discs (median 4) with decreased SI. Of 1,590 discs, 737 (46 %) were grade 1; 711 (45 %) grade 2; 133 (8 %) grade 3; 8 (1 %) grade 4 and 1 (0 %) grade 5. Secondary signs of degeneration were rare and seen predominantly in C5-C7 and appear to be related to signal loss grade 3 and 4. Low signal intensity of intervertebral discs in absence of secondary degenerative signs in the cervical spine on fluid sensitive MR images might be pre-existing and part of the natural course. (orig.)

  17. 磁共振测量腰骶椎矢状面参数与L5/S1椎间盘退变的关系%Lumbosacral sagittal parameters measured by magnetic resonance in association to L5/S1 intervertebral disc degeneration

    Institute of Scientific and Technical Information of China (English)

    丁慕晨; 石志才; 卢春闻; 吴锦辉; 王超; 袁佳滨; 周振

    2016-01-01

    背景:以往已有一些关于腰骶椎矢状面参数与腰椎间盘退变性疾病相关性的报道,但试验对象多是笼统的椎间盘突出的患者,试验数据也多是在X射线片或CT上测得,而从磁共振成像得的腰骶段矢状面参数与出现腰骶椎间盘脱出的手术病例的相关性报道则较少见。  目的:磁共振测量和评价出现腰骶椎间盘脱出患者的腰骶矢状面参数变化,分析腰骶矢状面参数与椎间盘退变性疾病之间的关系。  方法:回顾性分析自2014年9月至2016年4月间上海第二军医大学附属长海医院骨科18-35岁腰痛患者90例,按有无L5/S1椎间盘突出分为无椎间盘突出组69例和脱出组21例,其中因L5/S1椎间盘脱出并行手术治疗的21例,其他69例为无椎间盘突出组;无椎间盘突出组按有无L5/S1椎间盘退变又分为退变组和对照组,其中仅有L5/S1椎间盘退变的35例作为退变组,剩余34例无椎间盘病变的作为对照组。测量的腰骶矢状面参数包括腰椎前凸角、骶骨平台角、腰骶关节角。  结果与结论:与对照组相比,退变组腰椎前凸角虽有减小但差异并不显著(P>0.05),而骶骨平台角及腰骶关节角均有明显减小(P OBJECTIVE:To measure and compare the lumbosacral sagittal parameters in L5/S1 disc extrusion patients, and to investigate the relationship between the lumbosacral sagittal parameters and L5/S1 disc degeneration diseases. METHODS:A total of 90 lumbago patients aged 18 to 35 years old were included from the Department of Orthopedics, Changhai Hospital Affiliated to The Second Military Medical University from September 2014 to April 2016 for retrospective analysis. According to with or without L5/S1 intervertebral disc protrusion, they were divided into intervertebral disc herniation group (69 cases) and disc extrusion group (21 cases received surgery). The intervertebral disc herniation group was

  18. Association between clinically diagnosed lumbar intervertebral disc prolapse and magnetic resonance image findings

    Directory of Open Access Journals (Sweden)

    Md. Habibur Rahman

    2016-09-01

    Full Text Available There are contradictory reports on the findings of magnetic resonance image (MRI in lumbar intervertebral disc prolapse. A study was conducted on 54 patients using 3 of 4 clinical criteria (low back pain with radiation down to the lower limbs, radicular pain along specific dermatomes, positive straight leg raising test, presence of neurological symptoms and signs e.g. motor or sensory deficit and MRI of lumbosacral spine of the respondent. Evaluation of MRI of lumbosacral spine was done based on extent of disc prolapse, disc degeneration, nerve root compression neural foramen compromise. The logistic regression analysis between the findings of MRI and the clinical features show that there was a significant association in the neural foramen or lateral recess (Odd's ratio 7.106, p<0.05, the root compression (p<0.01 as well as the disc extrusion (p<0.05. There was no statistical association between clinical levels and other MRI findings like disc protrusion and disc bulge (p value 0.21 and 0.14, respectively. The strength of agreement between clinical and MRI diagnosis level of disc prolapse was calculated using kappa statistics (k-value. The test revealed a very good agreement for L3/4 (k-value = 0.812 and good agreement for L4/5 and L5/SI  level (k-value 0.75 and 0.75 respectively between these two procedures, suggesting that level of disc prolapse could be correctly  diagnosed without MRI findings.  In conclusion, clinically diagnosed levels associate well with MRI levels, but all MRI abnormalities do not have any clinical significance. 

  19. Expression of matrix factors in the process of neovascularization of intervertebral disc

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Isoldi Pohl

    2015-06-01

    Full Text Available OBJECTIVE: To investigate the effects of proteins products of endothelial cells (ECs on the annulus fibrosus (AF cell metabolism in an in vitro culture.METHODS:Human AF cells were expanded in monolayer cultures and treated with proteins from the medium of cell line HMEC-1 (Human Microvascular Endothelial Cells (125µg/ml. After 72h of treatment RNA was isolated from AF cells for analysis of gene expression and the culture medium was collected for protein expression analysis.RESULTS: The qRT-PCR analysis demonstrated increased gene expression of matrix metalloproteinases (MMPs in AF cells treated with protein products of endothelial cells compared with cells from control group of AF cells: MMP-1 243.10 times (pCONCLUSIONS: In this study, we observed that the proteins produced by ECs induced the MMPs expression and suppressed the TIMPs as well as the aggrecan in primary cells of the human intervertebral disc, targeting the development of potential treatments for intervertebral disc degeneration and associated discogenic pain.

  20. Cell-seeded polyurethane-fibrin structures – A possible system for intervertebral disc regeneration

    Directory of Open Access Journals (Sweden)

    C Mauth

    2009-10-01

    Full Text Available Nowadays, intervertebral disc (IVD degeneration is one of the principal causes of low back pain involving high expense within the health care system. The long-term goal is the development of a medical treatment modality focused on a more biological regeneration of the inner nucleus pulposus (NP. Hence, interest in the endoscopic implantation of an injectable material took center stage in the recent past. We report on the development of a novel polyurethane (PU scaffold as a mechanically stable carrier system for the reimplantation of expanded autologous IVD-derived cells (disc cells to stimulate regenerative processes and restore the chondrocyte-like tissue within the NP. Primary human disc cells were seeded into newly developed PU spheroids which were subsequently encapsulated in fibrin hydrogel. The study aims to analyze adhesion properties, proliferation capacity and phenotypic characterization of these cells. Polymerase chain reaction was carried out to detect the expression of genes specifically expressed by native IVD cells. Biochemical analyses showed an increased DNA content, and a progressive enhancement of total collagen and glycosaminoglycans (GAG was observed during cell culture. The results suggest the synthesis of an appropriate extracellular matrix as well as a stable mRNA expression of chondrogenic and/or NP specific markers. In conclusion, the data presented indicate an alternative medical approach to current treatment options of degenerated IVD tissue.

  1. An Experimental Study of the Effects of Nicotine on the Intervertebral Disc

    Directory of Open Access Journals (Sweden)

    Nahla M. Afifi**# and Kawther A. Hafez

    2007-06-01

    Full Text Available Backgrounds: Clinically it had been noticed that a large proportion of patients presenting with low back pain are smokers. Therefore, in this experimental study the histological effects of nicotine on the lumbar intervertebral discs of the rabbits was investigated. Material and Methods: Eighteen rabbits were divided equally into 3 groups, Group 1 (a & b; as control. Group2 injected intraperitoneally by 5000 ng/kg nicotine daily for 4 weeks. Group3 injected intraperitoneally by 5000 ng/kg nicotine daily for 8 weeks. The selected dose produced blood nicotine levels equivalent to those found in heavy smokers (30 cigarettes / day. Results: Light and electron microscopic studies revealed that nicotine injection showed a variety of histological changes, which were not observed in the control group. This includes appearance of spaces within the nucleus pulposus and separation from the adjacent fibrous lamellae in the annulus fibrosus. Also loss of the regularity of the multilayered structure of the annulus fibrosus, and excessive inclusions associated with vacuoles which continue with the rough endoplasmic reticulum within the chondrocytes. Disc degeneration was more marked in rabbits injected with nicotine for 8 weeks (G3 than in those injected for 4 weeks (G2. Conclusion: It could be concluded that the disc degeneration is more common among smokers and is correlated with the duration of exposure to nicotine.

  2. A potential biological therapy with interleukin-10 and transforming growth factor-β for intervertebral disc degeneration in an in vitro beagle model%IL-10和TGF-β介导的生物学治疗犬椎间盘退变的体外实验研究

    Institute of Scientific and Technical Information of China (English)

    李威; 唐勇; 刘天懿; 贾治伟; 白雪东; 阮狄克

    2015-01-01

    Objective To explore the biological function and mechanism of underlying suppression of the release of inflammatory cytokines from degenerative disc cells and to evaluate the effectiveness of interleukin ( IL )-10 and transforming growth factor ( TGF )-β in suppressing the release of inflammatory cytokines from degenerative disc cells. Methods Six 1-year-old male beagle dogs were used. A beagle model of intervertebral disc degeneration ( IDD ) was established using an anular stab. The intervertebral discs were incised when the dogs were sacriifced 6 weeks later, and nucleus pulposus ( NP ) cells were isolated and cultured in vitro. The cultured degenerative NP cells were divided into 4 groups, including untreated degenerative NP cells, degenerative NP cells treated with 20 ng/ml IL-10, degenerative NP cells treated with 20 ng/ml TGF-βand degenerative NP cells treated with 20 ng/ml IL-10 and 20 ng / ml TGF-β. An enzyme-linked immunosorbent assay ( ELISA ) and real-time polymerase chain reaction ( PCR ) were performed to determine the effects of IL-10 and TGF-βon the protein and gene expressions of inflammatory cytokines. Results Higher expressions of inflammatory cytokines were observed in untreated degenerative NP cells. IL-10 and TGF-βblocked the cascade of inflammatory cytokines produced by degenerative disc cells and limited the development of inlfammatory responses. Conclusions The expressions of IL-1βand tumor necrosis factor ( TNF )-αin degenerative disc cells can be signiifcantly and stably suppressed by IL-10 and TGF-β. Thus, IL-10 and TGF-βmay be suitable biological therapeutic agents for IDD.%目的:探索利用细胞因子抑制退变椎间盘细胞释放炎症因子的生物学机制及作用,评价IL-10和TGF-β抑制退变椎间盘细胞释放炎症因子的有效性。方法建立6条1岁龄比格犬针刺退变模型,6周后处死动物取出退变椎间盘髓核组织,体外分离培养,将培养的退变髓核细胞分为4

  3. Tissue engineering and the intervertebral disc: the challenges

    OpenAIRE

    Kandel, Rita; Roberts, Sally; Urban, Jill P.G

    2008-01-01

    Disc degeneration is a common disorder. Although the back pain that can develop in association with this is rarely life-threatening, the annual cost in terms of morbidity, lost productivity, medical expenses and workers’ compensation benefits is significant. Surgical intervention as practised currently is directed towards removing the damaged or altered tissue. Development of new treatment modalities is critical as there is a growing consensus that the strategies used currently for symptomati...

  4. Changes seen on magnetic resonance imaging in the intervertebral disc space after chemonucleosis: a hypothesis concerning regeneration of the disc after chemonucleosis

    Energy Technology Data Exchange (ETDEWEB)

    Kato, F.; Mimatsu, K.; Kawakami, N.; Miura, T. (Dept. of Orthopaedic Surgery, School of Medicine, Nagoya Univ. (Japan))

    1992-08-01

    Measurements of the intervertebral disc space were made by magnetic resonance imaging and plain film examinations over a period of 2 years in 26 patients who had undergone chemonucleolysis. The height of the posterior portion of the disc decreased after 3 months and never recovered; the height of the anterior portion also decreased but recovered slightly over the same period. The angle of lordosis and the range of motion in the treated segment were decreased, but recovered. Marked decrease in signal from the disc was observed after 2 weeks which did not recover till 2 years after chemonucleolysis. We suspect that the disc degenerated markedly after chemonucleolysis and changed into a type of scar tissue, maturation of which could stabilize the affected segment. (orig.).

  5. Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar Correspondencia entre las clasificaciones de Pfirrmann y Modic en la degeneración del disco intervertebral lumbar Correlation between Pfirrmann and Modic classifications in the degeneration of lumbar intervertebral disc

    Directory of Open Access Journals (Sweden)

    Marcio Squassoni Leite

    2010-12-01

    con Pfirrmann tipo V, y el 36,4% de las alteraciones Modic 1 fueron por igual entre Pfirrmann tipo IV y V. Se encontró una asociación estadísticamente significativa entre los cambios de Modic y Pfirrmann (pOBJECTIVE: to correlate the changes found in the lumbar magnetic resonance imaging according to Modic and Pfirrmann classifications. METHODS: lumbar spine resonances of 54 outpatients were selected (23 men and 31 women, who were already under investigation because of their comorbidity. According to their degree of Pfirrmann classification, 264 intervertebral discs (L1 to S1 were classified. The presence of signal abnormalities of the vertebral body was recorded as Modic classification. The χ2 mwas applied, adopting significance levels below 0.05 (a=5%. RESULTS: The mean age studied was of 48.4 years (26-77 years. A higher prevalence of Pfirrmann type IV (31.1% was observed. In 88.3% of the sample, Modic was absent, and also Modic 3; 60% of Modic 2 was related to Pfirrmann type V, and 36.4% of Modic 1 was equally distributed among Pfirrmann type IV and V. Statistically significant association between Modic changes and Pfirrmann (p<0.001 was found. CONCLUSION: there was a clear association between the classifications studied, comparing the stages of Pfirrmann (IV and V with Modic type 1 and 2.

  6. Dynamic, six-axis stiffness matrix characteristics of the intact intervertebral disc and a disc replacement.

    Science.gov (United States)

    Holsgrove, Timothy P; Gill, Harinderjit S; Miles, Anthony W; Gheduzzi, Sabina

    2015-11-01

    Thorough pre-testing is critical in assessing the likely in vivo performance of spinal devices prior to clinical use. However, there is a lack of data available concerning the dynamic testing of lumbar (porcine model) total disc replacements in all six axes under preload conditions. The aim of this study was to provide new data comparing porcine lumbar spinal specimen stiffness between the intact state and after the implantation of an unconstrained total disc replacement, in 6 degrees of freedom. The dynamic, stiffness matrix testing of six porcine lumbar isolated disc specimens was completed using triangle waves at a test frequency of 0.1 Hz. An axial preload of 500 N was applied during all testing. Specimens were tested both in the intact condition and after the implantation of the total disc replacement. Sixteen key stiffness terms were identified for the comparison of the intact and total disc replacement specimens, comprising the 6 principal stiffness terms and 10 key off-axis stiffness terms. The total disc replacement specimens were significantly different to the intact specimens in 12 of these key terms including all six principal stiffness terms. The implantation of the total disc replacement resulted in a mean reduction in the principal stiffness terms of 100%, 91%, and 98% in lateral bending, flexion-extension, and axial rotation, respectively. The novel findings of this study have demonstrated that the unconstrained, low-friction total disc replacement does not replicate the stiffness of the intact specimens. It is likely that other low-friction total disc replacements would produce similar results due to stiffness being actively minimised as part of the design of low-friction devices, without the introduction of stiffening elements or mechanisms to more accurately replicate the mechanical properties of the natural intervertebral disc. This study has demonstrated, for the first time, a method for the quantitative comparative mechanical function

  7. Lateral Surgical Approach to Lumbar Intervertebral Discs in an Ovine Model

    OpenAIRE

    David Oehme; Tony Goldschlager; Jeffrey Rosenfeld; Andrew Danks; Peter Ghosh; Anne Gibbon; Graham Jenkin

    2012-01-01

    The sheep is becoming increasingly used as a large animal model for preclinical spine surgery studies. Access to the ovine lumbar intervertebral discs has traditionally been via an anterior or anterolateral approach, which requires larger wound incisions and, at times, significant abdominal retraction. We present a new minimally invasive operative technique for a far-lateral approach to the ovine lumbar spine that allows for smaller incisions, excellent visualisation of intervertebral discs,...

  8. [The synergistic effect of amygdalin and HSYA on the IL-1beta induced endplate chondrocytes of rat intervertebral discs].

    Science.gov (United States)

    Niu, Kai; Zhao, Yong-Jian; Zhang, Lei; Li, Chen-Guang; Wang, Yong-Jun; Zheng, Wei-Chao

    2014-08-01

    The effect of amygdalin joint hydroxysafflor yellow A (HSYA) on the endplate chondrocytes derived from intervertebral discs of rats induced by IL-1beta and the possible mechanism were studied and explored. Chondrocytes were obtained from endplate of one-month SD rat intervertebral discs and cultured primary endplate chondrocytes. After identification, they were divided into normal group, induced group, amygdalin group, HSYA group and combined group. CCK-8 kit was adopted to detect the proliferation of the endplate chondrocytes. FCM was measured to detect the apoptosis. Real-time PCR method was adopted to observe the mRNA expression of Aggrecan, Col 2 alpha1, Col 10 alpha1, MMP-13 and the inflammatory cytokines IL-1beta. The protein expression of Col II, Col X was tested through immunofluorescence. Compared with the normal group, the proliferation of the endplate chondrocytes decreased while the apoptosis increased (P amygdalin group, HSYA group, the combined group could inhibit the apoptosis and promote the proliferation (P amygdalin and HSYA. Amygdalin joint HSYA could inhibit the degeneration of the endplate chondrocytes derived from intervertebral discs of rats induced by IL-1beta and better than the single use of amygdalin or HSYA.

  9. Text-mining network analysis of the response to osmotic stimuli in the intervertebral disc.

    Science.gov (United States)

    Xu, X; Liu, L; Lu, Q Y

    2013-05-13

    Intervertebral disc cells experience a broad range of physical stimuli under physiologic conditions, including alterations in their osmotic environment. The purpose of this study was to construct a text-mining network of the genes induced during the response to osmotic stimuli in the intervertebral disc. We obtained a gene expression profile of human intervertebral disc cells from the National Center for Biotechnology Information, after culture under hyper- and hypo-osmotic conditions compared to iso-osmotic conditions, and we identified 65 differentially expressed genes of intervertebral disc cells. We constructed a text-mining network using Biblio-MetReS between the differentially expressed genes and other genes that were included in the same document as the differentially expressed genes. Then, we performed pathway-enrichment analysis to identify the most relevant pathways for the response to osmotic stimuli in intervertebral disc cells. Our data provide a comprehensive bioinformatics analysis of genes and pathways that may be involved in the response to osmotic stimuli in the intervertebral disc.

  10. Lubricin deficiency in the murine lumbar intervertebral disc results in elevated torsional apparent modulus.

    Science.gov (United States)

    Teeple, Erin; Aslani, Koosha; Shalvoy, Matthew R; Medrano, Jade E; Zhang, Ling; Machan, Jason T; Fleming, Braden C; Jay, Gregory D

    2015-07-16

    The purpose of this study was to investigate the mechanical consequences of proteoglycan 4 (Prg4) deficiency on intervertebral disc mechanics using a Prg4 knockout mouse model. Prg4, also called lubricin, was first identified as the boundary lubricant in synovial fluid but has subsequently been localized within a number of musculoskeletal tissues in areas subjected to shear and tensile stresses, including the intervertebral disc. The function of lubricin in the intervertebral disc has not been determined. Lumbar level 1-2 vertebral body-disc-vertebral body motion segments were isolated from Prg4 null mice and wild type (WT) litter mate controls. Disc dimensions were measured and motion segments were tested in axial loading and torsion. Torque measurements and disc dimensions were used to calculate the torsional apparent modulus for discs from Prg4 null and WT discs. Discs from Prg4 null mice had a significantly smaller mean transverse disc area (p=0.0057), with a significantly larger proportion of this area occupied by the nucleus pulposus (p<0.0001), compared to WT specimens. Apparent torsional moduli were found to be elevated in Prg4 null lumbar discs compared to WT controls at 10-10° (p=0.0048) and 10-30° (p=0.0127) rotation. This study suggests a functional role for Prg4 in the murine intervertebral disc. The absence of Prg4 was associated with an increased apparent torsional modulus and the structural consequences of Prg4 deficiency in the intervertebral disc, with expansion of the area of the nucleus pulposus relative to the transverse disc area in Prg4 null specimens.

  11. Disc degeneration-related clinical phenotypes.

    Science.gov (United States)

    Battié, Michele C; Lazáry, Aron; Fairbank, Jeremy; Eisenstein, Stephen; Heywood, Chris; Brayda-Bruno, Marco; Varga, Péter Pál; McCall, Iain

    2014-06-01

    The phenotype, or observable trait of interest, is at the core of studies identifying associated genetic variants and their functional pathways, as well as diagnostics. Yet, despite remarkable technological developments in genotyping and progress in genetic research, relatively little attention has been paid to the equally important issue of phenotype. This is especially true for disc degeneration-related disorders, and the concept of degenerative disc disease, in particular, where there is little consensus or uniformity of definition. Greater attention and rigour are clearly needed in the development of disc degeneration-related clinical phenotypes if we are to see more rapid advancements in knowledge of this area. When selecting phenotypes, a basic decision is whether to focus directly on the complex clinical phenotype (e.g. the clinical syndrome of spinal stenosis), which is ultimately of interest, or an intermediate phenotype (e.g. dural sac cross-sectional area). While both have advantages, it cannot be assumed that associated gene variants will be similarly relevant to both. Among other considerations are factors influencing phenotype identification, comorbidities that are often present, and measurement issues. Genodisc, the European research consortium project on disc-related clinical pathologies has adopted a strategy that will allow for the careful characterisation and examination of both the complex clinical phenotypes of interest and their components.

  12. Expression of the Trp2 allele of COL9A2 is associated with alterations in the mechanical properties of human intervertebral discs.

    Science.gov (United States)

    Aladin, Darwesh M K; Cheung, Kenneth M C; Chan, Danny; Yee, Anita F Y; Jim, Jeffrey J T; Luk, Keith D K; Lu, William W

    2007-12-01

    Biomechanical study into the association between genetic polymorphism in COL9A2 and mechanical properties of human nucleus pulposus. To examine whether there is an association between genetic polymorphism in a structural gene, and alterations in the mechanical properties of the intervertebral discs that may predispose to disc degeneration. Genetic studies have demonstrated that a polymorphism (Trp2 allele) in COL9A2 coding for alpha2 chain of collagen IX predisposes the individual to disc degeneration. The mechanism of this predisposition is not known. Blood and whole disc samples were retrieved from adolescents and young adults during scoliosis surgery, degenerated discs were retrieved from patients with back pain during anterior spinal fusion. Anulus fibrosus and nucleus pulposus from a set of the scoliosis discs were used to perform immunohistochemistry to demonstrate the presence of collagen IX in the scoliosis discs. For the remaining samples, DNA was extracted from blood to determine the Trp2 status by sequencing. Nondegenerated (Trp2-), nondegenerated (Trp2+), and degenerated (Trp2-) nucleus pulposus samples were tested in confined compression. Swelling pressure and compressive modulus were measured and compared between groups. Positive staining of collagen IX was detected in both anulus fibrosus and nucleus pulposus sections confirming its presence in the scoliosis discs. The mean swelling pressure and compressive modulus values of 6 nondegenerated (Trp2+) samples (swelling pressure = 0.0019 MPa, compressive modulus = 0.97 MPa) were significantly lower (P pressure = 0.015 MPa; compressive modulus = 1.89 MPa). This is the first study to demonstrate an association between the Trp2 allele and disc mechanics, thus relating genetic variations and debilitating mechanical alterations that may ultimately result in intervertebral disc degeneration.

  13. Adipose-derived mesenchymal stem cells combined with platelet gel for repair of intervertebral disc degeneration in rats%脂肪间充质干细胞复合血小板凝胶修复兔椎间盘退变★

    Institute of Scientific and Technical Information of China (English)

    孟繁星; 李放; 叶超群; 阴彦斌; 高阳

    2013-01-01

    -adipose derived mesenchymal stem cel s complex on rabbit intervertebral disc degeneration. METHODS: Rabbit arterial blood was extracted to prepare autologous platelet-rich plasma using secondary centrifugal method, and adipose-derived mesenchymal stem cel s were isolated from the fat tissue of rabbit scapular area. Then, adipose-derived mesenchymal stem cel s-platelet-rich plasma gel complex was prepared. New Zealand white rabbits were randomized into control group, model group, platelet-rich plasma gel group and complex group (adipose-derived mesenchymal stem cel s-platelet-rich plasma gel complex). Intervertebral disc degeneration model was made in the latter three groups using puncture method. At 2 weeks after modeling, corresponding materials were injected into the disc in the four groups, respectively. RESULTS AND CONCLUSION: After intervertebral disc degeneration in rabbits, the intervertebral gap was significantly reduced, the nucleus pulposus signal was obviously decreased, nucleus pulposus matrix appeared to have a high density and to be deeply stained. The symptoms above mentioned were improved significantly after intervention with the platelet-rich plasma gel or the complex of adipose-derived mesenchymal stem cel s-platelet-rich plasma gel, while the latter was better in curative effects. Injection of platelet-rich plasma gel and adipose-derived mesenchymal stem cel s-platelet-rich plasma gel complex can reduce the influence of disc degeneration, and the effect of adipose-derived mesenchymal stem cel s-platelet-rich plasma gel complex is more outstanding.

  14. Establishment of the intervertebral disc degeneration model of rabbits by using homemade puncture needles percutaneous puncturing the anulus fibrosus at surface allocation%经皮穿刺纤维环建立兔腰椎间盘退变模型

    Institute of Scientific and Technical Information of China (English)

    黄杰烽; 郑杨; 夏臣杰; 何川; 赵凯; 杜文喜; 陈俊杰; 童培建

    2016-01-01

    目的:探讨使用自制穿刺针经皮穿刺纤维环制备兔腰椎间盘退变模型的可行性。方法将18只新西兰大白兔分为实验组、假手术组及空白对照组。实验组及假手术组使用自制穿刺针穿刺L3~4、L4~5和L5~6椎间盘位置,实验组穿刺椎间盘深度为5 mm,假手术组钝性穿刺但不损伤椎间盘,空白对照组不作处理。术后3、6、9周每组取2只兔麻醉后行腰椎MRI检查,处死行大体观察并取椎间盘行HE染色及髓核蛋白多糖含量测定。结果术后3周开始实验组MRI信号强度、髓核蛋白多糖含量与其他两组相比明显下降( P<0.05),其后呈逐渐下降趋势,大体观察及HE染色显示实验组髓核及纤维环呈逐渐退变趋势。结论自制穿刺针经皮穿刺纤维环法能成功建立兔腰椎间盘退变模型,具有操作简单、损伤小、动物存活率高等优点。%Objective To establish of rabbit intervertebral disc degeneration models by using homemade puncture needles percutaneous annulus fibrosus puncture and assess the feasibility and controllability. Methods 18 New Zea-land white rabbits were divided into the experimental group, the sham group and the control group. L3~4 , L4~5 and L5~6 discs were punctured by the homemade puncture needles in the experimental group as well as in the sham group. The discs were punctured in the experimental group with a depth of 5mm. The sham group was treated by puncture without damage the discs. 2 rabbits were used to observe the anatomical structures. Two rabbits were anesthetized in 3, 6 and 9 weeks respectively after operation for MRI images. Then the animals were killed, the change of lumbar in-tervertebral discs was observed by MRI, histological and nucleus proteoglycan contents were measured. Results All animals were survived, no death, infection, paralysis and other complications. Signal intensity of the intervention group showed a progressive downtrend at 3 weeks after intervention (P<0

  15. Research Advances in Intervertebal Disc Degeneration Models%椎间盘退变模型的研究进展

    Institute of Scientific and Technical Information of China (English)

    王凯

    2013-01-01

    目前国内外关于椎间盘退变的病因和发病机制尚无定论,构建能模拟人退变椎间盘的动物模型是研究的关键.常用于研究椎间盘退行性疾病的模型可分为体内、体外模型.目前已成功建立的椎间盘动物模型均具有一定的局限性,尚无公认的能够完全模拟人类椎间盘退变的标准模型.随着大型动物与灵长类动物模型的建立,动物椎间盘退变模型与人类椎间盘退变之间的相关性和可比性逐渐明确,其在椎间盘退变疾病的研究中具有广阔的前景.%The etiology and pathogenesis of intervertebal disc degeneration is still not clear at home and abroad, and an animal model which can simulate the human intervertebral disc degeneration is the key to the study. Presently,the intervertebral disc degeneration model can be divided into two kinds:in vivo and ex vivo models. The established intervertebral disc animal models have certain limitations, and there is no acknowledged standard model which can completely simulate human intervertebral disc degeneration. With the large animal and primate animal models established,the relativity and comparability between animal and human intervertebal disc degeneration are gradually clear, and the animal models have broad prospects in the research.

  16. Biochemical imaging of cervical intervertebral discs with glycosaminoglycan chemical exchange saturation transfer magnetic resonance imaging: feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, Christoph; Mueller-Lutz, Anja; Zimmermann, Lisa; Boos, Johannes; Wittsack, Hans-Joerg; Antoch, Gerald; Miese, Falk [Department of Diagnostic and Interventional Radiology, University Dusseldorf, Medical Faculty, Dusseldorf (Germany); Schmitt, Benjamin [Siemens Ltd. Australia, Healthcare Sector, Macquarie Park, NSW (Australia)

    2016-01-15

    To evaluate glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging at 3T in the assessment of the GAG content of cervical IVDs in healthy volunteers. Forty-two cervical intervertebral discs of seven healthy volunteers (four females, three males; mean age: 21.4 ± 1.4 years; range: 19-24 years) were examined at a 3T MRI scanner in this prospective study. The MRI protocol comprised standard morphological, sagittal T2 weighted (T2w) images to assess the magnetic resonance imaging (MRI) based grading system for cervical intervertebral disc degeneration (IVD) and biochemical imaging with gagCEST to calculate a region-of-interest analysis of nucleus pulposus (NP) and annulus fibrosus (AF). GagCEST of cervical IVDs was technically successful at 3T with significant higher gagCEST values in NP compared to AF (1.17 % ± 1.03 % vs. 0.79 % ± 1.75 %; p = 0.005). We found topological differences of gagCEST values of the cervical spine with significant higher gagCEST effects in lower IVDs (r = 1; p = 0). We could demonstrate a significant, negative correlation between gagCEST values and cervical disc degeneration of NP (r = -0.360; p = 0.019). Non-degenerated IVDs had significantly higher gagCEST effects compared to degenerated IVDs in NP (1.76 % ± 0.92 % vs. 0.52 % ± 1.17 %; p < 0.001). Biochemical imaging of cervical IVDs is feasible at 3T. GagCEST analysis demonstrated a topological GAG distribution of the cervical spine. The depletion of GAG in the NP with increasing level of morphological degeneration can be assessed using gagCEST imaging. (orig.)

  17. Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population

    Directory of Open Access Journals (Sweden)

    Andrzej Nowakowski

    2015-05-01

    Full Text Available Objective. Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Materials and methods. Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results. Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions. This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation.

  18. Combined expression of CTGF and tissue inhibitor of metalloprotease-1 promotes synthesis of proteoglycan and collagen type Ⅱ in rhesus monkey lumbar intervertebral disc cells in vitro

    Institute of Scientific and Technical Information of China (English)

    LIU Yong; KONG Jie; CHEN Bo-hua; HU You-gu

    2010-01-01

    Background Low back pain has emerged as a widespread disease often caused by intervertebral disc degeneration.This study aimed to establish an in vitro cell culture model of rhesus monkey lumbar intervertebral discs and to investigate the effect of combined connective tissue growth factor (CTGF) and tissue inhibitor of metalloprotease-1(TIMP-1) expression mediated by adeno-associated virus (AAV) on collagen type Ⅱ and proteoglycan levels.The purpose of these investigations was to explore potential methods for relieving the degeneration of lumbar intervertebral disc cells.Methods Rhesus monkey lumbar intervertebral disc nucleus pulposus cells (NPCs) were isolated by enzyme digestion,cultured, and transduced with rAAV2-CTGF-IRES-TIMP-1, rAAV2-CTGF, or rAAV2-TIMP-1 at a multiplicity of infection (MOl) of 106.The expression of collagen type Ⅱ and proteoglycan was measured using RT-PCR and Western blotting.The synthetic rate of proteoglycan was measured using 35S incorporation.Results Rhesus monkey lumbar intervertebral disc NPCs were transduced with rAAV2-CTGF-IRES-TIMP-1,rAAV2-CTGF, and rAAV2-TIMP-1 and the transduced genes were expressed and detected.Compared to the control,CTGF promoted the synthesis of collagen type Ⅱ and proteoglycan.TIMP-1 showed an enhancing effect on the expression of proteoglycan but no effect on collagen type Ⅱ.Expression of both genes in rhesus monkey lumbar intervertebral disc NPCs significantly enhances the synthesis of proteoglycan and collagen type Ⅱ.Conclusions Single gene transduction of CTGF or TIMP-1 can enhanced synthesis of proteoglycan.CTGF expression can also enhance collagen type Ⅱ protein synthesis.Combined transduction of both CTGF and TIMP1 can significantly promote the expression of proteoglycan and collagen type Ⅱ to levels greater than transduction of a single gene alone.Our study provides a good basis for multi-gene therapy to treat lumbar intervertebral disc degeneration.

  19. Up-regulation of Niacinamide in Intervertebral Disc Aggrecan in vitro

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The regulatory effects of niacinamide (Nia) on intervertebral disc (IVD) aggrecan in vitro was investigated. Chiba's 10 ng/mL interleukin-1 (IL-1)-induced rabbit IVD degeneration model in vitro was established. 0.5, 0.25 and 0.05 mg/mL Nia was added to normal and degenerated IVDs for intervention. On the first and second week after intervention, safranin O-fast green staining intensity and glycosaminoglycan (GS) content were measured. The expression of aggrecan core protein was detected by RT-PCR. The results showed: (1) After treatment with 0.5 mg/mL Nia for one week, the GS content in nucleus pulposus (NP) was increased by 44.8 % as compared with control group (P<0.01); The GS content in IL-1 induction groups was increased with the increase of Nia concentrations: After treatment with 0.5 mg/mL for one week, the GS content in NP was increased by 68.3 % as compared with control group (P<0.01). After two weeks, GS content in NP and fibrous rings was still higher than in control group at the same period (P<0.01)and untreated group (P<0.01). (2) Safranin O-fast green staining revealed that with the increase of Nia concentrations, staining density in NP and fibrous rings was increased and histological structure damage to IVDs by IL-1β was alleviated. (3) RT-PCR showed that the expression of core protein gene in IL-1β-induced degenerated IVDS was increased with the increase of Nia concentrations.It was concluded that under conditions in vitro, Nia could up-regulate the expression of aggrecan in IVDs and protect IVDs from IL-1β-induced degeneration at least partially, which offers a potential choice for IVD degeneration clinical therapy.

  20. Up-regulation of niacinamide in intervertebral disc aggrecan in vitro.

    Science.gov (United States)

    Xiong, Xiaoqian; Yang, Shuhua; Shao, Zengwu; Liu, Xin; Zhan, Zirui; Duan, Deyu

    2006-01-01

    The regulatory effects of niacinamide (Nia) on intervertebral disc (IVD) aggrecan in vitro was investigated. Chiba's 10 ng/mL interleukin-1 (IL-1)-induced rabbit IVD degeneration model in vitro was established. 0.5, 0.25 and 0.05 mg/mL Nia was added to normal and degenerated IVDs for intervention. On the first and second week after intervention, safranin O-fast green staining intensity and glycosaminoglycan (GS) content were measured. The expression of aggrecan core protein was detected by RT-PCR. The results showed: (1) After treatment with 0.5 mg/mL Nia for one week, the GS content in nucleus pulposus (NP) was increased by 44.8% as compared with control group (P < 0 01); The GS content in IL-1 induction groups was increased with the increase of Nia concentrations: After treatment with 0.5 mg/mL for one week, the GS content in NP was increased by 68.3% as compared with control group (P < 0.01). After two weeks, GS content in NP and fibrous rings was still higher than in control group at the same period (P < 0.01) and untreated group (P < 0.01). (2) Safranin O-fast green staining revealed that with the increase of Nia concentrations, staining density in NP and fibrous rings was increased and histological structure damage to IVDs by IL-1beta was alleviated. (3) RT-PCR showed that the expression of core protein gene in IL-1beta-induced degenerated IVDS was increased with the increase of Nia concentrations. It was concluded that under conditions in vitro, Nia could up-regulate the expression of aggrecan in IVDs and protect IVDs from IL-1beta-induced degeneration at least partially, which offers a potential choice for IVD degeneration clinical therapy.

  1. Studies of human intervertebral disc cell function in a constrained in vitro tissue culture system.

    Science.gov (United States)

    Le Maitre, Christine Lyn; Hoyland, Judith Alison; Freemont, Anthony J

    2004-06-01

    This is a laboratory-based study examining a novel in vitro culture system for intervertebral disc tissue. Address the hypothesis that "the novel culture system will preserve intervertebral disc tissue matrix and cell function and prevent cellular apoptosis for periods up to 21 days." Studies of cell function in human intervertebral disc tissue are scarce. In vivo study of human intervertebral disc cells remains impracticable; in situ molecular biology in histologic sections lacks a dynamic dimension; and as for in vitro studies, cell culture often lacks physiologic relevance and explant cultures are subject to loss of tissue integrity and altered cell behavior. There is a biologic and therapeutic need for a satisfactory explant culture system for studying human intervertebral disc tissue in a controlled environment. Samples of human intervertebral disc tissue, obtained at surgery, were examined for a number of tissue and cell parameters immediately after excision (controls) and following culture of tissue samples either in a plastic ring or unconstrained in tissue culture medium for up to 3 weeks. Data were compared between cultured tissue and controls. By comparison with control tissue, unconstrained explants swelled, tissue structure was disturbed, and there were profound changes in cell function. By contrast, tissue cultured in plastic rings maintained tissue structure, and after 3 weeks, the cellular parameters were the same as in controls. This is the first reported system to preserve cell function of human discal explants for long periods in tissue culture. It will be a useful tool for a wide range of investigations of intervertebral disc biology that have not hitherto been possible.

  2. Cell therapy for intervertebral disc repair: advancing cell therapy from bench to clinics

    Directory of Open Access Journals (Sweden)

    LM Benneker

    2014-05-01

    Full Text Available Intervertebral disc (IVD degeneration is a major cause of pain and disability; yet therapeutic options are limited and treatment often remains unsatisfactory. In recent years, research activities have intensified in tissue engineering and regenerative medicine, and pre-clinical studies have demonstrated encouraging results. Nonetheless, the translation of new biological therapies into clinical practice faces substantial barriers. During the symposium "Where Science meets Clinics", sponsored by the AO Foundation and held in Davos, Switzerland, from September 5-7, 2013, hurdles for translation were outlined, and ways to overcome them were discussed. With respect to cell therapy for IVD repair, it is obvious that regenerative treatment is indicated at early stages of disc degeneration, before structural changes have occurred. It is envisaged that in the near future, screening techniques and non-invasive imaging methods will be available to detect early degenerative changes. The promises of cell therapy include a sustained effect on matrix synthesis, inflammation control, and prevention of angio- and neuro-genesis. Discogenic pain, originating from "black discs" or annular injury, prevention of adjacent segment disease, and prevention of post-discectomy syndrome were identified as prospective indications for cell therapy. Before such therapy can safely and effectively be introduced into clinics, the identification of the patient population and proper standardisation of diagnostic parameters and outcome measurements are indispensable. Furthermore, open questions regarding the optimal cell type and delivery method need to be resolved in order to overcome the safety concerns implied with certain procedures. Finally, appropriate large animal models and well-designed clinical studies will be required, particularly addressing safety aspects.

  3. The study of migration of bone mesenchymal stem cells transplanted in intervertebral discs of rabbits and expression of exogenous gene

    Institute of Scientific and Technical Information of China (English)

    Jintang Wang; Hong Zhang; Yingang Zhang; Xiaowei Zhang; Meng Li

    2006-01-01

    Objective: To explore the survival and migration of bone mesenchymal stem cells transplantated in intervertebral disc of rabbits and expression of the exogenic genes. Methods: Thirty-two rabbits were used, A randomized block design was used and discs in the same rabbit were one block,the lumbar discs from L2-3 to L5-6 were randomly divided into blank group, saline group, cell transplantation group Ⅰ and cell transplantation group Ⅱ. The fluorescence microscopy was used to determine the fluorescence of the maker protein GFP and DNA-PCR was used to analyze the copies of DNA of neomycin-resistant gene at 1, 3, 6, months after transplantation. Results: There was fluorescence in cell transplantation group Ⅰ and Ⅱ and none in blank group, saline group at 1, 3, 6 months after transplantation. In cell transplantation groups,the fluorescent distribution was more scatter with time, but no significant difference between cell groups Ⅰ and Ⅱ. The test of neomycin resistant gene expressed in cell transplantation group Ⅰ and Ⅱ and quantitative analysis showed that there was no significant difference between the cell groups Ⅰ and Ⅱ (P>0.05). Conclusion: The transplanted bone mesenchymal stem cells can survive, migrate and the transfer genes can express efficiently, it suggests that the BMSC therapy may be effective to prevent and treat intervertebral disc degeneration.

  4. Construction of a tissue engineered intervertebral disc with high biological activity using an allogeneic intervertebral disc supplemented with transfected nucleus pulposus cells expressing exogenous dopamine beta-hydroxylase.

    Science.gov (United States)

    Bai, M; Wang, Y H; Yin, H P; Li, S W

    2015-09-09

    This study addressed the in vitro construction and biological activity of tissue engineered intervertebral discs with exogenous human dopamine beta-hydroxylase (DBH) nucleus pulposus cells. pSNAV2.0-DBH expression plasmids were utilized to enhance the survival rates of intervertebral disc tissue cells. Various concentrations of transfected nucleus pulposus cells were injected into the discs, and DBH mRNA expression was determined using polymerase chain reaction amplification. Polysaccharide content and total collagen protein content in the engineered disc nucleus pulposus tissue were determined. The visible fluorescence intensities of the 1 x 10(5) and 1 x 10(6) groups vs the 1 x 10(4) group were significantly increased (P 0.05) at 7 days after injection. DBH mRNA expression could be detected in the all but the EGFP control group at 14 days culture. No significant difference was observed in the protein content between the 1 x 10(4) and the control groups at various times, while the protein content was significantly higher in the 1 x 10(5) vs the control and the 1 x 10(4) groups at 7-, 14-, and 21-day cultures. These results demonstrate that a tissue engineered intervertebral disc with high biological activity can be constructed by utilizing allogeneic intervertebral discs stored in liquid nitrogen and a 1 x 10(5) transfected nucleus pulposus cell complex with in vitro culture for 14 days. This model can be used in animal experiments to study the biological activity of the engineered discs.

  5. Translation of an engineered nanofibrous disc-like angle-ply structure for intervertebral disc replacement in a small animal model.

    Science.gov (United States)

    Martin, John T; Milby, Andrew H; Chiaro, Joseph A; Kim, Dong Hwa; Hebela, Nader M; Smith, Lachlan J; Elliott, Dawn M; Mauck, Robert L

    2014-06-01

    Intervertebral disc degeneration has been implicated in the etiology of low back pain; however, the current surgical strategies for treating symptomatic disc disease are limited. A variety of materials have been developed to replace disc components, including the nucleus pulposus (NP), the annulus fibrosus (AF) and their combination into disc-like engineered constructs. We have previously shown that layers of electrospun poly(ε-caprolactone) scaffold, mimicking the hierarchical organization of the native AF, can achieve functional parity with native tissue. Likewise, we have combined these structures with cell-seeded hydrogels (as an NP replacement) to form disc-like angle-ply structures (DAPS). The objective of this study was to develop a model for the evaluation of DAPS in vivo. Through a series of studies, we developed a surgical approach to replace the rat caudal disc with an acellular DAPS and then stabilized the motion segment via external fixation. We then optimized cell infiltration into DAPS by including sacrificial poly(ethylene oxide) layers interspersed throughout the angle-ply structure. Our findings illustrate that DAPS are stable in the caudal spine, are infiltrated by cells from the peri-implant space and that infiltration is expedited by providing additional routes for cell migration. These findings establish a new in vivo platform in which to evaluate and optimize the design of functional disc replacements.

  6. Morphologic features of spontaneous annular tears and disc degeneration in the aging sand rat (Psammomys obesus obesus).

    Science.gov (United States)

    Gruber, H E; Hanley, E N

    2017-08-11

    The sand rat, a member of the gerbil family, is a valuable small animal model in which intervertebral disc degeneration occurs spontaneously as the animal ages. Radiographic features of cervical and lumbar degeneration resemble those in human spines. We conducted a retrospective analysis of spines of 140 animals 3-41 months old focusing specifically on the presence of annular tears that are not visible by radiography and have not been described previously in the sand rat disc. During degeneration of the nucleus pulposus, notochordal cell death occurs and granular material, which stains with Alcian blue for proteoglycans, accumulates. Lamellar architecture also deteriorates and annular tears occur that are morphologically similar to the concentric, radiating and transdiscal annular tears in human discs. These tears contain granular material that provides a "marker" that can be used to distinguish the annular tears from artefactual separations during sectioning. We observed lamellar degeneration and separation in the annulus fibrosus at 4 months with associated tears that contained granular material in the nucleus. Tears that contained granular material and displacement of the degenerating nucleus were common in cervical and lumbar discs of animals older than 9 months; some specimens showed tears at 4 and 5 months. With advanced degeneration, granular globules were displaced dorsally adjacent to and into the spinal cord area and also ventrally into regions where osteophytes formed. We present morphologic data that expand the utility of this rodent model of spontaneous age-related disc degeneration and provide novel information on annular tears and disc degeneration.

  7. The use of a novel injectable hydrogel nucleus pulposus replacement in restoring the mechanical properties of cyclically fatigued porcine intervertebral discs.

    Science.gov (United States)

    Balkovec, Christian; Vernengo, Jennifer; McGill, Stuart M

    2013-06-01

    Repeated flexion and extension of an intervertebral disc has been shown to affect the angular stiffness of spinal motion segments and is a barometer of the mechanical integrity of the disc. A degenerated disc that loses height causes higher levels of stress on the annulus and facet joints which may increase its level of degeneration; restoring disc height may therefore help to slow this degenerative cascade. Previous research has indicated that nucleus implants have the potential to improve the mechanical characteristics of a disc and an implant that is custom-fit to the intervertebral disc yields the best results with respect to decreasing annular degeneration. Two groups of porcine spinal motion segments were exposed to repeated flexion and extension. One group was then injected with a novel hydrogel while the other group was used as a control. Both groups were then exposed to another round of cyclic flexion and extension to examine the effect that the hydrogel had on restoring the original mechanics to the motion segments. Angular stiffness was restored to the group which received the hydrogel injection in addition to a significant improvement in specimen height. No significant changes were seen in the group which did not receive an injection. It would appear that use of the novel injectable hydrogel is able to restore angular stiffness to cyclically fatigued spinal motion segments. It is also important to note that continued repetition of the event causing specimen fatigue after performing hydrogel injection will result in an eventual return to the same fatigued state.

  8. Distinction between the extracellular matrix of the nucleus pulposus and hyaline cartilage: a requisite for tissue engineering of intervertebral disc

    Directory of Open Access Journals (Sweden)

    Mwale F.

    2004-12-01

    Full Text Available Tissue engineering of intervertebral discs (IVD using mesenchymal stem cells (MSCs induced to differentiate into a disc-cell phenotype has been considered as an alternative treatment for disc degeneration. However, since there is no unique marker characteristic of discs and since hyaline cartilage and immature nucleus pulposus (NP possess similar macromolecules in their extracellular matrix, it is currently difficult to recognize MSC conversion to a disc cell. This study was performed to compare the proteoglycan to collagen ratio (measured as GAG to hydroxyproline ratio in the NP of normal disc to that of the hyaline cartilage of the endplate within the same group of individuals and test the hypothesis that this ratio can be used for in vivo studies to distinguish between a normal NP and hyaline cartilage phenotype. Whole human lumbar spine specimens from fresh cadavers, ranging in age from 12 weeks to 79 years, were used to harvest the IVDs and adjacent endplates. The GAG to hydroxyproline ratio within the NP of young adults is approximately 27:1, whereas the ratio within the hyaline cartilage endplate of the same aged individuals is about 2:1. The production of an extracellular matrix with a high proteoglycan to collagen ratio can be used in vivo to distinguish NP cells from chondrocytes, and could help in identifying a NP-like phenotype in vivo as opposed to a chondrocyte when MSCs are induced to differentiate for tissue engineering of a disc.

  9. Riboflavin crosslinked high-density collagen gel for the repair of annular defects in intervertebral discs: An in vivo study.

    Science.gov (United States)

    Grunert, Peter; Borde, Brandon H; Towne, Sara B; Moriguchi, Yu; Hudson, Katherine D; Bonassar, Lawrence J; Härtl, Roger

    2015-10-01

    Open annular defects compromise the ability of the annulus fibrosus to contain nuclear tissue in the disc space, and therefore lead to disc herniation with subsequent degenerative changes to the entire intervertebral disc. This study reports the use of riboflavin crosslinked high-density collagen gel for the repair of annular defects in a needle-punctured rat-tail model. High-density collagen has increased stiffness and greater hydraulic permeability than conventional low-density gels; riboflavin crosslinking further increases these properties. This study found that treating annular defects with crosslinked high-density collagen inhibited the progression of disc degeneration over 18 weeks compared to untreated control discs. Histological sections of FITC-labeled collagen gel revealed an early tight attachment to host annular tissue. The gel was subsequently infiltrated by host fibroblasts which remodeled it into a fibrous cap that bridged the outer disrupted annular fibers and partially repaired the defect. This repair tissue enhanced retention of nucleus pulposus tissue, maintained physiological disc hydration, and preserved hydraulic permeability, according to MRI, histological, and mechanical assessments. Degenerative changes were partially reversed in treated discs, as indicated by an increase in nucleus pulposus size and hydration between weeks 5 and 18. The collagen gel appeared to work as an instant sealant and by enhancing the intrinsic healing capabilities of the host tissue.

  10. Assessment of mechanical properties of isolated bovine intervertebral discs from multi-parametric magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Recuerda Maximilien

    2012-10-01

    principal component. The dendograms showed a natural division into four clusters for the nucleus pulposus and into three or four clusters for the annulus fibrosus. Conclusions The compressive moduli and the permeabilities of isolated IVDs can be assessed mostly by MT and diffusion sequences. However, the relationships have to be improved with the inclusion of MRI parameters more sensitive to IVD degeneration. Before the use of this technique to quantify the mechanical properties of IVDs in vivo on patients suffering from various diseases, the relationships have to be defined for each degeneration state of the tissue that mimics the pathology. Our MRI protocol associated to principal component analysis and agglomerative hierarchical clustering are promising tools to classify the degenerated intervertebral discs and further find biomarkers and predictive factors of the evolution of the pathologies.

  11. Potential application of notochordal cells for intervertebral disc regeneration: an in vitro assessment

    Directory of Open Access Journals (Sweden)

    E Potier

    2014-07-01

    Full Text Available Recent studies suggest that notochordal cells (NCs might be involved in intervertebral disc homeostasis, a role exploitable to counteract matrix degradation as observed during degeneration. This study aimed to evaluate the potential of NCs to promote matrix production by nucleus pulposus cells (NPCs and to compare it to the currently proposed addition of bone marrow stromal cells (BMSCs. Using alginate beads, bovine NPCs were exposed for 28 d to porcine NC conditioned medium (NCCM; direct co-culture with porcine NCs or bovine BMSCs; or the combination of BMSCs and NCCM. Effects on cell proliferation, disc matrix production (proteoglycans, collagens and disc matrix protein expression (aggrecan, collagen 1 and 2, SOX9 were determined and compared to TGFβ stimulation. NCCM strongly promoted NPC proliferation (x 2.2 and matrix production (x 3.9 to levels similar to that with TGFβ, whereas the direct addition of NCs had no effect. Co-culture of NPCs and BMSCs led to proteoglycan synthesis similar to NPCs alone, which was slightly improved by NCCM (x 1.5. Histological analysis confirmed biochemical data. Gene expression of analysed proteins remained stable for all groups and unaffected by medium conditions. NCs could substantially stimulate NPCs through factors secreted into conditioned medium and in levels similar to the addition of BMSCs. This study showed that molecular agents secreted by NCs constitute a promising alternative to the proposed “standard” injection of BMSCs for disc repair: their effects are similar, do not require the injection of a large number of cells and can be further amplified when the factors are identified.

  12. Characterization of slow-gelling alginate hydrogels for intervertebral disc tissue-engineering applications.

    Science.gov (United States)

    Growney Kalaf, Emily A; Flores, Reynaldo; Bledsoe, J Gary; Sell, Scott A

    2016-06-01

    Reversal of intervertebral disc degeneration can have a potentially monumental effect on spinal health. As such, the goal of this research is to create an injectable, cellularized alginate-based nucleus pulposus that will restore disc function; with the primary goal of creating an alginate gel with tailorable rates of gelation to improve functionality over standard CaCl2 crosslinking techniques. Gelation characteristics of 1% sodium alginate were analyzed over various molar concentrations of a 1:2 ratio of CaCO3:glucono-δ-lactone (GDL), with 10% CaCl2 as the control crosslinker. Alginate construct characterization for all concentrations was performed via ultimate and cyclic compressive testing over a 28day degradation period in PBS. Dehydration, swell testing, and albumin release kinetics were determined, and cytotoxicity and cell homogeneity tests showed promise for cellularization strategies. Overall, the 30 and 60mM GDL alginate concentrations presented the most viable option for use in further studies, with a gelation time between 10 and 30min, low hysteresis over control, low percent change in thickness and weight under both PBS degradation and swelling conditions, and stable mechanical properties over 28days in vitro.

  13. Sesamin inhibits lipopolysaccharide-induced inflammation and extracellular matrix catabolism in rat intervertebral disc.

    Science.gov (United States)

    Li, Kang; Li, Yan; Xu, Bo; Mao, Lu; Zhao, Jie

    2016-09-01

    Intervertebral disc (IVD) degeneration contributes to most spinal degenerative diseases, while treatment inhibiting IVD degeneration is still in the experimental stage. Sesamin, a bioactive component extracted from sesame, has been reported to exert chondroprotective and anti-inflammatory effects. Here, we analyzed the anti-inflammatory and anti-catabolic effects of sesamin on rat IVD in vitro and ex vivo. Results show that sesamin significantly inhibits the lipopolysaccharide (LPS)-induced expression of catabolic enzymes (MMP-1, MMP-3, MMP-13, ADAMTS-4, ADAMTS-5) and inflammation factors (IL-1β, TNF-α, iNOS, NO, COX-2, PGE2) in a dose-dependent manner in vitro. It is also proven that migration of macrophages induced by LPS can be inhibited by treatment with sesamin. Organ culture experiments demonstrate that sesamin protects the IVD from LPS-induced depletion of the extracellular matrix ex vivo. Moreover, sesamin suppresses LPS-induced activation of the mitogen-activated protein kinase (MAPK) pathway through inhibiting phosphorylation of JNK, the common downstream signaling pathway of LPS and IL-1β, which may be the potential mechanism of the effects of sesamin. In light of our results, sesamin protects the IVD from inflammation and extracellular matrix catabolism, presenting positive prospects in the treatment of IVD degenerative diseases.

  14. Intervertebral disc segmentation in MR images with 3D convolutional networks

    Science.gov (United States)

    Korez, Robert; Ibragimov, Bulat; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2017-02-01

    The vertebral column is a complex anatomical construct, composed of vertebrae and intervertebral discs (IVDs) supported by ligaments and muscles. During life, all components undergo degenerative changes, which may in some cases cause severe, chronic and debilitating low back pain. The main diagnostic challenge is to locate the pain generator, and degenerated IVDs have been identified to act as such. Accurate and robust segmentation of IVDs is therefore a prerequisite for computer-aided diagnosis and quantification of IVD degeneration, and can be also used for computer-assisted planning and simulation in spinal surgery. In this paper, we present a novel fully automated framework for supervised segmentation of IVDs from three-dimensional (3D) magnetic resonance (MR) spine images. By considering global intensity appearance and local shape information, a landmark-based approach is first used for the detection of IVDs in the observed image, which then initializes the segmentation of IVDs by coupling deformable models with convolutional networks (ConvNets). For this purpose, a 3D ConvNet architecture was designed that learns rich high-level appearance representations from a training repository of IVDs, and then generates spatial IVD probability maps that guide deformable models towards IVD boundaries. By applying the proposed framework to 15 3D MR spine images containing 105 IVDs, quantitative comparison of the obtained against reference IVD segmentations yielded an overall mean Dice coefficient of 92.8%, mean symmetric surface distance of 0.4 mm and Hausdorff surface distance of 3.7 mm.

  15. REDUCED TISSUE OSMOLARITY INCREASES TRPV4 EXPRESSION AND PRO-INFLAMMATORY CYTOKINES IN INTERVERTEBRAL DISC CELLS

    Science.gov (United States)

    Walter, B.A.; Purmessur, D; Moon, A.; Occhiogrosso, J.; Laudier, D.M.; Hecht, A.C.; Iatridis, J.C.

    2016-01-01

    The mechanical behaviour and cellular metabolism of intervertebral discs (IVDs) and articular cartilage are strongly influenced by their proteoglycan content and associated osmotic properties. This osmotic environment is a biophysical signal that changes with disease and may contribute to the elevated matrix breakdown and altered biologic response to loading observed in IVD degeneration and osteoarthritis. This study tested the hypothesis that changes in osmo-sensation by the transient receptor potential vallinoid-4 (TRPV4) ion channel occur with disease and contribute to the inflammatory environment found during degeneration. Immunohistochemistry on bovine IVDs from an inflammatory organ culture model were used to investigate if TRPV4 is expressed in the IVD and how expression changes with degeneration. Western blot, live-cell calcium imaging, and qRT-PCR were used to investigate whether osmolarity changes or tumour necrosis factor α (TNFα) regulate TRPV4 expression, and how altered TRPV4 expression influences calcium signalling and pro-inflammatory cytokine expression. TRPV4 expression correlated with TNFα expression, and was increased when cultured in reduced medium osmolarity and unaltered with TNFα-stimulation. Increased TRPV4 expression increased the calcium flux following TRPV4 activation and increased interleukin-1β (IL-1β) and IL-6 gene expression in IVD cells. TRPV4 expression was qualitatively elevated in regions of aggrecan depletion in degenerated human IVDs. Collectively, results suggest that reduced tissue osmolarity, likely following proteoglycan degradation, can increase TRPV4 signalling and enhance pro-inflammatory cytokine production, suggesting changes in TRPV4 mediated osmo-sensation may contribute to the progressive matrix breakdown in disease. PMID:27434269

  16. Formation of lamellar cross bridges in the annulus fibrosus of the intervertebral disc is a consequence of vascular regression.

    Science.gov (United States)

    Smith, Lachlan J; Elliott, Dawn M

    2011-05-01

    of cross bridges in the aging and degenerating intervertebral disc would be advantageous or detrimental, and this question should be addressed by future studies.

  17. The relationship between disc degeneration and flexibility of the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Nobuhiro; Fujimoto, Yoshinori; Ochi, Mitsuo [Hiroshima Univ. (Japan). Graduate School of Biomedical Sciences; An, H.S.; Lim, T.H.; Fujiwara, Atsushi [Rush-Presbyterian-St. Luke' s Medical Center, Chicago, IL (United States)

    2003-04-01

    The purpose of this study was to investigate the relationship between grade of degeneration of intervertebral discs and 3-dimensional biomechanical characteristics of the motion segment under multidirectional loading conditions. The material used in this study consisted of 114 lumbar motion segments from T12-L1 to L5-S1 retrieved from 47 fresh cadaver spines (average age at death, 68 years; range, 39 to 87 years). The severity of degeneration (grades I to V according to Thomson's system) was determined by examining magnetic resonance (MR) images and cryomicrotome sections. Pure unconstrained moments with dead weights were applied to the motion segments in 6 load steps. The directions of loading included flexion, extension, right and left axial rotation, and right and left lateral bending. Segments from the upper lumbar levels (T12-L1 to L3-4) tended to have greater rotational movement in flexion, extension, and axial rotation with disc degeneration up to grade IV, but the motion decreased when the disc degeneration reached grade V. In the lower lumbar spine, motion in axial rotation and lateral bending at L4-5 and L5-S1 was increased in grade III. These results suggest that kinematic properties of the lumbar spine are related to disc degeneration. Disc degeneration, particularly in grades III and IV, in which radial tears of the anulus fibrosus are found, was generally associated with greater motion. Disc space collapse and osteophyte formation, as found in grade V, resulted in stabilization of the motion segments. (author)

  18. Wnt signaling activates Shh signaling in early postnatal intervertebral discs, and re-activates Shh signaling in old discs in the mouse.

    Science.gov (United States)

    Winkler, Tamara; Mahoney, Eric J; Sinner, Debora; Wylie, Christopher C; Dahia, Chitra Lekha

    2014-01-01

    Intervertebral discs (IVDs) are strong fibrocartilaginous joints that connect adjacent vertebrae of the spine. As discs age they become prone to failure, with neurological consequences that are often severe. Surgical repair of discs treats the result of the disease, which affects as many as one in seven people, rather than its cause. An ideal solution would be to repair degenerating discs using the mechanisms of their normal differentiation. However, these mechanisms are poorly understood. Using the mouse as a model, we previously showed that Shh signaling produced by nucleus pulposus cells activates the expression of differentiation markers, and cell proliferation, in the postnatal IVD. In the present study, we show that canonical Wnt signaling is required for the expression of Shh signaling targets in the IVD. We also show that Shh and canonical Wnt signaling pathways are down-regulated in adult IVDs. Furthermore, this down-regulation is reversible, since re-activation of the Wnt or Shh pathways in older discs can re-activate molecular markers of the IVD that are lost with age. These data suggest that biological treatments targeting Wnt and Shh signaling pathways may be feasible as a therapeutic for degenerative disc disease.

  19. Treatment of 116 Cases of Cervical Intervertebral Disc Protrusion by Tuina

    Institute of Scientific and Technical Information of China (English)

    WANG Guang-zong; XIAO Yuan-chun

    2007-01-01

    Objective: To observe the clinical efficacy of uplifting massage therapy in the treatment of cervical intervertebral disc protrusion and study the effectiveness of this massage therapy for cervical intervertebral disc protrusion. Methods: 116 subjects were randomized into two groups: treatment group in which 60 cases were treated by uplifting massage therapy and conventional massage, and control group in which 56 cases were treated by simple conventional massage. Results: After 1-2 courses of treatment, the total effective rate was 95.0% in treatment group and 80.4% in control group; the former rate was higher than the latter one(P<0.05).Conclusion: The uplifting massage therapy combined with conventional massage has better effects than simple conventional massage in the treatment of cervical intervertebral disc protrusion.

  20. Intervention of CT Localization plus TCM Therapy on Prolapse of Lumbar Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    LUO Zhi-hong; SHEN Wei-na

    2003-01-01

    Purpose To observe the curative effect of interventional therapy by CT localization combined traditional Chinese medicine on prolapse of lumbar intervertebral disc. Method The inpatients of lumbar intervertebral disc prolapse were randomly divided into treatmentgroup and control group. Interventional therapy by CT localization combined TCM was used in the treatment group while in the control group TCM therapy was taken only. The treatment lasted for 10 days in both groups. Results The curative effect was 94.3% in the treatment group while 76.8% in the control one (P < 0.05), which had statistical meaning. Conclusion Interventional therapy by CT localization combined TCM on prolapse of lumbar intervertebral disc had better effect and shorter treatment course.

  1. CELL THERAPY FOR INTERVERTEBRAL DISC REPAIR: ADVANCING CELL THERAPY FROM BENCH TO CLINICS

    Science.gov (United States)

    Benneker, L.M.; Andersson, G.; Iatridis, J.C.; Sakai, D.; Härtl, R.; Ito, K.; Grad, S.

    2016-01-01

    Intervertebral disc (IVD) degeneration is a major cause of pain and disability; yet therapeutic options are limited and treatment often remains unsatisfactory. In recent years, research activities have intensified in tissue engineering and regenerative medicine, and pre-clinical studies have demonstrated encourageing results. Nonetheless, the translation of new biological therapies into clinical practice faces substantial barriers. During the symposium “Where Science meets Clinics”, sponsored by the AO Foundation and held in Davos, Switzerland, from September 5–7, 2013, hurdles for translation were outlined, and ways to overcome them were discussed. With respect to cell therapy for IVD repair, it is obvious that regenerative treatment is indicated at early stages of disc degeneration, before structural changes have occurred. It is envisaged that in the near future, screening techniques and non-invasive imageing methods will be available to detect early degenerative changes. The promises of cell therapy include a sustained effect on matrix synthesis, inflammation control, and prevention of angio- and neurogenesis. Discogenic pain, originating from “black discs” or annular injury, prevention of adjacent segment disease, and prevention of post-discectomy syndrome were identified as prospective indications for cell therapy. Before such therapy can safely and effectively be introduced into clinics, the identification of the patient population and proper standardisation of diagnostic parameters and outcome measurements are indispensable. Furthermore, open questions regarding the optimal cell type and delivery method need to be resolved in outline order to overcome the safety concerns implied with certain procedures. Finally, appropriate large animal models and well-designed clinical studies will be required, particularly addressing safety aspects. PMID:24802611

  2. IAPP modulates cellular autophagy, apoptosis, and extracellular matrix metabolism in human intervertebral disc cells

    Science.gov (United States)

    Wu, Xinghuo; Song, Yu; Liu, Wei; Wang, Kun; Gao, Yong; Li, Shuai; Duan, Zhenfeng; Shao, Zengwu; Yang, Shuhua; Yang, Cao

    2017-01-01

    The pathogenic process of intervertebral disc degeneration (IDD) is characterized by imbalance in the extracellular matrix (ECM) metabolism. Nucleus pulposus (NP) cells have important roles in maintaining the proper structure and tissue homeostasis of disc ECM. These cells need adequate supply of glucose and oxygen. Islet amyloid polypeptide (IAPP) exerts its biological effects by regulating glucose metabolism. The purpose of this study was to investigate the expression of IAPP in degenerated IVD tissue, and IAPP modulation of ECM metabolism in human NP cells, especially the crosstalk mechanism between apoptosis and autophagy in these cells. We found that the expression of IAPP and Calcr-RAMP decreased considerably during IDD progression, along with the decrease in the expression of AG, BG, and Col2A1. Induction of IAPP in NP cells by transfection with pLV-IAPP enhanced the synthesis of aggrecan and Col2A1 and attenuated the expression of pro-inflammatory factors, tumor necrosis factor (TNF)-α, and interleukin (IL)-1. Upregulation of IAPP also affected the expression of the catabolic markers—matrix metalloproteinases (MMPs) 3, 9 and 13 and ADAMTS 4 and 5. Downregulation of IAPP by siRNA inhibited the expression of anabolic genes but increased the expression of catabolic genes and inflammatory factors. The expressions of autophagic and apoptotic markers in NP cells transfected with pLV-IAPP were upregulated, including BECLIN1, ATG5, ATG7, LC3 II/I and Bcl-2, while significantly increase in the expression of Bax and Caspase-3 in NP cells transfected with pLV-siIAPP. Mechanistically, PI3K/AKT-mTOR and p38/JNK MAPK signal pathways were involved. We propose that IAPP might play a pivotal role in the development of IDD, by regulating ECM metabolism and controlling the crosstalk between apoptosis and autophagy in NP, thus potentially offering a novel therapeutic approach to the treatment of IDD.

  3. Release of active and depot GDF-5 after adenovirus-mediated overexpression stimulates rabbit and human intervertebral disc cells.

    Science.gov (United States)

    Wang, Haili; Kroeber, Markus; Hanke, Michael; Ries, Rainer; Schmid, Carsten; Poller, Wolfgang; Richter, Wiltrud

    2004-02-01

    To develop new therapeutic options for the treatment of disc degeneration we tested the possibility of overexpression of active growth and differentiation factor (GDF) 5 and of transforming growth factor (TGF) beta(1) by adenoviral gene transfer and characterized its effect on cell proliferation and matrix synthesis of cultured rabbit and human intervertebral disc cells. Recombinant adenovirus encoding for GDF-5 or TGF-beta(1) was developed and transgene expression characterized by RT-PCR, western blot and ELISA. Growth and matrix synthesis of transduced cells was measured by [(3)H]thymidine or [(35)S]sulfate incorporation. Disc cells expressed the receptors BMPR1A, BMPR1B, and BMPR2, which are relevant for GDF-5 action. Adenovirus efficiently transferred the GDF-5 gene or the TGF-beta(1) gene to rabbit and human intervertebral disc cells. About 50 ng GDF-5 protein/10(6 )cells per 24 h or 7 ng TGF-beta(1) protein/10(6 )cells per 24 h was produced. According to western blotting, two GDF-5 forms, with molecular weights consistent with the activated GDF-5 dimer and the proform, were secreted over the 3 weeks following gene transfer. Overexpressed GDF-5 and TGF-beta(1) were bioactive and promoted growth of rabbit disc cells in monolayer culture. Our results suggest that ex vivo gene delivery of GDF-5 and TGF-beta(1) is an attractive approach for the release of mature and pre-GDF-5 in surrounding tissue. This leads us to hope that it will prove possible to improve the treatment of degenerative disc disease by means of ex vivo gene transfer of single or multiple growth factors.

  4. The effect of posterior spinal fixation with acrylic cement on the vertebral growth plate and intervertebral disc in dogs.

    Science.gov (United States)

    Moon, M S; Ok, I Y; Ha, K Y

    1986-01-01

    We have attempted to clarify the serial histological changes in the growing spine of dogs following posterior fixation with acrylic cement. Twenty-four male mongrel dogs aged 8 weeks were used for the study. The lumbar spine from L.3 to L.5 was fixed posteriorly with acrylic cement. Three dogs were then sacrificed every four weeks up to 32 weeks, and the histological changes of the vertebral disc, growth plate and vertebral bodies were observed by light microscopy. Thinning of the growth plate and distortion of the cartilage columns has been demonstrated, but premature fusion of the growth plate did not result and vertebral body growth continued. Anterior wedging of the intervertebral disc was seen with some thinning of the bony trabeculae of the vertebral body. Degeneration of the nucleus pulposus resulted, with replacement by fibrous tissue. The normal horizontal arrangement of the fibres of the annulus fibrosus altered to a vertical configuration by 32 weeks.

  5. Prevalence of Age-Related Changes in Ovine Lumbar Intervertebral Discs during Computed Tomography and Magnetic Resonance Imaging.

    Science.gov (United States)

    Nisolle, Jean-François; Bihin, Benoît; Kirschvink, Nathalie; Neveu, Fabienne; Clegg, Peter; Dugdale, Alexandra; Wang, Xiaoqing; Vandeweerd, Jean-Michel

    2016-01-01

    Ovine models are used to study intervertebral disc (IVD) degeneration. The objective of the current study was to assess the naturally occurring age-related changes of the IVD that can be diagnosed by CT and MRI in the lumbar spine of sheep. We used CT and T2-weighted MR images to score the IVD (L6S1 to L1L2) in 41 sheep (age, 6 mo to 11 y) that were euthanized for reasons not related to musculoskeletal disease. T2 mapping and measurement of T2 time of L6S1 to L2L3 were performed in 22 of the sheep. Degenerative changes manifested as early as 2 y of age and occurred at every IVD level. Discs were more severely damaged in older sheep. The age effect of the L6S1 IVD was larger than the average age effect for the other IVD. The current study provides evidence that lesions similar to those encountered in humans can be identified by CT and MRI in lumbar spine of sheep. Ideally, research animals should be assessed at the initiation of preclinical trials to determine the extent of prevalent degenerative changes. The ovine lumbosacral disc seems particularly prone to degeneration and might be a favorable anatomic site for studying IVD degeneration.

  6. Pathophysiological basis of lumbar disc degeneration: imaging analysis.

    Science.gov (United States)

    Ostrum, B J; Romy, M; Swartz, J D

    1993-12-01

    This article provides a brief synopsis of the pathoanatomic basis of disc degeneration. An attempt is made to correlate CT, MR and CT discographic findings. The T2-weighted sagittal images are the most sensitive for evaluating disc degeneration. The contour changes on axial CT and MR scans are sensitive for abnormalities but not always specific. The CT discogram adds information unavailable by other imaging methods pertaining to the internal architecture of the disc. It additionally defines focal nuclear herniations and also is helpful in evaluating the stage of disc degeneration.

  7. Treatment of 30 Cases of Prolapse of Lumbar Intervertebral Disc by Electroacupuncture plus Tuina

    Institute of Scientific and Technical Information of China (English)

    JIANG Gui-mei; JIA Chao; WU Xue-fei

    2003-01-01

    Purpose: To observe the clinical therapeutic effect of electro acupuncture plus Tuina on treating prolapse of lumbar intervertebral disc. Methods: Electro -acupuncture at Jiaji(Ex-B 2) acupoints plus reduction manipulations were used to treat 30 cases of prolapse of lumbar intervertebral disc. Results: After 2 courses of treatment, among the 30 cases, 8 cases were cured and 22cases got improvements, and the effective rate was 100%.Conclusion: Electroacupuncture plus reduction manipula -tions had a satisfactory effect on treating this disease;and it can significantly improve the clinical symptoms of the patients.

  8. Lateral Surgical Approach to Lumbar Intervertebral Discs in an Ovine Model

    Directory of Open Access Journals (Sweden)

    David Oehme

    2012-01-01

    Full Text Available The sheep is becoming increasingly used as a large animal model for preclinical spine surgery studies. Access to the ovine lumbar intervertebral discs has traditionally been via an anterior or anterolateral approach, which requires larger wound incisions and, at times, significant abdominal retraction. We present a new minimally invasive operative technique for a far-lateral approach to the ovine lumbar spine that allows for smaller incisions, excellent visualisation of intervertebral discs, and minimal abdominal retraction and is well tolerated by animals with minimal morbidity.

  9. Lateral surgical approach to lumbar intervertebral discs in an ovine model.

    Science.gov (United States)

    Oehme, David; Goldschlager, Tony; Rosenfeld, Jeffrey; Danks, Andrew; Ghosh, Peter; Gibbon, Anne; Jenkin, Graham

    2012-01-01

    The sheep is becoming increasingly used as a large animal model for preclinical spine surgery studies. Access to the ovine lumbar intervertebral discs has traditionally been via an anterior or anterolateral approach, which requires larger wound incisions and, at times, significant abdominal retraction. We present a new minimally invasive operative technique for a far-lateral approach to the ovine lumbar spine that allows for smaller incisions, excellent visualisation of intervertebral discs, and minimal abdominal retraction and is well tolerated by animals with minimal morbidity.

  10. Long-Term Creep Behavior of the Intervertebral Disc: Comparison between Bioreactor Data and Numerical Results

    Directory of Open Access Journals (Sweden)

    APG eCastro

    2014-11-01

    Full Text Available The Loaded Disc Culture System (LDCS is an Intervertebral Disc (IVD-oriented bioreactor developed by the VU Medical Center (VUmc, Amsterdam, The Netherlands, which has the capacity of maintaining up to 12 IVDs in culture, for approximately 3 weeks after extraction. Using this system, 8 goat IVDs were provided with the essential nutrients and submitted to compression tests without losing their biomechanical and physiological properties, for 22 days. Based on previous reports (Detiger et al., 2013; Paul et al., 2013, 2012, 4 of these IVDs were kept in physiological condition (control and the other 4 were previously injected with chondroitinase ABC (CABC, in order to promote Degenerative Disc Disease (DDD. The loading profile intercalated 16h of activity loading with 8h of loading recovery to express the standard circadian variations.The displacement behavior of these 8 IVDs along the first 2 days of the experiment was numerically reproduced, using an IVD osmo-poro-hyper-viscoelastic and fiber-reinforced Finite Element (FE model. The simulations were run on a custom FE solver (Castro et al., 2014.The analysis of the experimental results allowed concluding that the effect of the CABC injection was only significant in 2 of the 4 IVDs. The 4 control IVDs showed no signs of degeneration, as expected. In what concerns to the numerical simulations, the IVD FE model was able to reproduce the generic behavior of the two groups of goat IVDs (control and injected. However, some discrepancies were still noticed on the comparison between the injected IVDs and the numerical simulations, namely on the recovery periods. This may be justified by the complexity of the pathways for DDD, associated with the multiplicity of physiological responses to each direct or indirect stimulus. Nevertheless, one could conclude that ligaments, muscles and IVD covering membranes could be added to the FE model, in order to improve its accuracy and properly describe the recovery

  11. Prolonged upright posture induces degenerative changes in intervertebral discs of rat cervical spine.

    Science.gov (United States)

    Liang, Qian-Qian; Cui, Xue-Jun; Xi, Zhi-Jie; Bian, Qin; Hou, Wei; Zhao, Yong-Jian; Shi, Qi; Wang, Yong-Jun

    2011-01-01

    An in vivo study of the cervical intervertebral discs (IVDs) response to upright posture was performed using an amputated bipedal rat model. To investigate the effects of upright posture on IVDs of rat cervical spine. The distinct arrangement of human neck muscle from that of cat and rhesus indicated that in the evolution process, upright posture might have affected cervical spine of human ancestors. However, the effects of upright posture on cervical spine have not been assessed. Forty-one-month-old rats were randomly divided into 5-month-control, 5-month-surgery, 7-month-control, and 7-month surgery group (n = 10 per group). Both forelimbs of 2 surgery group rats were amputated, and those rats were then induced to be upright in the custom-made cages. Two control group rats were kept in regular cages. These rats were respectively killed at the fifth and seventh month after surgery and the IVD samples of lumbar spine were harvested for histologic and immunohistochemical studies. Total RNA isolated from these samples were used for real-time polymerase chain reaction of type II collagen (Col2a1), type X collagen, matrix metalloproteinase 13 (MMP-13), MMP-3, aggre-can, and aggrecanase-2 (ADAMTS-5). Upright posture affects histologic changes of the cervical IVDs such as fissures of anulus fibrosus and decreased height of disc, decreased protein level of Col2a1 at nucleus pulposus and anulus fibrosus, up-regulated MMP-13, MMP-3, ADAMTS-5, and type X collagen mRNA expression, and downregulated mRNA expression of Col2a1 and aggrecan. Upright stance accelerates cervical disc degeneration in rats.

  12. Experimental study on the effect of manipulation on IL-6 and TNF-α of degenerated cervical intervertebral discs in rabbits%手法对颈椎病模型兔颈椎间盘炎性因子的影响

    Institute of Scientific and Technical Information of China (English)

    赵凯; 盛杰; 夏亮

    2012-01-01

    Objective To explore the anti - inflammation effect of manipulation on cervical spondylosis in the cervical intervertebral disc of degenerated cervical vertebral of rabbits. Methods 34 six - month - old New Zealand rabbits, weight 2. 0 - 3. Okg each, male or female informality, were randomly divided into two groups: model group and sham group. The animal model was established by surgical intervention induced static force imblance combination of fixed at a specially - made sitting or flexion scaffold. All of the rabbits were examined with lateral cervical spine X - ray and at 4 and 8 weeks after modeling. The pathological examination was performed for the cervical intervertebral disc 8 weeks later. The animal model was verified successfully according to X - ray pathology result, and the model rabbits were divided into 2 groups randomly: treatment group and model control group. The rabbits were fed freely in model control group and sham group, not fixed sitting or flexion. The treatment group was administered with manipulation for once a day. The rabbits were killed to collect experimental samples after 8 weeks treatment, and then the cerival intervertebral disc specimens were homogenated to test the contents of IL - 6 and TNF - αby radioimmunoassay. Results The contens of IL - 6 and TNF -α in discs of degenerated cervical vertebral rabbits model were significantly higher than those of sham group( P < 0.01 ). The contents of IL - 6 and TNF - α in disc of treatment group were lower than those of model control group ( P <0.01 ). Conclusion The manipulation can inhibit the inflammatory reaction and attain its effect in the prevention and treatment of cervical spondylosis.%目的 观察手法干预对实验性家兔退变颈椎间盘组织IL-6、TNF-α活性的影响,以探讨手法治疗颈椎病的抗炎作用机制.方法 34只6月龄新西兰大白兔,体质量2.0~3.0 kg,雌雄不分.随机分为模型组(n=22)、假手术对照组(n=12).模型组采用静力

  13. Stimulation of gene expression and loss of anular architecture caused by experimental disc degeneration--an in vivo animal study.

    Science.gov (United States)

    Guehring, Thorsten; Omlor, Georg W; Lorenz, Helga; Bertram, Helge; Steck, Eric; Richter, Wiltrud; Carstens, Claus; Kroeber, Markus

    2005-11-15

    An external compression model was used to evaluate gene and protein expression in intervertebral discs with moderate disc degeneration. To determine messenger ribonucleic acid and protein expression levels of relevant disc components. An animal model of mechanically induced disc degeneration was developed and characterized histologically. However, little is known at the molecular level in moderate disc degeneration. There were 8 New Zealand white rabbits subjected to monosegmental posterior compression to induce moderate disc degeneration. Twelve animals served as controls or sham controls. Discs were analyzed using immunohistochemistry for collagen type 1 (COL1), COL2, aggrecan, and bone morphogenetic protein-2/4 (BMP-2/4). For gene analysis, conventional and quantitative polymerase chain reactions were used for COL1A2, COL2A1, aggrecan, BMP-2, biglycan, decorin, osteonectin, fibromodulin, fibronectin, matrix metalloproteinase-13 (MMP-13), and tissue inhibitor of MMP-1. Gene expression for nontreated, sham-treated, and compressed discs was quantified in relation to the housekeeping gene glyceraldehyde-3-phosphate dehydrogenase. Immunohistochemistry of compressed discs showed a loss of anular architecture, and a significant reduction of BMP-2/4 and COL2 positive cells. Gene expression analysis showed a significant up-regulation of COL1A2, osteonectin, decorin, fibronectin, tissue inhibitor of MMP-1, BMP-2, and MMP-13 in compressed discs. Experimental moderate disc degeneration is characterized by a loss of BMP-2/4 and COL2 positive cells, although gene expression of disc constituents, catabolic enzymes, and growth factors is stimulated to reestablish disc integrity.

  14. Target radiofrequency combined with collagenase chemonucleolysis in the treatment of lumbar intervertebral disc herniation.

    Science.gov (United States)

    Zhang, Daying; Zhang, Yong; Wang, Zhijian; Zhang, Xuexue; Sheng, Mulan

    2015-01-01

    Both target radiofrequency thermocoagulation and collagenase chemonucleolysis are effective micro-invasive therapy means for lumbar intervertebral disc herniation. In order to analyze the clinical effects of target radiofrequency thermocoagulation combined with collagenase chemonucleolysis on lumbar intervertebral disc herniation, the contents of hydroxyproline and glycosaminoglycan were measured and the histological changes of nucleus pulposus was detected in the vitro experiments. Radiofrequency thermocoagulation reduced the hydrolyzation of herniated nucleus pulposus caused by collagenase, as well as the content of hydroxyproline and glycosaminoglycan. Furthermore, 236 patients with lumbar intervertebral disc herniation were treated by target radiofrequency thermocoagulation combined with collagenase chemonucleolysis. The efficiency was evaluated according to Macnab criteria, and the index of lumbar disc herniation (IDH) was compared pre-operation with 3 months post-operation. The post-operative good rate was 66.5% (157/236) at 2 weeks post-operation, and 88.1% (208/236) at 3 months post-operation. In the post-operative follow-up exam, 86.8% of the re-examined cases demonstrated smaller or ablated protrusion, with reduced IDH values from pre-operation, which was statistically significant. No serious complications were detected intra-operatively and post-operatively. In conclusion, target radiofrequency combined with collagenase chemonucleolysis was an effective and safe method for treatment of lumbar intervertebral disc herniation.

  15. Regenerative and immunogenic characteristics of cultured nucleus pulposus cells from human cervical intervertebral discs.

    Directory of Open Access Journals (Sweden)

    Stefan Stich

    Full Text Available Cell-based regenerative approaches have been suggested as primary or adjuvant procedures for the treatment of degenerated intervertebral disc (IVD diseases. Our aim was to evaluate the regenerative and immunogenic properties of mildly and severely degenerated cervical nucleus pulposus (NP cells with regard to cell isolation, proliferation and differentiation, as well as to cell surface markers and co-cultures with autologous or allogeneic peripheral blood mononuclear cells (PBMC including changes in their immunogenic properties after 3-dimensional (3D-culture. Tissue from the NP compartment of 10 patients with mild or severe grades of IVD degeneration was collected. Cells were isolated, expanded with and without basic fibroblast growth factor and cultured in 3D fibrin/poly (lactic-co-glycolic acid transplants for 21 days. Real-time reverse-transcription polymerase chain reaction (RT-PCR showed the expression of characteristic NP markers ACAN, COL1A1 and COL2A1 in 2D- and 3D-culture with degeneration- and culture-dependent differences. In a 5,6-carboxyfluorescein diacetate N-succinimidyl ester-based proliferation assay, NP cells in monolayer, regardless of their grade of degeneration, did not provoke a significant proliferation response in T cells, natural killer (NK cells or B cells, not only with donor PBMC, but also with allogeneic PBMC. In conjunction with low inflammatory cytokine expression, analyzed by Cytometric Bead Array and fluorescence-activated cell sorting (FACS, a low immunogenicity can be assumed, facilitating possible therapeutic approaches. In 3D-culture, however, we found elevated immune cell proliferation levels, and there was a general trend to higher responses for NP cells from severely degenerated IVD tissue. This emphasizes the importance of considering the specific immunological alterations when including biomaterials in a therapeutic concept. The overall expression of Fas receptor, found on cultured NP cells, could have

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

    Energy Technology Data Exchange (ETDEWEB)

    Kliskey, Karolina; Williams, Kelly; Yu, J.; Urban, Jill; Athanasou, Nick [University of Oxford, Nuffield Department of Orthopaedic, Rheumatology and Musculoskeletal Science, Oxford (United Kingdom); Jackson, David [Weatherall Institute of Molecular Medicine, Human Immunology Unit, Oxford (United Kingdom)

    2009-12-15

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

  17. Development of a method for quantitative measures of lumbar intervertebral disc structures

    DEFF Research Database (Denmark)

    Tunset, Andreas; Kjær, Per; Chreiteh, Shadi Samir

    2013-01-01

    applicable description of quantitative methods for measuring lumbar disc herniations and related structures on sagittal MRIs. The objectives of this study were: 1) to develop methods for quantitative measures of intervertebral discs, lumbar disc herniations and dural sac/spinal canal using MRIs, 2......) to evaluate the agreement of these methods, and 3) to identify factors in the measurement procedures that may compromise agreement. Methods: In this intra- and inter-rater agreement study, lumbar quantitative measurements were performed on magnetic resonance images from 32 participants from a study cohort...... representative of the Danish general population. A new method for quantitative measures of intervertebral discs and related structures was developed and systematically described. MRI-images were measured twice by one rater for intra-rater agreement and once by a second rater for inter-rater agreement. Length...

  18. Development of a method for quantitative measures of lumbar intervertebral disc structures

    DEFF Research Database (Denmark)

    Tunset, Andreas; Kjær, Per; Chreiteh, Shadi Samir;

    2013-01-01

    applicable description of quantitative methods for measuring lumbar disc herniations and related structures on sagittal MRIs. The objectives of this study were: 1) to develop methods for quantitative measures of intervertebral discs, lumbar disc herniations and dural sac/spinal canal using MRIs, 2......) to evaluate the agreement of these methods, and 3) to identify factors in the measurement procedures that may compromise agreement. Methods: In this intra- and inter-rater agreement study, lumbar quantitative measurements were performed on magnetic resonance images from 32 participants from a study cohort...... representative of the Danish general population. A new method for quantitative measures of intervertebral discs and related structures was developed and systematically described. MRI-images were measured twice by one rater for intra-rater agreement and once by a second rater for inter-rater agreement. Length...

  19. Pathology and possible mechanisms of nervous system response to disc degeneration.

    Science.gov (United States)

    Brisby, Helena

    2006-04-01

    Degeneration of the intervertebral disc is clinically considered to be an important source of pain in patients with low-back pain. Disc deterioration and/or degeneration may influence the nervous system by stimulation of nociceptors in the anulus fibrosus, causing nociceptive pain that is often referred to as discogenic pain. The stimulation of the nociceptors may be of mechanical or inflammatory origin. Deterioration of a disc with loss of normal structure and weight-bearing properties may lead to abnormal motions that cause mechanical stimulation. This theory is supported by the fact that patients commonly experience an increase in pain with weight-bearing and certain movements. In addition, an ingrowth of vessels and nerve fibers into deeper layers of the anulus fibrosus has been observed in degenerated discs. A large number of inflammatory and signaling substances, such as tumor necrosis factor and interleukins (interleukin-1beta, interleukin-6, and interleukin-8), may also play a role in the development of back pain. Independent of stimulus of the nociceptors, the pain impulses are conducted through myelinated A delta fibers and unmyelinated C fibers to the dorsal root ganglion and continue by way of the spinothalamic tract to the thalamus and the somatosensory cortex. In response to stimulation of the nociceptors in the disc, the somatosensory system may increase its sensitivity, resulting in a nonfunctional response; that is, normally innocuous stimuli may generate an amplified response (peripheral sensitization). When disc degeneration leads to a disc herniation, the adjacent nervous system structures, such as the nerve roots or the dorsal root ganglion, can be affected, causing neuropathic pain of mechanical or biochemical origin. Disc deterioration also influences other spinal structures, such as facet joints, ligaments, and muscles, which can also become pain generators. Thus, disc degeneration may be responsible for the development of chronic low

  20. Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

    2016-05-01

    The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion.

  1. Foxa1 and Foxa2 are required for formation of the intervertebral discs.

    Directory of Open Access Journals (Sweden)

    Jennifer A Maier

    Full Text Available The intervertebral disc (IVD is composed of 3 main structures, the collagenous annulus fibrosus (AF, which surrounds the gel-like nucleus pulposus (NP, and hyaline cartilage endplates, which are attached to the vertebral bodies. An IVD is located between each vertebral body. Degeneration of the IVD is thought to be a major cause of back pain, a potentially chronic condition for which there exist few effective treatments. The NP forms from the embryonic notochord. Foxa1 and Foxa2, transcription factors in the forkhead box family, are expressed early during notochord development. However, embryonic lethality and the absence of the notochord in Foxa2 null mice have precluded the study of potential roles these genes may play during IVD formation. Using a conditional Foxa2 allele in conjunction with a tamoxifen-inducible Cre allele (ShhcreER(T2, we removed Foxa2 from the notochord of E7.5 mice null for Foxa1. Foxa1(-/-;Foxa2(c/c;ShhcreER(T2 double mutant animals had a severely deformed nucleus pulposus, an increase in cell death in the tail, decreased hedgehog signaling, defects in the notochord sheath, and aberrant dorsal-ventral patterning of the neural tube. Embryos lacking only Foxa1 or Foxa2 from the notochord were indistinguishable from control animals, demonstrating a functional redundancy for these genes in IVD formation. In addition, we provide in vivo genetic evidence that Foxa genes are required for activation of Shh in the notochord.

  2. Organotypic Cultures of Intervertebral Disc Cells: Responses to Growth Factors and Signaling Pathways Involved

    Directory of Open Access Journals (Sweden)

    Harris Pratsinis

    2015-01-01

    Full Text Available Intervertebral disc (IVD degeneration is strongly associated with low back pain, a major cause of disability worldwide. An in-depth understanding of IVD cell physiology is required for the design of novel regenerative therapies. Accordingly, aim of this work was the study of IVD cell responses to mitogenic growth factors in a three-dimensional (3D organotypic milieu, comprising characteristic molecules of IVD’s extracellular matrix. In particular, annulus fibrosus (AF cells were cultured inside collagen type-I gels, while nucleus pulposus (NP cells in chondroitin sulfate A (CSA supplemented collagen gels, and the effects of Platelet-Derived Growth Factor (PDGF, basic Fibroblast Growth Factor (bFGF, and Insulin-Like Growth Factor-I (IGF-I were assessed. All three growth factors stimulated DNA synthesis in both AF and NP 3D cell cultures, with potencies similar to those observed previously in monolayers. CSA supplementation inhibited basal DNA synthesis rates, without affecting the response to growth factors. ERK and Akt were found to be phosphorylated following growth factor stimulation. Blockade of these two signaling pathways using pharmacologic inhibitors significantly, though not completely, inhibited growth factor-induced DNA synthesis. The proposed culture systems may prove useful for further in vitro studies aiming at future interventions for IVD regeneration.

  3. Morphologic characteristics of processes of nucleus pulposus cells in adult human intervertebral disc

    Science.gov (United States)

    Liu, Xiaoyun; Wu, Xinghuo; Hui, Liu; Xu, Weihua; Liu, Xianze; Yang, Shuhua

    2008-12-01

    To explore morphologic characterizatics of cellular processes from adult human nucleus pulposus cells, the nucleus pulposus of adult human intervertebral disc were obtained from 8 patients (Thompson's grade I~II) and then the tissues specimens were carried out by frozen section and electron microscopic section as well as cell isolation and cultured, processes of nucleus pulposus cells were examined using light microscopy, laser scanning confocal microscopy and transmission electron microscopy. When examined at both the confocal and electron microscope level, all the cells possessed the processes and adjacent nucleus pulposus cells processes possessed a gap junction. But elongated and round cells can be examined when NP cells were monolayer cultured. The rate of elongated cells to round cells is 2.3 to 1. The elongated cells protrude along with the long axis of cell body without second processes. Dendritic processes of round cells protrude to all directions from the cell body with multiple-level processes. Processes are one of the morphologic characteristics of intervertebral disc cells which are different from articular cartilage chondrocytes. The research on processes functions will be helpful to understand pathomechanism of intervertebral disc degradation and open a new approach for cytobiology treatment of the intervertebral disc diseases.

  4. Effect of Static Load on the Nucleus Pulposus of Rabbit Intervertebral Disc Motion Segment in an Organ Culture

    Directory of Open Access Journals (Sweden)

    Jia-Wen Zhan

    2016-01-01

    Full Text Available The development of mechanically active culture systems helps in understanding of the role of mechanical stress in intervertebral disc (IVD degeneration. Motion segment cultures facilitate the application and control of mechanical loads. The purpose of this study was to establish a culturing method for rabbit IVD motion segments to observe the effect of static load on the whole disc organ. Segments were cultured in custom-made apparatuses under a constant, compressive load (3 kg for 2 weeks. Tissue integrity, matrix synthesis, and matrix gene expression profile were assessed and compared with fresh one. The results showed ex vivo culturing of samples gradually destroyed the morphology. Proteoglycan contents and gene expression were decreased and downregulated obviously. However, immunohistochemical staining intensity and collagen type II gene expression were significantly enhanced and upregulated. In contrast, these trends were reversed under constant compression. These results indicated short-term static load stimulated the synthesis of type II collagen; however, constant compression led to progressive degeneration and specifically to proteoglycan. Through this study a loading and organ-culturing system for ex vivo rabbit IVD motion segments was developed, which can be used to study the effects of mechanical stimulation on the biology of IVDs and the pathomechanics of IVD degeneration.

  5. An injectable hydrogel incorporating mesenchymal precursor cells and pentosan polysulphate for intervertebral disc regeneration.

    Science.gov (United States)

    Frith, Jessica E; Cameron, Andrew R; Menzies, Donna J; Ghosh, Peter; Whitehead, Darryl L; Gronthos, Stan; Zannettino, Andrew C W; Cooper-White, Justin J

    2013-12-01

    Intervertebral disc (IVD) degeneration is one of the leading causes of lower back pain and a major health problem worldwide. Current surgical treatments include excision or immobilisation, with neither approach resulting in the repair of the degenerative disc. As such, a tissue engineering-based approach in which stem cells, coupled with an advanced delivery system, could overcome this deficiency and lead to a therapy that encourages functional fibrocartilage generation in the IVD. In this study, we have developed an injectable hydrogel system based on enzymatically-crosslinked polyethylene glycol and hyaluronic acid. We examined the effects of adding pentosan polysulphate (PPS), a synthetic glycosaminoglycan-like factor that has previously been shown (in vitro and in vivo) to this gel system in order to induce chondrogenesis in mesenchymal precursor cells (MPCs) when added as a soluble factor, even in the absence of additional growth factors such as TGF-β. We show that both the gelation rate and mechanical strength of the resulting hydrogels can be tuned in order to optimise the conditions required to produce gels with the desired combination of properties for an IVD scaffold. Human immunoselected STRO-1+ MPCs were then incorporated into the hydrogels. They were shown to retain good viability after both the initial formation of the gel and for longer-term culture periods in vitro. Furthermore, MPC/hydrogel composites formed cartilage-like tissue which was significantly enhanced by the incorporation of PPS into the hydrogels, particularly with respect to the deposition of type-II-collagen. Finally, using a wild-type rat subcutaneous implantation model, we examined the extent of any immune reaction and confirmed that this matrix is well tolerated by the host. Together these data provide evidence that such a system has significant potential as both a delivery vehicle for MPCs and as a matrix for fibrocartilage tissue engineering applications.

  6. Differential expression of galectin-1 and its interactions with cells and laminins in the intervertebral disc.

    Science.gov (United States)

    Jing, Liufang; So, Stephen; Lim, Shaun W; Richardson, William J; Fitch, Robert D; Setton, Lori A; Chen, Jun

    2012-12-01

    Galectin-1 (Gal-1), an endogenous β-galactoside-binding protein, binds to laminins, which are highly expressed in the nucleus pulposus (NP) of the intervertebral disc (IVD). The objective of this study is to evaluate the expression of Gal-1 protein in IVD tissues during aging and the effect of Gal-1 on IVD cell adhesion to laminins. Tissues from rat, porcine, and human (scoliosis or disc degeneration) IVDs were used to evaluate Gal-1 expression via immunostaining, RT-PCR, and Western blot analysis. Attachment of isolated IVD cells (porcine and human) on select laminin isoforms (LM-111 and LM-511) was compared with/without pre-incubation with exogenous Gal-1. A biotinylated Gal-1(B-Gal-1) was used to evaluate for binding to IVD cells and to select for IVD cells by magnetic activated cell sorting (MACS). NP cells expressed high levels of Gal-1 protein as compared to anulus fibrosus (AF) cells in immature tissues, while exogenous Gal-1 increased both NP and AF cell attachment to laminins and exhibited a similar binding to both cell types in vitro. With aging, Gal-1 levels in NP tissue appeared to decrease. In addition, incubation with B-Gal-1 was able to promote the retention of more than 50% of IVD cells via MACS. Our results provide new findings for the presence and functional role of Gal-1 within IVDs. Similar staining patterns for Gal-1 and LM-511 in IVD tissue suggest that Gal-1 may serve as an adhesion molecule to interact with both cells and laminins. This MACS protocol may be useful for selecting pure IVD cells from mixed cells of pathological tissue.

  7. Water diffusion pathway, swelling pressure, and biomechanical properties of the intervertebral disc during compression load

    Energy Technology Data Exchange (ETDEWEB)

    Ohshima, H.; Tsuji, H.; Hirano, N.; Ishihara, H.; Katoh, Y.; Yamada, H. (Toyama Medical and Pharmaceutical Univ. (Japan))

    1989-11-01

    The behavior of water in the intervertebral disc of pig tail and its physiologic and biomechanical properties were investigated in relation to compression load. The water content, chemical composition, and swelling pressure in the intervertebral disc were measured, and the mechanism of the generation of the swelling pressure in relation to compression load stress was studied. The swelling pressure, through regulation of the water content of the disc and the resistance of the external load, differs with the region of the intervertebral disc. In the nucleus pulposus and the inner layer of the anulus fibrosus, the swelling pressure rises in proportion to the load, but few changes occur in the outer layer of the anulus fibrosus, and the constant pressure environment is thus maintained. The tritiated water (3H2O) uptake of the disc under various loads was measured. The molar partition coefficient of tritiated water is almost equal to 1 even under a compression load, which suggests that water is freely exchangeable. The diffusion of 3H2O in the intervertebral disc was traced using two pathway models: the perianular route and the end-plate route. The diffusion of water in the unloaded disc for both uptake and washout was about 2 to 3 times larger in the perianular route than in the end-plate route. Under load, the water diffusion was inhibited in both pathways. The relation between the load and displacement revealed viscoelastic properties indicating creep and stress relaxation. Young's modulus and the stiffness increased with a rise in load speed.

  8. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Ponrartana, Skorn; Fisher, Carissa L.; Aggabao, Patricia C. [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Chavez, Thomas A. [Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Broom, Alexander M.; Wren, Tishya A.L.; Skaggs, David L. [Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Gilsanz, Vicente [Keck School of Medicine, University of Southern California, Department of Radiology, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Pediatrics, Children' s Hospital Los Angeles, Los Angeles, CA (United States); Keck School of Medicine, University of Southern California, Department of Orthopaedic Surgery, Children' s Hospital Los Angeles, Los Angeles, CA (United States)

    2016-09-15

    When compared to boys, girls have smaller vertebral cross-sectional area, which conveys a greater spinal flexibility, and a higher prevalence of adolescent idiopathic scoliosis. To test the hypothesis that small vertebral cross-sectional area and tall intervertebral disc height are structural characteristics of patients with adolescent idiopathic scoliosis. Using multiplanar imaging techniques, measures of vertebral cross-sectional area, vertebral height and intervertebral disc height in the lumbar spine were obtained in 35 pairs of girls and 11 pairs of boys with and without adolescent idiopathic scoliosis of the thoracic spine matched for age, height and weight. Compared to adolescents without spinal deformity, girls and boys with adolescent idiopathic scoliosis had, on average, 9.8% (6.68 ± 0.81 vs. 7.40 ± 0.99 cm{sup 2}; P = 0.0007) and 13.9% (8.22 ± 0.84 vs. 9.55 ± 1.61 cm{sup 2}; P = 0.009) smaller vertebral cross-sectional dimensions, respectively. Additionally, patients with adolescent idiopathic scoliosis had significantly greater values for intervertebral disc heights (9.06 ± 0.85 vs. 7.31 ± 0.62 mm and 9.09 ± 0.87 vs. 7.61 ± 1.00 mm for girls and boys respectively; both P ≤ 0.011). Multiple regression analysis indicated that the presence of scoliosis was negatively associated with vertebral cross-sectional area and positively with intervertebral disc height, independent of sex, age and body mass index. We provide new evidence that girls and boys with adolescent idiopathic scoliosis have significantly smaller vertebral cross-sectional area and taller intervertebral disc heights - two major structural determinants that influence trunk flexibility. With appropriate validation, these findings may have implications for the identification of children at the highest risk for developing scoliosis. (orig.)

  9. Mesenchymal stem cells in regenerative medicine: Focus on articular cartilage and intervertebral disc regeneration.

    Science.gov (United States)

    Richardson, Stephen M; Kalamegam, Gauthaman; Pushparaj, Peter N; Matta, Csaba; Memic, Adnan; Khademhosseini, Ali; Mobasheri, Reza; Poletti, Fabian L; Hoyland, Judith A; Mobasheri, Ali

    2016-04-15

    Musculoskeletal disorders represent a major cause of disability and morbidity globally and result in enormous costs for health and social care systems. Development of cell-based therapies is rapidly proliferating in a number of disease areas, including musculoskeletal disorders. Novel biological therapies that can effectively treat joint and spine degeneration are high priorities in regenerative medicine. Mesenchymal stem cells (MSCs) isolated from bone marrow (BM-MSCs), adipose tissue (AD-MSCs) and umbilical cord (UC-MSCs) show considerable promise for use in cartilage and intervertebral disc (IVD) repair. This review article focuses on stem cell-based therapeutics for cartilage and IVD repair in the context of the rising global burden of musculoskeletal disorders. We discuss the biology MSCs and chondroprogenitor cells and specifically focus on umbilical cord/Wharton's jelly derived MSCs and examine their potential for regenerative applications. We also summarize key components of the molecular machinery and signaling pathways responsible for the control of chondrogenesis and explore biomimetic scaffolds and biomaterials for articular cartilage and IVD regeneration. This review explores the exciting opportunities afforded by MSCs and discusses the challenges associated with cartilage and IVD repair and regeneration. There are still many technical challenges associated with isolating, expanding, differentiating, and pre-conditioning MSCs for subsequent implantation into degenerate joints and the spine. However, the prospect of combining biomaterials and cell-based therapies that incorporate chondrocytes, chondroprogenitors and MSCs leads to the optimistic view that interdisciplinary approaches will lead to significant breakthroughs in regenerating musculoskeletal tissues, such as the joint and the spine in the near future.

  10. A CLINICAL STUDY OF OPERATIVE TREATMENT FOR LUMBAR INTERVERTEBRAL DISC PROLAPSE

    Directory of Open Access Journals (Sweden)

    Anilkumar S. D

    2016-09-01

    Full Text Available BACKGROUND Amongst painful diseases, sciatica occupies a foremost place by reason of its prevalence, its production by a great variety of conditions, the great disablement it may produce and its tending to relapse all of which have led to its recognition as one of the great scourges of humanity. Intervertebral disc prolapse is the important and common cause of low back pain and sciatica. Here, the subject of laminectomy and discectomy in the treatment of proven intervertebral disc prolapse in the lower lumbar region is reviewed and its results examined. AIM OF STUDY This study was undertaken in order to evaluate the following objectives. PRIMARY Analysis of clinical parameters and per operative findings of lumbar intervertebral disc prolapse. SECONDARY Analysis of clinical parameters and surgical outcome in lumbar intervertebral disc prolapse with respect to improvement in pain and neurological status. MATERIALS AND METHODS The study was undertaken in 22 patients who attended the Orthopaedic Department of Mount Zion Medical College, Adoor, between August 2014 to July 2015. All of them were suffering from a prolapsed lumbar vertebral disc as shown by clinical examination and investigations. Lumbar laminectomy and discectomy constituted the operative procedure for all of them. RESULTS In acute onset cases and cases with short duration, results were good. By six months, 80% of patients recorded of good pain relief, 80% of patients returned to work within six 6 months, 60% of patients showed good neurological recovery by 6 months. Laminectomy and discectomy in proven cases of lumbar intervertebral disc prolapse is a rewarding procedure. LT definitely relieved pain in all cases and improved morbidity and neurological deficits in most of the cases. CONCLUSION 1. Laminectomy and discectomy is an effective method of treatment in herniation of lumbar intervertebral disc. 2. The procedure is ideally done in those with the disc prolapse proved with the

  11. Geometry of the Intervertebral Volume and Vertebral Endplates of the Human Spine

    NARCIS (Netherlands)

    van der Houwen, E.B.; Baron, P.; Veldhuizen, A.G.; Burgerhof, J.G.M.; van Ooijen, P.M.A.; Verkerke, Gijsbertus Jacob

    2010-01-01

    Replacement of a degenerated vertebral disc with an artificial intervertebral disc (AID) is currently possible, but poses problems, mainly in the force distribution through the vertebral column. Data on the intervertebral disc space geometry will provide a better fit of the prosthesis to the vertebr

  12. Geometry of the Intervertebral Volume and Vertebral Endplates of the Human Spine

    NARCIS (Netherlands)

    van der Houwen, E. B.; Baron, P.; Veldhuizen, A. G.; Burgerhof, J. G. M.; van Ooijen, P. M. A.; Verkerke, G. J.

    2010-01-01

    Replacement of a degenerated vertebral disc with an artificial intervertebral disc (AID) is currently possible, but poses problems, mainly in the force distribution through the vertebral column. Data on the intervertebral disc space geometry will provide a better fit of the prosthesis to the vertebr

  13. Effect of intervertebral disc disease on scoliosis in the lumbar spine

    Directory of Open Access Journals (Sweden)

    Wojcik Gustaw

    2014-09-01

    Full Text Available Lumbar intervertebral discopathy is a common clinical problem and a significant cause of low back pain. Usually it is associated with overload and damage to the intervertebral disc, which directly relates to the instability of the motion segment. Renal normal anatomy between tissues within the spinal canal is a cause of the reflex curvature of the spine, the goal is to increase the volume of the spinal channel and reduce the compression of the nerve tissue. Knee-jerk reaction to pain is an non physiological change of the setting of the spine in the frontal plane.

  14. Region specific response of intervertebral disc cells to complex dynamic loading: an organ culture study using a dynamic torsion-compression bioreactor.

    Directory of Open Access Journals (Sweden)

    Samantha C W Chan

    Full Text Available The spine is routinely subjected to repetitive complex loading consisting of axial compression, torsion, flexion and extension. Mechanical loading is one of the important causes of spinal diseases, including disc herniation and disc degeneration. It is known that static and dynamic compression can lead to progressive disc degeneration, but little is known about the mechanobiology of the disc subjected to combined dynamic compression and torsion. Therefore, the purpose of this study was to compare the mechanobiology of the intervertebral disc when subjected to combined dynamic compression and axial torsion or pure dynamic compression or axial torsion using organ culture. We applied four different loading modalities [1. control: no loading (NL, 2. cyclic compression (CC, 3. cyclic torsion (CT, and 4. combined cyclic compression and torsion (CCT] on bovine caudal disc explants using our custom made dynamic loading bioreactor for disc organ culture. Loads were applied for 8 h/day and continued for 14 days, all at a physiological magnitude and frequency. Our results provided strong evidence that complex loading induced a stronger degree of disc degeneration compared to one degree of freedom loading. In the CCT group, less than 10% nucleus pulposus (NP cells survived the 14 days of loading, while cell viabilities were maintained above 70% in the NP of all the other three groups and in the annulus fibrosus (AF of all the groups. Gene expression analysis revealed a strong up-regulation in matrix genes and matrix remodeling genes in the AF of the CCT group. Cell apoptotic activity and glycosaminoglycan content were also quantified but there were no statistically significant differences found. Cell morphology in the NP of the CCT was changed, as shown by histological evaluation. Our results stress the importance of complex loading on the initiation and progression of disc degeneration.

  15. A computational model for investigating the effects of changes in bioavailability of insulin-like growth factor-1 on the homeostasis of the intervertebral disc.

    Science.gov (United States)

    Elmasry, Shady; Asfour, Shihab; de Rivero Vaccari, Juan Pablo; Travascio, Francesco

    2016-11-01

    Insulin-like growth factor-1 (IGF-1) is well-known for upregulating cell proliferation and biosynthesis of the extracellular matrix in the intervertebral disc (IVD). Pathological conditions, such as obesity or chronic kidney disease cause IGF-1 deficiency in plasma. How this deficiency impacts disc homeostasis remains unknown. Pro-anabolic approaches for the treatment of disc degeneration based on enhancing IGF-1 bioavailability to tissue-cells are considered, but knowledge of their effectiveness in enhancing cellular anabolism of a degenerated disc is limited. In this study, we developed a computational model for disc homeostasis specifically addressing the role of IGF-1 in modulating both extracellular matrix biosynthesis and cellularity in the IVD. This model was applied to investigate how changes in IGF-1 bioavailability, namely deficiency or enhancement of growth factor, affect disc health. In this study, it was found that IGF-1 deficiency mainly affects the biosynthesis of ECM components, especially in the most external regions of the IVD such as the cartilage endplates and the outer portion of annulus fibrosus. Also, a total of three approaches for increasing IGF-1 bioavailability as a therapy for degenerated IVDs were investigated. It was found that all these strategies are only beneficial to those disc regions receiving sufficient nutritional supply (i.e., the outmost IVD regions), while they exacerbate tissue degradation in malnourished regions (i.e., inner portion of the disc). This suggests that pro-anabolic growth factor-based therapies are limited in that their success strongly depends on an adequate nutritional supply to the IVD tissue, which is not guaranteed in degenerated discs. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. In-vivo T2-relaxation times of asymptomatic cervical intervertebral discs

    Energy Technology Data Exchange (ETDEWEB)

    Driscoll, Sean J.; Mao, Haiqing; Li, Guoan [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Zhong, Weiye [Massachusetts General Hospital/Harvard Medical School, Bioengineering Laboratory, Department of Orthopaedic Surgery, Boston, MA (United States); Second Xiangya Hospital and Central South University, Department of Spinal Surgery, Changsha, Hunan (China); Torriani, Martin [Massachusetts General Hospital/Harvard Medical School, Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Wood, Kirkham B.; Cha, Thomas D. [Massachusetts General Hospital/Harvard Medical School, Spine Service, Department of Orthopaedic Surgery, Boston, MA (United States)

    2016-03-15

    Limited research exists on T2-mapping techniques for cervical intervertebral discs and its potential clinical utility. The objective of this research was to investigate the in-vivo T2-relaxation times of cervical discs, including C2-C3 through C7-T1. Ten asymptomatic subjects were imaged using a 3.0 T MR scanner and a sagittal multi-slice multi-echo sequence. Using the mid-sagittal image, intervertebral discs were divided into five regions-of-interest (ROIs), centered along the mid-line of the disc. Average T2 relaxation time values were calculated for each ROI using a mono-exponential fit. Differences in T2 values between disc levels and across ROIs of the same disc were examined. For a given ROI, the results showed a trend of increasing relaxation times moving down the spinal column, particularly in the middle regions (ROIs 2, 3 and 4). The C6-C7 and C7-T1 discs had significantly greater T2 values compared to superior discs (discs between C2 and C6). The results also showed spatial homogeneity of T2 values in the C3-C4, C4-C5, and C5-C6 discs, while C2-C3, C6-C7, and C7-T1 showed significant differences between ROIs. The findings indicate there may be inherent differences in T2-relaxation time properties between different cervical discs. Clinical evaluations utilizing T2-mapping techniques in the cervical spine may need to be level-dependent. (orig.)

  17. The effects of cervical intervertebral disc replacemen on the range of movement and pressure change of intervertebral discs at adjacent segments%人工椎间盘置换对颈椎临近节段活动度及椎间盘内压力的影响

    Institute of Scientific and Technical Information of China (English)

    张维成; 麦伟; 廖兴华; 黄晓魏; 方文焕; 李智

    2009-01-01

    Objective To study the efects of cervical intervertebral disc replacemen on the range of movement and pressure change of intervertebral discs at adjacent segments.Methods 20 patients with cervical spondylosis were treated with cervical intervertebral disc replacement.The pressure change of intervertebral discs at adjacent segments were measured in the operation,and dynamical X-rays examination were carried out preoperatively and 3 month and 6 month postoperatively.The range of movement at the adjacent segments were studied.Results There were no significant diferences between pre-operative and post-operative on the range of movement and pressure change of intervertebral discs at adjacent segments(P>0.05).Conclusion The normal range of movement and pressure of intervertebral discs at the adjacent segments can be saved in the application of cervical intervertebral disc replacement,and then adjacent degeneration can be prevented.%目的 观察人工椎间盘置换对颈椎临近节段活动度及椎间盘内压力的影响.方法 应用人工椎间盘置换术治疗颈椎病患者20例,于术中椎间盘置换前后分别测量临近节段椎间盘内压力,并于术前及术后3个月、半年分别摄颈椎动力位x线片,观察上下临近节段的活动度.结果 人工椎间盘置换术后颈椎临近节段椎间盘内压力较术前无明显变化(P>0.05),上下临近关节活动度未显著增加(P>0.05).结论 人工椎间盘置换在治疗颈椎病的同时保留正常的椎间运动而不影响邻近节段,从而防止邻近节段继发性退变.

  18. Study of the influence of degenerative intervertebral disc changes on the deformation behavior of the cervical spine segment in flexion

    Science.gov (United States)

    Kolmakova, Tatyana V.

    2016-11-01

    The paper describes the model of the cervical spine segment (C3-C4) and the calculation results of the deformation behavior of the segment under degenerative changes of the intervertebral disc. The segment model was built based on the experimental literature data taking into account the presence of the cortical and cancellous bone tissue of vertebral bodies. The calculation results show that degenerative changes of the intervertebral disc cause the immobility of the C3 vertebra at flexion.

  19. Protective effect of p53 on the viability of intervertebral disc nucleus pulposus cells under low glucose condition.

    Science.gov (United States)

    Xiong, Xifeng; Dai, Libing; Liang, Weiguo; Zhang, Jinli; Qin, Shengnan; Cao, Wenjuan; Ye, Dongping; Liang, Peihong; Liu, Zhihe

    2017-09-02

    P53 is a famous cancer suppressor and plays key roles in metabolism. Intervertebral disc (IVD) is the largest avascular cartilaginous structure in humans and its degeneration is a common cause of spine diseases initiated from damaged nucleus pulposus (NP) cells. The potential cause of disc degeneration has been attributed to aging, genetic factors, mechanical factors and nutrition. In this study, we found that p53 decreased and leaked to the cytoplasm in NP cells as the glucose level decreases, in contrast to cancer cells in which p53 increases and concentrates to the nuclei. Comparing with in p53 knockdown NP cells, relative high p53 expression in normal control NP cells inhibited autophagy and the pentose phosphate pathway. Furthermore, the expression of Sox 9 and type II collagen were higher in p53 normal control than p53 knockdown NP cells. Based on these results, we believe that relative high p53 facilitates NP cell viability and integrity. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Clinical Effects of Acupuncture after Surgical Operation in Patients with Prolapse of the Lumbar Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    ZHAO Bin-xiu; WANG Kun-zheng; ZHAO Jie-xiu; WANG Chun-sheng; HUANG Xiag-hui; MA Shu-qiang; QIANG Hui

    2008-01-01

    Objective;To investigate the clinical effects of acupuncture after surgical operation in patients wim prolapse of the lumbar intervertebral disc(PLID).Methods;Sixty-nine patients in this series,who had undergone the removal of nucleus pulposus and the intervertebral fusion as well,were randomly divided into a treatment group of 35 cases and a control group of 34 cases.The former was treated by acupuncture and conventional rehabilitation therapy,and the latter only by the rehabilitation therapy.The therapeutic effects were evaluated according to the scoring system stipulated by Japanese Orthopedics Association(JOA).Results;In the treatment group,the average functional recovery rates in 3-month,6-month and one-year periods were respectively 49.93\t,90.3 1%and 95.08%;while the rates were repesctively 26.24%,63.42%and 71.36%in the control group,showing statistically significant difference between the two groups(P<0.05).Conclusions;Acupuncture can confirmatively promote the functional recovery for patients with prolapse of the lumbar intervertebral disc after surgical removal of nucleus pulposus and with intervertebral fusion.

  1. Genetic association studies in lumbar disc degeneration: a systematic review.

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    Pasi J Eskola

    Full Text Available OBJECTIVE: Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI in humans. METHODS: A systematic literature search was conducted in MEDLINE, MEDLINE In-Process, SCOPUS, ISI Web of Science, The Genetic Association Database and The Human Genome Epidemiology Network for information published between 1990-2011 addressing genes and lumbar disc degeneration. Two investigators independently identified studies to determine inclusion, after which they performed data extraction and analysis. The level of cumulative genetic association evidence was analyzed according to The HuGENet Working Group guidelines. RESULTS: Fifty-two studies were included for review. Forty-eight studies reported at least one positive association between a genetic marker and lumbar disc degeneration. The phenotype definition of lumbar disc degeneration was highly variable between the studies and replications were inconsistent. Most of the associations presented with a weak level of evidence. The level of evidence was moderate for ASPN (D-repeat, COL11A1 (rs1676486, GDF5 (rs143383, SKT (rs16924573, THBS2 (rs9406328 and MMP9 (rs17576. CONCLUSIONS: Based on this first extensive systematic review on the topic, the credibility of reported genetic associations is mostly weak. Clear definition of lumbar disc degeneration phenotypes and large population-based cohorts are needed. An international consortium is needed to standardize genetic association studies in relation to disc degeneration.

  2. Magnetic Resonance Classification System of Cervical Intervertebral Disk Degeneration: Its Validity and Meaning.

    Science.gov (United States)

    Suzuki, Akinobu; Daubs, Michael D; Hayashi, Tetsuo; Ruangchainikom, Monchai; Xiong, Chenjie; Phan, Kevin; Scott, Trevor P; Wang, Jeffery C

    2017-06-01

    Retrospective analysis of kinetic magnetic resonance images (kMRIs). (1) To analyze the changes seen on MRI related to disk degeneration and to develop a new grading system for cervical disk degeneration. (2) To evaluate the reliability and validity of the grading system. Few have studied the relationship between changes seen on MRI with cervical disk degeneration and the chronological order of disk degeneration. A few grading systems for cervical disk degeneration have been reported; however, there have been problems related to subjectivity and lack of a clear, reliable algorithm. A total of 300 cervical intervertebral disks were graded for nucleus color, structure, disk bulge, and disk height. On the basis of the analysis, a new grading system consisting of 4 grades (grade 0-III) and algorithm were developed. Intraobserver and interobserver reliabilities were assessed. A total of 2802 intervertebral disks were then evaluated using the grading system to correlate disk degeneration grades with patient age and function and to evaluate the validity of the new system. On the basis of cross-table analysis, disk degeneration presents in the following order: (1) decrease and/or change of nucleus intensity; (2) loss of distinction between nucleus and annulus; (3) positive disk bulge; and (4) disk height decrease. The κ-coefficients for intraobserver and interobserver agreements were 0.96 and 0.90, respectively. Severe disk degeneration is most common at C5/C6 followed by C6/C7 and C4/C5, and total disk degeneration grade is correlated with age (R=0.467). There was a decrease of angular motion in grades I-III and an increase in translational motion and decrease of space available for the cord in grades II-III. We developed a new classification system of cervical disk degeneration based on analysis of the changes seen on MRI. Reliability tests indicated high reproducibility of this system, and further analysis confirmed its validity and clinical significance.

  3. Topical vancomycine and bacterial culture from intervertebral herniated disc prevent postoperative osteodiscitis

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    Adam1 Danil

    2014-12-01

    Full Text Available Osteodiscitis represents a serious complication of lumbar disc herniation operations. The treatment of osteodiscitis is controversial and expensive to society. It extends over a period of several months from diagnosis. Reducing postoperative osteodiscitis by using simple measures may limit patient's suffering and reduce costs. The purpose of this study is to evaluate the early diagnosis of bacterial infections of the intervertebral disc by isolating germs located in the herniated disc fragment and topical Vancomycine powder application, along with the conventional anti-infective therapy. Medical files of patients who were operated on for lumbar disc herniations during 01.01.2013 - 30.06.2014 were reviewed. The diagnosis of lumbar disc herniation was established based on the clinical evaluation, confirmed by MRI results. The surgical intervention was performed by mini-open approach: fenestration and foraminotomy completed with removal of the herniated disc fragment and disc remnants from the intervertebral space. A group of 162 patients (group A received conventional therapy for prevention of post-operative infections with 2 doses of cephalosporin. In the second group of 137 patients (group B, after the removal of the herniated disc fragments, 1g of Vancomycine powder was topically applied and the disc fragments were bacteriologically analyzed. They received the conventional treatment of preventing post-operative infections with cephalosprin - 2 doses. The two groups of patients were similar in terms of demographic characteristics: age, sex, operative level. Out of the 162 patients of group A, one patient developed postoperative osteodiscitis and was treated for 3 months with antibiotics. Regarding patients in group B, in four cases Staphylococcus was isolated from the disc fragments. Postoperative treatment for these patients with prolonged antibiotic therapy over the standard period avoided the developement of the clinical picture of

  4. Transcript levels of major interleukins in relation to the clinicopathological profile of patients with tuberculous intervertebral discs and healthy controls.

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    Chong Liu

    Full Text Available The purpose of the present study was to simultaneously examine the transcript levels of a large number of interleukins (ILs; IL-9, IL-10, IL-12, IL-13, IL-16, IL-17, IL-18, IL-26, and IL-27 and investigate their correlation with the clinicopathological profiles of patients with tuberculous intervertebral discs.Clinical data were collected from 150 patients participating in the study from January 2013 to December 2013. mRNA expression levels in 70 tuberculous, 70 herniated, and 10 control intervertebral disc specimens were determined by real-time polymerase chain reaction.IL-10, IL-16, IL-17, IL-18, and IL-27 displayed stronger expression in tuberculous spinal disc tissue than in normal intervertebral disc tissue (P<0.05. Our results illustrated multiple correlations among IL-10, IL-16, IL-17, IL-18, and IL-27 mRNA expression in tuberculous samples. Smoking habits were found to have a positive correlation with IL-17 transcript levels and a negative correlation with IL-10 transcript levels (P<0.05. Pain intensity, symptom duration, C-reactive protein levels, and the erythrocyte sedimentation rate exhibited multiple correlations with the transcript levels of several ILs (P<0.05.The experimental data imply a double-sided effect on the activity of ILs in tuberculous spinal intervertebral discs, suggesting that they may be involved in intervertebral discs destruction. Our findings also suggest that smoking may affect the intervertebral discs destruction process of spinal tuberculosis. However, further studies are necessary to elucidate the exact role of ILs in the intervertebral discs destruction process of spinal tuberculosis.

  5. Localization of cathepsins G and L in spontaneous resorption of intervertebral discs in a rat experimental model.

    Science.gov (United States)

    Meng, W; Yonenobu, K; Ariga, K; Nakase, T; Okuda, S; Obata, K; Yoshikawa, H

    2001-12-01

    To determine the involvement of cathepsins G and L in the mechanism of spontaneous resorption of herniated intervertebral discs, localization of these cathepsins in this process was examined immunohistochemically using a rat model of autologous transplantation of coccygeal discs. Rat coccygeal discs were resected and autotransplanted into the subcutaneous space of the skin of the back. Paraffin-embedded sections of intervertebral disc tissue, harvested at various post-transplantational periods, were immunohistochemically stained with antibodies for cathepsin G, cathepsin L, MMP-1, MMP-3 and ED-2. The number of positive cells was counted in each part of the transplanted discs. Immunolocalization of cathepsins G and L in various types of disc cells was first observed early in the post-transplantation period. From two days after the operation, histology showed invasion by granulation tissue, with many macrophages, in all sections. Subsequently, the number of macrophages in granulation tissue was observed to increase, along with a gradual increase in the percentage of cells positive for MMP-1 and MMP-3. In addition to the ability of cathepsins G and L to degrade major extracellular matrix components of intervertebral discs, cathepsin G is capable of activating latent pro-MMPs. The up-regulation of cathepsins G and L in the intervertebral disc tissue in this spontaneous resorption model suggests that these proteinases may be involved in degradation of extracellular matrix, leading to the natural resorption of herniated discs.

  6. Coupling of small leucine-rich proteoglycans to hypoxic survival of a progenitor cell-like subpopulation in Rhesus Macaque intervertebral disc.

    Science.gov (United States)

    Huang, Shishu; Leung, Victor Y L; Long, Dan; Chan, Danny; Lu, William W; Cheung, Kenneth M C; Zhou, Guangqian

    2013-09-01

    Degeneration of the intervertebral disc (IVD) is a major spinal disorder that associates with neck and back pain. Recent studies of clinical samples and animal models for IVD degeneration have identified cells with multi-potency in the IVD. However, IVD tissue-specific progenitor cells and their niche components are not clear, although degenerated IVD-derived cells possess in vitro characteristics of mesenchymal stromal cell (MSCs). Here, we firstly identified the tissue-specific intervertebral disc progenitor cells (DPCs) from healthy Rhesus monkey and report the niche components modulated the survival of DPCs under hypoxia. DPCs possess clonogenicity, multipotency and retain differentiation potential after extended expansion in vitro and in vivo. In particular, the nucleus pulposus-derived DPCs are sensitive to low oxygen tension and undergo apoptosis under hypoxic conditions due to their inability to induce/stabilize hypoxia-inducible factors (HIF). The presence of small leucine-rich proteoglycans (SLRP), biglycan or decorin, can reduce the susceptibility of DPCs to hypoxia-induced apoptosis via promoting the activation/stabilization of HIF-1α and HIF-2α. As IVD is avascular, we propose SLRPs are niche components of DPCs in IVD homeostasis, providing new insights in progenitor cell biology and niche factors under a hypoxic microenvironment.

  7. Stem-cell treatment in disc degeneration: What is the evidence?

    Directory of Open Access Journals (Sweden)

    Manuela Peletti-Figueiró

    2013-01-01

    Full Text Available To review the potential role of stem cells in treating degenerative disc disease of the intervertebral disc (IVD. A review was performed of articles from the Medline database concerning stem cells and degenerative disc disease (DDD. To discuss the data, the papers were classified as: review, in vitro, experimental, and clinical. The currently available treatments were basically for symptom reduction, not to revert the IVD degenerative process. The use of mesenchymal stem cells (MSC is being proposed as an option of treatment for DDD. In vitro studies have shown that the MSC are able to differentiate into NP cells and that the MSC also reduce the inflammatory levels of the degenerated IVD. Besides, experimental studies demonstrated that the MSC remained viable when injected into the IVD, and that they were able to regenerate partially from the degenerated IVD and its structure. The few clinical studies found in the literature presented diverging results. The use of MSC is being widely studied and shows promising results for the treatment of DDD. Although many advances are being achieved in studies in vitro and experimental, there is a lack of clinical studies to prove the role of MSC in DDD management.

  8. Lumbar disc degeneration was not related to spine and hip bone mineral densities in Chinese: facet joint osteoarthritis may confound the association.

    Science.gov (United States)

    Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue

    2017-12-01

    A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P  0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.

  9. A 1-D model of the nonlinear dynamics of the human lumbar intervertebral disc

    Science.gov (United States)

    Marini, Giacomo; Huber, Gerd; Püschel, Klaus; Ferguson, Stephen J.

    2017-01-01

    Lumped parameter models of the spine have been developed to investigate its response to whole body vibration. However, these models assume the behaviour of the intervertebral disc to be linear-elastic. Recently, the authors have reported on the nonlinear dynamic behaviour of the human lumbar intervertebral disc. This response was shown to be dependent on the applied preload and amplitude of the stimuli. However, the mechanical properties of a standard linear elastic model are not dependent on the current deformation state of the system. The aim of this study was therefore to develop a model that is able to describe the axial, nonlinear quasi-static response and to predict the nonlinear dynamic characteristics of the disc. The ability to adapt the model to an individual disc's response was a specific focus of the study, with model validation performed against prior experimental data. The influence of the numerical parameters used in the simulations was investigated. The developed model exhibited an axial quasi-static and dynamic response, which agreed well with the corresponding experiments. However, the model needs further improvement to capture additional peculiar characteristics of the system dynamics, such as the change of mean point of oscillation exhibited by the specimens when oscillating in the region of nonlinear resonance. Reference time steps were identified for specific integration scheme. The study has demonstrated that taking into account the nonlinear-elastic behaviour typical of the intervertebral disc results in a predicted system oscillation much closer to the physiological response than that provided by linear-elastic models. For dynamic analysis, the use of standard linear-elastic models should be avoided, or restricted to study cases where the amplitude of the stimuli is relatively small.

  10. Enhancing cell migration in shape-memory alginate-collagen composite scaffolds: In vitro and ex vivo assessment for intervertebral disc repair.

    Science.gov (United States)

    Guillaume, Olivier; Naqvi, Syeda Masooma; Lennon, Kerri; Buckley, Conor Timothy

    2015-04-01

    Lower lumbar disc disorders pose a significant problem in an aging society with substantial socioeconomic consequences. Both inner tissue (nucleus pulposus) and outer tissue (annulus fibrosus) of the intervertebral disc are affected by such debilitating disorders and can lead to disc herniation and lower back pain. In this study, we developed an alginate-collagen composite porous scaffold with shape-memory properties to fill defects occurring in annulus fibrosus tissue of degenerated intervertebral discs, which has the potential to be administered using minimal invasive surgery. In the first part of this work, we assessed how collagen incorporation on preformed alginate scaffolds influences the physical properties of the final composite scaffold. We also evaluated the ability of annulus fibrosus cells to attach, migrate, and proliferate on the composite alginate-collagen scaffolds compared to control scaffolds (alginate only). In vitro experiments, performed in intervertebral disc-like microenvironmental conditions (low glucose and low oxygen concentrations), revealed that for alginate only scaffolds, annulus fibrosus cells agglomerated in clusters with limited infiltration and migration capacity. In comparison, for alginate-collagen scaffolds, annulus fibrosus cells readily attached and colonized constructs, while preserving their typical fibroblastic-like cell morphology with spreading behavior and intense cytoskeleton expression. In a second part of this study, we investigated the effects of alginate-collagen scaffold when seeded with bone marrow derived mesenchymal stem cells. In vitro, we observed that alginate-collagen porous scaffolds supported cell proliferation and extracellular matrix deposition (collagen type I), with secretion amplified by the local release of transforming growth factor-β3. In addition, when cultured in ex vivo organ defect model, alginate-collagen scaffolds maintained viability of transplanted mesenchymal stem cells for up to 5

  11. Degeneration of the intervertebral disc:pathogenesis and repair%椎间盘退变的机制及修复

    Institute of Scientific and Technical Information of China (English)

    孟祥宇; 夏建龙; 杨挺; 蔡平

    2015-01-01

    背景:目前为止,椎间盘退变源性腰痛的发病机制研究并不十分清楚明了,对于其治疗的手段也多种多样,但效果不一。目的:综述近年国内外椎间盘退变机制及修复的研究进展。方法:由第一作者检索至2014年11月为止 PubMed数据(http://www.ncbi.nlm.nih.gov/PubMed)及CNKI中国期刊全文数据库(http://www.cnki.net/),以“椎间盘退变因素,椎间盘源性腰痛,椎间盘退变治疗”等为检索词,共检索到78篇相关文献,排除重复研究,共30篇文献符合纳入标准。结果与结论:综合大量国内外科研人员对椎间盘退变的研究,目前比较推崇的退变因素包括形态学上的改变、炎性递质和细胞外基质的变化、生长因子的作用等,治疗上仍处于对其形态学的修复方面,其中经皮穿刺椎间盘减压、椎体融合、人工椎间盘置换、动态稳定系统等手术治疗方法对椎间盘退变引起的症状有确切的疗效。%BACKGROUND:So far, the pathogenesis of discogenic low back pain is poorly understood. A great diversity of therapeutic means is developed for discogenic low back pain, but the therapeutic outcomes are mixed. OBJECTIVE:To review the research progress in mechanisms and repair of intervertebral disc degeneration in recent years. METHODS: The first author retrieved the PubMed and CNKI databases for relevant articles published before November 2014 using the keywords of “disc degeneration factor, discogenic low back pain, disc degeneration therapy” in English and Chinese, respectively. Initialy, 78 relevant articles were retrieved, but only 30 articles were included in result analysis folowing elimination of duplicate studies. RESULTS AND CONCLUSION:The relatively respected factors for intervertebral disc degeneration include changes in morphology, inflammatory neurotransmitters and the extracelular matrix as wel as role of growth factors. The treatment for

  12. Biomechanical Analysis Of The Intervertebral Disc Implant Using The Finite Element Method

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    Kajzer W.

    2015-09-01

    Full Text Available Dysfunctions of the vertebral column belong to a group of civilisation diseases and they affect approximately 80% of population. The underlying cause is modern (sedentary lifestyle, low locomotive activity of people and frequent motor vehicle and sports accidents. Despite civilisation’s progress, no injury prophylactics or prevention of dysfunctions of the vertebral column have been introduced. The key element influencing function of the vertebral column is the intervertebral disc. It enables multidimensional movements and constitutes a basic connective element between the joints of the vertebral column. It also enables performing basic daily activities. Acting as a “damper”, it cushions vibrations and transmits loads between the vertebrae. One of the diseases affecting the intervertebral disc is discopathy. This is the most common degenerative disease, which can be treated by both conservative and surgical treatment. After removal of the damaged disc, it can be replaced by an adequate implant, which will assume its function. The implant will be expected to restore the vertebral column motor function, as well as to eliminate the pain resulting from compression of the spine caused by the damaged disc.

  13. INNERVATION OF SENSORY NERVE TERMINALS IN RAT LUMBAR INTERVERTEBRAL DISC AND POSTERIOR LONGITUDINAL LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To investigate the distribution of sensory nerve terminals in the lumbar intervertebral disc and posterior longitudinal ligament(PLL)in an animal model.Methods:Immunohistochemical method was used to visualize nerve terminals with antibodies of substanceP(SP) and calcitonin gene-related peptide(CGRP),and to characterize sensory nerve terminals on sections from lumbar intervertebral disc and posterior longitudinal ligament(PLL) of the sprague Dawley rate.Results :The immunostaining revealed an extensive distribution of SP and CGRP immunoreactive nerve filbers in the surface and most superficial portions of all annulus fibrosus and PLL.Most immunoreactions were observed in ventral and lateral regions of the annulus fibrosus,Morphologically,both thin varicose nerve fibers and tiny punctate nerve terminals could be observed.Conclusion:This study demonstrates an extensive distribution of SP and CGRP immunoreactive nerve fibers throughout the PLL and the peripheral annulus fibrosus and provides an illustration of this distribution.This finding supports a role for the disc as a source of low back pain and provides the neuroanatomic foundation of the disc-genic pain.

  14. Magnetic resonance imaging on disc degeneration changes after implantation of an interspinous spacer and fusion of the adjacent segment.

    Science.gov (United States)

    Liu, Xiaokang; Liu, Yingjie; Lian, Xiaofeng; Xu, Jianguang

    2015-01-01

    The aim of the study was to investigate the changes of the lumbar intervertebral disc degeneration by magnetic resonance imaging (MRI) after the implantation of interspinous device and the fusion of the adjacent segment. A total of 62 consecutive patients suffering L5/S1 lumbar disc herniation (LDH) with concomitant disc space narrowing or low-grade instability up to 5 mm translational slip in L5/S1 level were treated with lumbar interbody fusion (LIF) via posterior approach. Thirty-four of these patients (Coflex group) received an additional implantation of the interspinous spacer device (Coflex™) in the level L4/L5, while the rest of 28 patients (fusion group) underwent the fusion surgery alone. Clinical and radiographic examinations were performed at pre- and postoperative visits to compare the clinical outcomes and the changes of the L4/L5 vertebral disc degeneration on MRI in both Coflex and fusion group. Although both Coflex and fusion group showed improvements of the clinical outcomes assessed by the Oswestry Disability Index (ODI) after surgery, patients in Coflex group had more significant amelioration (P degeneration changes in Coflex group assessed by the relative signal intensity (RSI) differed from those in fusion group (P degeneration of the adjacent segment.

  15. Comparison of Farfan modified and Frobin methods to evaluate the intervertebral disc height

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    Michel Kanas

    2014-03-01

    Full Text Available OBJECTIVE: To evaluate the reliability and reproducibility of Farfan modified and Frobin methods to measure the intervertebral disc height in radiographs with inter- and intraobserver comparison. METHOD: Six radiographs of different patients treated for low back pain have been collected and digitized, and five lumbar disc of each patient were evaluated by six examiners with different levels of experience. The measures were done in Image Pro Plus 6.0 software. RESULTS: When compared, both methods showed more than 95% concordance. In intraexaminer analysis, both also shown to be reliable and reproducible, with a high level of concordance. By comparing the correlation between classes of examiners, the higher the level of experience, the greater the agreement for both methods. CONCLUSION: Farfan modified and Frobin are reliable methods to measure the disc height in the lateral radiographs. The higher level of experience of the examiner, the higher was the correlation between measurements.

  16. EVALUATION OF TERMINAL VERTEBRAL PLATE ON CERVICAL SPINE AT DIFFERENT AGE GROUPS AND ITS CORRELATION WITH INTERVERTEBRAL DISC THICKNESS

    Science.gov (United States)

    Luiz Vieira, Juliano Silveira; da Silva Herrero, Carlos Fernando Pereira; Porto, Maximiliano Aguiar; Nogueira Barbosa, Marcello Henrique; Garcia, Sérgio Britto; Zambelli Ramalho, Leandra Náira; Aparecido Defino, Helton Luiz

    2015-01-01

    To evaluate, by means of histomorphometry, terminal vertebral plate thickness, intervertebral disc thickness and its correlation on different age groups, seeking to identify its correlation. Methods: C4-C5 and C5-C6 cervical segments removed from human cadavers of both genders were assessed and divided into five groups of 10-year age intervals, from 21 years old. TVP and intervertebral disc thickness evaluation was made by means of histomorphometry of histological slides stained with hematoxylin and eosyn. Lower C4 TVP, upper C5 TVP, and upper C6 TVP de were compared between each other and to the interposed intervertebral disc thickness between relevant TVP. Results: The thickness of terminal vertebral plates adjacent to the same ID did not show statistic differences. However, the comparison of upper and lower vertebral plates thickness on the same cervical vertebra (C5), showed statistical difference on all age groups studied. We found a statistical correlation coefficient above 80% between terminal vertebral plate and adjacent intervertebral disc, with a proportional thickness reduction of both structures on the different cervical levels studied, and also on the different age groups assessed. Conclusion: Terminal vertebral plate shows a morphologic correlation with the intervertebral disc next to it, and does not show correlation with the terminal vertebral plate on the same vertebra. PMID:26998448

  17. Gender difference in genetic association between IL1A variant and early lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Kjær, Per; Sorensen, Joan S;

    2012-01-01

    The purpose of the present study was to analyze the associations between specific genetic markers and early disc degeneration (DD) or early disc degeneration progression (DDP) defined by magnetic resonance imaging (MRI)....

  18. Gender difference in genetic association between IL1A variant and early lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Kjær, Per; Sorensen, Joan S

    2012-01-01

    The purpose of the present study was to analyze the associations between specific genetic markers and early disc degeneration (DD) or early disc degeneration progression (DDP) defined by magnetic resonance imaging (MRI).......The purpose of the present study was to analyze the associations between specific genetic markers and early disc degeneration (DD) or early disc degeneration progression (DDP) defined by magnetic resonance imaging (MRI)....

  19. Mechanical Characterization of the Human Lumbar Intervertebral Disc Subjected to Impact Loading Conditions

    Science.gov (United States)

    Jamison, David, IV

    Low back pain is a large and costly problem in the United States. Several working populations, such as miners, construction workers, forklift operators, and military personnel, have an increased risk and prevalence of low back pain compared to the general population. This is due to exposure to repeated, transient impact shocks, particularly while operating vehicles or other machinery. These shocks typically do not cause acute injury, but rather lead to pain and injury over time. The major focus in low back pain is often the intervertebral disc, due to its role as the major primary load-bearing component along the spinal column. The formation of a reliable standard for human lumbar disc exposure to repeated transient shock could potentially reduce injury risk for these working populations. The objective of this project, therefore, is to characterize the mechanical response of the lumbar intervertebral disc subjected to sub-traumatic impact loading conditions using both cadaveric and computational models, and to investigate the possible implications of this type of loading environment for low back pain. Axial, compressive impact loading events on Naval high speed boats were simulated in the laboratory and applied to human cadaveric specimen. Disc stiffness was higher and hysteresis was lower than quasi-static loading conditions. This indicates a shift in mechanical response when the disc is under impact loads and this behavior could be contributing to long-term back pain. Interstitial fluid loss and disc height changes were shown to affect disc impact mechanics in a creep study. Neutral zone increased, while energy dissipation and low-strain region stiffness decreased. This suggests that the disc has greater clinical instability during impact loading with progressive creep and fluid loss, indicating that time of day should be considered for working populations subjected to impact loads. A finite element model was developed and validated against cadaver specimen

  20. Method for obtaining simple shear material properties of the intervertebral disc under high strain rates.

    Science.gov (United States)

    Ott, Kyle A; Armiger, Robert S; Wickwire, Alexis C; Carneal, Catherine M; Trexler, Morgana M; Lennon, Andrew M; Zhang, Jiangyue; Merkle, Andrew C

    2012-01-01

    Predicting spinal injury under high rates of vertical loading is of interest, but the success of computational models in modeling this type of loading scenario is highly dependent on the material models employed. Understanding the response of these biological materials at high strain rates is critical to accurately model mechanical response of tissue and predict injury. While data exists at lower strain rates, there is a lack of the high strain rate material data that are needed to develop constitutive models. The Split Hopkinson Pressure Bar (SHPB) has been used for many years to obtain properties of various materials at high strain rates. However, this apparatus has mainly been used for characterizing metals and ceramics and is difficult to apply to softer materials such as biological tissue. Recently, studies have shown that modifications to the traditional SHPB setup allow for the successful characterization of mechanical properties of biological materials at strain rates and peak strain values that exceed alternate soft tissue testing techniques. In this paper, the previously-reported modified SHPB technique is applied to characterize human intervertebral disc material under simple shear. The strain rates achieved range from 5 to 250 strain s-1. The results demonstrate the sensitivity to the disc composition and structure, with the nucleus pulposus and annulus fibrosus exhibiting different behavior under shear loading. Shear tangent moduli are approximated at varying strain levels from 5 to 20% strain. This data and technique facilitates determination of mechanical properties of intervertebral disc materials under shear loading, for eventual use in constitutive models.

  1. Graph cuts with invariant object-interaction priors: application to intervertebral disc segmentation.

    Science.gov (United States)

    Ben Ayed, Ismail; Punithakumar, Kumaradevan; Garvin, Gregory; Romano, Walter; Li, Shuo

    2011-01-01

    This study investigates novel object-interaction priors for graph cut image segmentation with application to intervertebral disc delineation in magnetic resonance (MR) lumbar spine images. The algorithm optimizes an original cost function which constrains the solution with learned prior knowledge about the geometric interactions between different objects in the image. Based on a global measure of similarity between distributions, the proposed priors are intrinsically invariant with respect to translation and rotation. We further introduce a scale variable from which we derive an original fixed-point equation (FPE), thereby achieving scale-invariance with only few fast computations. The proposed priors relax the need of costly pose estimation (or registration) procedures and large training sets (we used a single subject for training), and can tolerate shape deformations, unlike template-based priors. Our formulation leads to an NP-hard problem which does not afford a form directly amenable to graph cut optimization. We proceeded to a relaxation of the problem via an auxiliary function, thereby obtaining a nearly real-time solution with few graph cuts. Quantitative evaluations over 60 intervertebral discs acquired from 10 subjects demonstrated that the proposed algorithm yields a high correlation with independent manual segmentations by an expert. We further demonstrate experimentally the invariance of the proposed geometric attributes. This supports the fact that a single subject is sufficient for training our algorithm, and confirms the relevance of the proposed priors to disc segmentation.

  2. Magnetic resonance imaging of lumbar intervertebral discs in elderly patients with minor trauma

    Energy Technology Data Exchange (ETDEWEB)

    Afzal, Suhail [Orthopaedic Spine Surgeon, Spine Clinic, Srinagar, Kashmir (India)], E-mail: drsuhaila@yahoo.com; Akbar, Saleem [Nehru Hospital, Rose Belle (Mauritius)

    2009-05-15

    Purpose: Vertebral body fractures due to minor trauma, which commonly occur in the elderly, are a frequently encountered clinical problem. We utilized MRI in patients with acute back pain following minor injury to ensure the earliest possible diagnosis. Lumbar discs adjacent to fractured vertebral bodies were evaluated, using magnetic resonance imaging (MRI), to elucidate how often these discs were injured and how the injured discs were depicted by MRI. Materials and methods: We retrospectively reviewed MR images of 74 discs from 37 elderly patients (>65-year-old) with a single level vertebral fracture (fracture group). Patients with multiple-level fractures, burst fractures and/or major trauma, such as that resulting from a traffic accident, were excluded from this study. We also reviewed MR images of 190 discs from 27 elderly patients diagnosed with lumbar stenosis, who had no previous history of vertebral body fractures (stenosis group). Results: In the fracture group, 23% (17/74) of T1-weighted images exhibited a high-intensity area in the disc, whereas only 3% (5/190) exhibited a high-intensity area in the stenosis group. In some cases, in the T2-weighted images we also found a high-intensity zone in discs that showed low- or iso-intensity. This phenomenon was more frequently observed in the fracture group (47%: 35/74) than in the stenosis group. Conclusion: The present study indicates that, in elderly patients, intervertebral discs adjacent to vertebral fractures resulting from minor trauma are often injured. Because hemorrhage is the most likely cause of a high-intensity T1-weighted image, the results indicate that hemorrhage can be induced in a disc adjacent to a vertebral body fractured by even minor trauma.

  3. CT and MRI Determination of Intermuscular Space within Lumbar Paraspinal Muscles at Different Intervertebral Disc Levels

    Science.gov (United States)

    Wang, Shidong; Zhang, Yu; Han, Hui; Zheng, Dengquan; Ding, Zihai; Wong, Kelvin K. L.

    2015-01-01

    Background Recognition of the intermuscular spaces within lumbar paraspinal muscles is critically important for using the paramedian muscle-splitting approach to the lumbar spine. As such, it is important to determine the intermuscular spaces within the lumbar paraspinal muscles by utilizing modern medical imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). Methods A total of 30 adult cadavers were studied by sectional anatomic dissection, and 60 patients were examined using CT (16 slices, 3-mm thickness, 3-mm intersection gap, n = 30) and MRI (3.0T, T2-WI, 5-mm thickness, 1-mm intersection gap, n = 30). The distances between the midline and the superficial points of the intermuscular spaces at different intervertebral disc levels were measured. Results Based on study of our cadavers, the mean distances from the midline to the intermuscular space between multifidus and longissimus, from intervertebral disc levels L1–L2 to L5–S1, were 0.9, 1.1, 1.7, 3.0, and 3.5 cm, respectively. Compared with the upper levels (L1–L3), the superficial location at the lower level (L4–S1) is more laterally to the midline (Pquadratus lumborum, and that between longissimus and iliocostalis did not exist at L4–S1. The intermuscular spaces in patients also varied at different levels of the lumbar spine showing a low discontinuous density in CT and a high signal in MRI. There were no significant differences between the observations in cadavers and those made using CT and MRI. Conclusion The intermuscular spaces within the paraspinal muscles vary at different intervertebral disc levels. Preoperative CT and MRI can facilitate selection of the muscle-splitting approach to the lumbar spine. This paper demonstrates the efficacy of medical imaging techniques in surgical planning. PMID:26458269

  4. CT and MRI Determination of Intermuscular Space within Lumbar Paraspinal Muscles at Different Intervertebral Disc Levels.

    Directory of Open Access Journals (Sweden)

    Xuefei Deng

    Full Text Available Recognition of the intermuscular spaces within lumbar paraspinal muscles is critically important for using the paramedian muscle-splitting approach to the lumbar spine. As such, it is important to determine the intermuscular spaces within the lumbar paraspinal muscles by utilizing modern medical imaging such as computed tomography (CT and magnetic resonance imaging (MRI.A total of 30 adult cadavers were studied by sectional anatomic dissection, and 60 patients were examined using CT (16 slices, 3-mm thickness, 3-mm intersection gap, n = 30 and MRI (3.0T, T2-WI, 5-mm thickness, 1-mm intersection gap, n = 30. The distances between the midline and the superficial points of the intermuscular spaces at different intervertebral disc levels were measured.Based on study of our cadavers, the mean distances from the midline to the intermuscular space between multifidus and longissimus, from intervertebral disc levels L1-L2 to L5-S1, were 0.9, 1.1, 1.7, 3.0, and 3.5 cm, respectively. Compared with the upper levels (L1-L3, the superficial location at the lower level (L4-S1 is more laterally to the midline (P<0.05. The intermuscular space between sacrospinalis and quadratus lumborum, and that between longissimus and iliocostalis did not exist at L4-S1. The intermuscular spaces in patients also varied at different levels of the lumbar spine showing a low discontinuous density in CT and a high signal in MRI. There were no significant differences between the observations in cadavers and those made using CT and MRI.The intermuscular spaces within the paraspinal muscles vary at different intervertebral disc levels. Preoperative CT and MRI can facilitate selection of the muscle-splitting approach to the lumbar spine. This paper demonstrates the efficacy of medical imaging techniques in surgical planning.

  5. Prevalence and breed predisposition for thoracolumbar intervertebral disc disease in cats.

    Science.gov (United States)

    De Decker, Steven; Warner, Anne-Sophie; Volk, Holger A

    2017-04-01

    Objectives The objective was to evaluate the prevalence and possible breed predilections for thoracolumbar intervertebral disc disease (IVDD) in cats. Methods Medical records and imaging studies of cats diagnosed with thoracolumbar IVDD between January 2008 and August 2014 were retrospectively reviewed and compared with the general hospital population. The association between type of IVDD (ie, intervertebral disc extrusion [IVDE] or intervertebral disc protrusion [IVDP]) and breed, age, sex, and duration and severity of clinical signs was also evaluated. Results Of 12,900 cats presented during the study period, 31 (0.24%) were diagnosed with IVDD, including 17 purebred and 14 non-purebred cats. Of all presented purebred cats, 0.52% were diagnosed with thoracolumbar IVDD. More specifically, 1.29% of all British Shorthairs and 1.83% of all presented Persians were diagnosed with IVDD. Compared with the general hospital population, purebred cats ( P = 0.0001), British Shorthairs ( P cats were younger than affected non-purebred cats ( P = 0.02). Of 31 cats with IVDD, 19 were diagnosed with IVDE and 12 with IVDP. Cats with IVDE had a significantly shorter duration of clinical signs ( P = 0.0002) and demonstrated more severe neurological deficits ( P = 0.04) than cats with IVDP. Conclusions and relevance Although thoracolumbar IVDD is an uncommon condition in cats, purebred cats, British Shorthairs and Persians, were overrepresented. It is currently unclear if this represents a true breed predisposition or a higher likelihood of owners of purebred cats seeking referral for advanced diagnostic imaging procedures.

  6. High incidence of persistence of sacral and coccygeal intervertebral discs in South Indians – a cadaveric study

    Science.gov (United States)

    Satheesha Nayak, B; Ashwini Aithal, P; Kumar, Naveen; George, Bincy M; Deepthinath, R; Shetty, Surekha D

    2016-01-01

    The sacrum, by virtue of its anatomic location plays a key role in providing stability and strength to the pelvis. Presence of intervertebral discs in sacrum and coccyx is rare. Knowledge of its variations is of utmost importance to surgeons and radiologists. The current study focused on the presence of intervertebral discs between the sacral and coccygeal vertebrae in south Indian cadaveric pelvises. We observed 56 adult pelvises of which, 34 (61%) pelvises showed the presence of intervertebral discs between the sacral vertebrae and between the coccygeal vertebrae, while 22 (39%) pelvises did not have the intervertebral discs either in the sacrum or the coccyx. We also found that most of the specimens had discs between S1 and S2 vertebrae (39%), followed by, between S4 and S5 (18%), between S2–S3 (14%) and least being between S3–S4 (13%). In the coccyx it was found that 7% of pelvises had disc between Co1-Co2, 4% of them had between Co2-Co3 and 4% had between Co3-Co4. Knowledge regarding such anatomic variations in the sacro-coccygeal region is important to note because they require alterations in various instrumentation procedures involving the sacrum. PMID:27385838

  7. TREATMENT OF 247 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC WITH COMPREHENSIVE PLUM-BLOSSOM MAGNETIC NEEDLE THERAPY

    Institute of Scientific and Technical Information of China (English)

    张保平; 周日清; 周登芳

    2004-01-01

    Objective: To observe the therapeutic effect of comprehensive plum-blossom magnetic needle therapy on prolapse of lumbar intervertebral disc. Methods: 247 cases of prolapse of lumbar intervertebral disc were treated first with manual treatment and then with plum-blossom magnetic needle therapy and effect-increasing pad therapy at specified points and reactive points. Results: After treatment for 2 therapeutic courses,153 cases were cured accounting for 61.94%, 71 cases were markedly effective accounting for 28.75%, 22 cases were improved accounting for8.91% and the rest one failed,accounting for 0.45%. Conclusion: The comprehensive plum-blossom magnetic needle therapy has a better therapeutic effect on prolapse of lumbar intervertebral disc.

  8. Comparison of Therapeutic Effects Between Acupuncture plus Sacral Injection and Simple Acupuncture for Lumbar Intervertebral Disc Herniation

    Institute of Scientific and Technical Information of China (English)

    YAN Jie-ying; XU Yao

    2007-01-01

    To compare the therapeutic effects between acupuncture plus sacral injection and simple acupuncture for intervertebral disc hemia.Methods:The patients with lumbar intervertebral disc hernia at the age of 30-45 years old were divided into No.1-80 upon their visiting order,with odd number as Group A and even number as Group B.Group A was treated by acupuncture plus sacral injection,and Group B was treated by simple acupuncture.Results:The clinical effective rate was higher in Group A than in Group B,with significant difference (P<0.05).Conclusion:Acupuncture plus sacral injection had the better therapeutic effect than simple acupuncture in treating lumbar intervertebral disc hernia.

  9. [Specific lumbocrural pain and the individual diagnosis of lumbar intervertebral disc herniation].

    Science.gov (United States)

    Huang, Shi-Rong; Shi, Yin-Yu; Zhan, Hong-Sheng

    2014-03-01

    Pain is all lumbocrural pain cases very common clinical symptoms,but the etiology, pathology, site (range or area), intensity, nature, evolution situation and influence factors of pain usually has some certain characteristics and rules, these differences particularly are regarded as the primary and important basis or clue for the clinical diagnosis and differential diagnosis of related diseases. In addition, according to these differences can determine the individual diagnosis of lumbar intervertebral disc herniation as well, including typical and atypical, simple and compound, the general and special cases, these be- come the basis to determine the individualized therapeutic schedule of this disese.

  10. [Research advances of three-dimension printing technology in vertebrae and intervertebral disc tissue engineering].

    Science.gov (United States)

    Yang, Zechuan; Li, Chunde; Sun, Haolin

    2016-03-01

    Three-dimensional (3D) printing technology is characterized by "inside-out" stack manufacturing. Compared with conventional technologies, 3D printing has the advantage of personalization and precision. Therefore, the shape and internal structure of the scaffolds made by 3D printing technology are highly biomimetic. Besides, 3D bioprinting can precisely deposit the biomaterials, seeding cells and cytokines at the same time, which is a breakthrough in printing technique and material science. With the development of 3D printing, it will make great contributions to the reconstruction of vertebrae and intervertebral disc in the future.

  11. Is a purpose of REM sleep atonia to help regenerate intervertebral disc volumetric loss?

    Directory of Open Access Journals (Sweden)

    Fryer Jerome CJ

    2009-01-01

    Full Text Available Abstract The nature of atonia in sleep continues to be enigmatic. This article discusses a new hypothesis for complete core muscle relaxation in REM sleep, suggesting a bottom-up recuperative perspective. That is, does the atonia in REM sleep provide a utility to help restore the mechanobiology and respective diurnal intervertebral disc hydraulic loss? By combining the effects of gravity with current compressive concepts in spinal stability, this article looks at vertebral approximation as a deleterious experience with an intrinsic biological need to keep vertebrae separated. Methods using polysomnography and recumbent MRI are discussed.

  12. Clinical Experience on Treatment of Lumbar Intervertebral Disc Protrusion by Traditional Manual Techniques plus Electric Acupuncture

    Institute of Scientific and Technical Information of China (English)

    LIANG Hao-wen; WU Fang; YANG Wan-zhang; ZHANG Min; HUANG Guo-qi

    2007-01-01

    52 cases of the patients with L4-S1 intervertebral disc protrusion were first treated by traditional Tuina manual techniques, including the rolling method, pressing method,oblique-plucking method and shaking method, and then treated by electric acupuncture on Shenshu (BL 23), Yaoyangguan (GV 3), Dachangshu (BL 25), Xiaochangshu (BL 27),Mingmen (GV 4) and Shangliao (BL 31). After 7-28 sessions of the treatments, the results showed cure in 40 cases, remarkable effect in 8 cases, effect in 3 cases, failure in 1 case, and the total effective rate in 98.1%.

  13. Influence of Porcine Intervertebral Disc Matrix on Stem Cell Differentiation

    Directory of Open Access Journals (Sweden)

    Hans-Lothar Fuchsbauer

    2011-08-01

    Full Text Available For back disorders, cell therapy is one approach for a real regeneration of a degenerated nucleus pulposus. Human mesenchymal stem cells (hMSC could be differentiated into nucleus pulposus (NP-like cells and used for cell therapy. Therefore it is necessary to find a suitable biocompatible matrix, which supports differentiation. It could be shown that a differentiation of hMSC in a microbial transglutaminase cross-linked gelatin matrix is possible, but resulted in a more chondrocyte-like cell type. The addition of porcine NP extract to the gelatin matrix caused a differentiation closer to the desired NP cell phenotype. This concludes that a hydrogel containing NP extract without any other supplements could be suitable for differentiation of hMSCs into NP cells. The NP extract itself can be cross-linked by transglutaminase to build a hydrogel free of NP atypical substrates. As shown by side-specific biotinylation, the NP extract contains molecules with free glutamine and lysine residues available for the transglutaminase.

  14. Collagen fibrillogenesis in the development of the annulus fibrosus of the intervertebral disc.

    Science.gov (United States)

    Hayes, Anthony J; Isaacs, Marc D; Hughes, C; Caterson, B; Ralphs, J R

    2011-10-11

    The annulus fibrosus of the intervertebral disc is a complex, radial-ply connective tissue consisting of concentric lamellae of oriented collagen. Whilst much is known of the structure of the mature annulus, less is known of how its complex collagenous architecture becomes established; an understanding of which could inform future repair/regenerative strategies. Here, using a rat disc developmental series, we describe events in the establishment of the collagenous framework of the annulus at light and electron microscopic levels and examine the involvement of class I and II small leucine rich proteoglycans (SLRPs) in the matrix assembly process. We show that a period of sustained, ordered matrix deposition follows the initial cellular differentiation/orientation phase within the foetal disc. Fibrillar matrix is deposited from recesses within the plasma membrane into compartments of interstitial space within the outer annulus - the orientation of the secreted collagen reflecting the initial cellular orientation of the laminae. Medially, we demonstrate the development of a reinforcing 'cage' of collagen fibre bundles around the foetal nucleus pulpous. This derives from the fusion of collagen bundles between presumptive end-plate and inner annulus. By birth, the distinct collagenous architectures are established and the disc undergoes considerable enlargement to maturity. We show that fibromodulin plays a prominent role in foetal development of the annulus and its attachment to vertebral bodies. With the exception of keratocan, the other SLRPs appear associated more with cartilage development within the vertebral column, but all become more prominent within the disc during its growth and differentiation.

  15. Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

    Science.gov (United States)

    Sugiura, Kosuke; Tonogai, Ichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Suzue, Naoto; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke; Kondo, Kenji; Tezuka, Fumitake; Mineta, Kazuaki; Takeuchi, Makoto; Takahashi, Mitsuhiko; Egawa, Hiroshi; Sairyo, Koichi

    2014-01-01

    A 32-year-old man underwent radiofrequency thermal annuloplasty (TA) with percutaneous endoscopic discectomy (PED) under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ) in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc. PMID:24963428

  16. Discoscopic Findings of High Signal Intensity Zones on Magnetic Resonance Imaging of Lumbar Intervertebral Discs

    Directory of Open Access Journals (Sweden)

    Kosuke Sugiura

    2014-01-01

    Full Text Available A 32-year-old man underwent radiofrequency thermal annuloplasty (TA with percutaneous endoscopic discectomy (PED under local anesthesia for chronic low back pain. His diagnosis was discogenic pain with a high signal intensity zone (HIZ in the posterior corner of the L4-5 disc. Flexion pain was sporadic, and steroid injection was given twice for severe pain. After the third episode of strong pain, PED and TA were conducted. The discoscope was inserted into the posterior annulus and revealed a migrated white nucleus pulposus which was stained blue. Then, after moving the discoscope to the site of the HIZ, a migrated slightly red nucleus pulposus was found, suggesting inflammation and/or new vessels penetrating the mass. After removing the fragment, the HIZ site was ablated by TA. To our knowledge, this is the first report of the discoscopic findings of HIZ of the lumbar intervertebral disc.

  17. The Effect of Electroacupuncture on the Extracellular Matrix Synthesis and Degradation in a Rabbit Model of Disc Degeneration

    Directory of Open Access Journals (Sweden)

    Guo-fu Huang

    2014-01-01

    Full Text Available The present study was aimed at determining if the electroacupuncture (EA is able to protect degenerated disc in vivo. New Zealand white rabbits (n=40 were used for the study. The rabbits were randomly assigned to four groups. EA intervention was applied to one of the four groups. Magnetic resonance imaging and Pfirrmann’s classification were obtained for each group to evaluate EA treatment on the intervertebral disc degeneration. Discs were analyzed using immunofluorescence for the labeling of collagens 1 and 2, bone morphogenetic protein-2 (BMP-2, matrix metalloproteinase-13 (MMP-13, and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1. For protein expression analysis, western blot was used for biglycan and decorin. Outcomes indicated that EA intervention decreased the grades compared with the compressed disc. Immunofluorescence analysis showed a significant increase of collagens 1 and 2, TIMP-1, and BMP-2 positive cells, in contrast to MMP-13 after EA treatment for 28 days. The protein expression showed a sign of regeneration that decorin and biglycan were upregulated. It was concluded that EA contributed to the extracellular matrix (ECM anabolic processes and increased the ECM components. MMPs and their inhibitors involved in the mechanism of EA intervention on ECM decreased disc. It kept a dynamic balance between ECM synthesis and degradation.

  18. CLINICAL OBSERVATION ON LUMBAR INTERVERTEBRAL DISC HERNIATION TREATED BY TRACTION COMBINED WITH ACUPUNCTURE

    Institute of Scientific and Technical Information of China (English)

    何涛; 何岚

    2004-01-01

    Objective: To observe the therapeutic effect of traction combined with acupuncture on lumbar intervertebral disc herniation (LIDH).Methods:Eighty-three patients diagnosed as LIDH were randomly divided into treatment group (n=42)and control group (n=41).In the treatment group, besides lumbar traction, electroacupuncture at Jiaji (EX-B 2, L3~5), Shenshu (BL 23), Qihai (CV 6), Mingmen (GV 4), Huantiao (GB 30), Chengshan (BL 57) and Yanglingquan (GB 34) was added.In the control group, only lumbar traction was applied.Results: In treatment group, the cure plus markedly effective rate was 80.95% with a total effective rate of 92.86%, while in control group, it was 39.02% with a total effective rate of 80.48%.The therapeutic effect in the treatment group was obviously better than that in the control group (P<0.001).Conclusion: Lumbar traction plus EA can effectively alleviate or even eliminate clinical symptoms and signs of lumbar intervertebral disc herniation.

  19. Treatment of 89 Cases of Lumbar Intervertebral Disc Herniation with Acupuncture

    Institute of Scientific and Technical Information of China (English)

    吴广伟; 杨湘宇

    2006-01-01

    采用以针刺为主、辅以腰部牵引和按摩等方法对89例腰椎间盘突出症患者进行综合治疗.经4个疗程的治疗,治愈65例,显效12例,有效7例,无效3例.采用以针刺为主的综合治疗腰椎间盘脱出症,能明显提高治疗效果,值得临床推广应用.%Eighty-nine cases of lumbar intervertebral disc herniation were mainly dealt with acupuncture method, supplementing with traction and Tuina at lumbar region. After 4 courses of treatment, 65 cases were cured, 12 cases got marked effects, 7 some effects, and 3 no effect. This integrated treatment had good effects on lumbar intervertebral disc herniation, and are worthy of being applied widely in clinic.

  20. Cervical intervertebral foraminal disc extrusion in dogs: clinical presentation, MRI characteristics and outcome after medical management.

    Science.gov (United States)

    Bersan, E; McConnell, F; Trevail, R; Behr, S; De Decker, S; Volk, H A; Smith, P M; Gonçalves, R

    2015-06-06

    The aim of the present study was to retrospectively evaluate the clinical signs, MRI characteristics, interobserver agreement and outcome after medical treatment in dogs affected by cervical intervertebral foraminal disc extrusion (CIFDE). The medical records of three referral institutions were searched for dogs diagnosed with CIFDE between 2010 and 2012. Thirteen dogs were identified with CIFDE; affected dogs often had a normal neurological examination, with cervical hyperaesthesia and lameness as the most common clinical signs. On MRI, sagittal images showed no evidence of compression of the spinal cord; CIFDE could be identified only on transverse sections in all cases. An excellent interobserver agreement was found in the localisation of the affected intervertebral disc space, and a substantial agreement was found on the detection of CIFDE versus foraminal stenosis caused by overgrowing articular processes. All but two dogs recovered completely, and they were considered free of clinical signs without analgesia within a median of 7.5 weeks (range: 2-20) after medical management was started. The remaining two dogs were surgically treated followed by complete recovery. In view of our findings, the importance of a thorough MRI investigation in dogs presenting with cervical hyperaesthesia as the sole clinical sign should be highlighted. British Veterinary Association.

  1. Validation of genome-wide intervertebral disc calcification associations in Dachshund and further investigation of the chromosome 12 susceptibility locus

    Directory of Open Access Journals (Sweden)

    Mette Sloth eMogensen

    2012-11-01

    Full Text Available Herniation of the intervertebral disc is a common cause of neurological dysfunction in the dog, particularly in the Dachshund. Using the Illumina CanineHD BeadChip, we have previously identified a major locus on canine chromosome 12 nucleotide positions 36,750,205-38,524,449 that strongly associates with intervertebral disc calcification in Danish wire-haired Dachshunds. In this study, targeted resequencing identified two synonymous variants in MB21D1 and one in the 5’-untranslated region of KCNQ5 that associates with intervertebral disc calcification in an independent sample of wire-haired Dachshunds. Haploview identified seven linkage disequilibrium blocks across the disease associated region. The effect of haplotype windows on disc calcification shows that all haplotype windows are significantly associated with disc calcification. However, our predictions imply that the causal variant(s are most likely to be found between nucleotide 36,750,205-37,494,845 as this region explains the highest proportion of variance in the dataset. Finally, we develop a risk prediction model for wire-haired Dachshunds.We validated the association of the chromosome 12 locus with disc calcification in an independent sample of wire-haired Dachshunds and identify potential risk variants. Additionally, we estimated haplotype effects and set up a model for prediction of disc calcifications in wire-haired dachshunds based on genotype data. This genetic prediction model may prove useful in selection of breeding animals in future breeding programs

  2. Photobiomodulation on human annulus fibrosus cells during the intervertebral disk degeneration: extracellular matrix-modifying enzymes.

    Science.gov (United States)

    Hwang, Min Ho; Kim, Kyoung Soo; Yoo, Chang Min; Shin, Jae Hee; Nam, Hyo Geun; Jeong, Jin Su; Kim, Joo Han; Lee, Kwang Ho; Choi, Hyuk

    2016-05-01

    Destruction of extracellular matrix (ECM) leads to degeneration of the intervertebral disk (IVD), which is a major contributor to many spine disorders. IVD degeneration is induced by pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), which are secreted by immune cells, including macrophages and neutrophils. The cytokines modulate ECM-modifying enzymes such as matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in human annulus fibrosus (AF) cells. The resulting imbalance in catabolic and anabolic enzymes can cause generalized back, neck, and low back pain (LBP). Photobiomodulation (PBM) is known to regulate inflammatory responses and wound healing. The aim of this study was to mimic the degenerative IVD microenvironment, and to investigate the effect of a variety of PBM conditions (wavelength: 635, 525, and 470 nm; energy density: 16, 32, and 64 J/cm(2)) on the production of ECM-modifying-enzymes by AF cells under degenerative conditions induced by macrophage-conditioned medium (MCM), which contains pro-inflammatory cytokines such as TNF-α and IL-β secreted by macrophage during the development of intervertebral disk inflammation. We showed that the MCM-stimulated AF cells express imbalanced ratios of TIMPs (TIMP-1 and TIMP-2) and MMPs (MMP-1 and MMP-3). PBM selectively modulated the production of ECM-modifying enzymes in AF cells. These results suggest that PBM can be a therapeutic tool for degenerative IVD disorders.

  3. Effects of Panax ginseng-containing herbal plasters on compressed intervertebral discs in an in vivo rat tail model

    Directory of Open Access Journals (Sweden)

    Chow Daniel H K

    2013-02-01

    Full Text Available Abstract Background Tienchi (Panax notoginseng has been used in conservative treatments for back pain as a major ingredient of many herbal medicines. This study aims to investigate the effects of a herbal medicine containing tienchi on compressed intervertebral discs in rats. Methods Using an in vivo rat tail model, intervertebral disc compression was simulated in the caudal 8–9 discs of 25 rats by continuous static compression (11 N for 2 weeks. An herbal medicine plaster (in which the major ingredient was tienchi was externally applied to the compressed disc (n=9 for three weeks, and held in place by an adhesive bandage, in animals in the Chinese Medicine (CM group. The effect of the bandage was evaluated in a separate placebo group (n=9, while no intervention with unrestricted motion was provided to rats in an additional control group (n=7. Disc structural properties were quantified by in vivo disc height measurement and in vitro morphological analysis. Results Disc height decreased after the application of compression (P P = 0.006 and placebo (P = 0.003 groups, but was maintained in the CM group (P = 0.494. No obvious differences in disc morphology were observed among the three groups (P = 0.896. Conclusion The tienchi-containing herbal plaster had no significant effect on the morphology of compressed discs, but maintained disc height in rats.

  4. Height of lumbar discs measured from radiographs compared with degeneration and height classified from MR images

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    Frobin, W.; Brinckmann, P. [Muenster Univ. (Germany). Inst. fuer Experimentelle Biomechanik; Kramer, M.; Hartwig, E. [Ulm Univ. (Germany). Sektion fuer Unfallchirurgische Forschung und Biomechanik

    2001-02-01

    The relation between height of lumbar discs (measured from lateral radiographic views) and disc degeneration (classified from MR images) deserves attention in view of the wide, often parallel or interchanged use of both methods. The time sequence of degenerative signs and decrease of disc height is controversial. To clarify the issue, this cross-sectional study documents the relation between disc degeneration and disc height in a selected cohort. Forty-three subjects were selected at random from a cohort examined for potential disc-related disease caused by long-term lifting and carrying. From each subject a lateral radiographic view of the lumbar spine as well as findings from an MR investigation of (in most cases) levels T12/L1 to L5/S1 were available; thus, n = 237 lumbar discs were available for measurement and classification. Disc height was measured from the radiographic views with a new protocol compensating for image distortion and permitting comparison with normal, age- and gender-appropriate disc height. Degeneration as well as disc height were classified twice from MR images by independent observers in a blinded fashion. Disc degeneration classified from MR images is not related to a measurable disc height loss in the first stage of degeneration, whereas progressive degeneration goes along with progressive loss of disc height, though with considerable interindividual variation. Loss of disc height classified from MR images is on average compatible with loss of disc height measured from radiographs. In individual discs, however, classification of height loss from MR images is imprecise. The first sign of disc degeneration (a moderate loss of nucleus signal) precedes disc height decrease. As degeneration progresses, disc height decreases. Disc height decrease and progress of degeneration, however, appear to be only loosely correlated. (orig.)

  5. Is the transport of a gadolinium-based contrast agent decreased in a degenerated or aged disc? A post contrast MRI study.

    Directory of Open Access Journals (Sweden)

    Marta Tibiletti

    Full Text Available A post contrast magnetic resonance imaging study has been performed in a wide population of low back pain patients to investigate which radiological and phenotypic characteristics influence the penetration of the contrast agent in lumbar discs in vivo. 37 patients affected by different pathologies (disc herniation, spondylolisthesis, foraminal stenosis, central canal stenosis were enrolled in the study. The selected population included 26 male and 11 female subjects, with a mean age of 42.4 ± 9.3 years (range 18-60. Magnetic resonance images of the lumbar spine were obtained with a 1.5 T scanner (Avanto, Siemens, Erlangen, Germany with a phased-array back coil. A paramagnetic non-ionic contrast agent was injected with a dose of 0.4 ml/kg. T1-weighted magnetic resonance images were subsequently acquired at 5 time points, 5 and 10 minutes, 2, 4 and 6 hours after injection. Endplates presented clear enhancement already 5 minutes after injection, and showed an increase in the next 2 hours followed by a decrease. At 5 and 10 minutes, virtually no contrast medium was present inside the intervertebral disc; afterwards, enhancement significantly increased. Highly degenerated discs showed higher enhancement in comparison with low and medium degenerated discs. Discs classified as Pfirrmann 5 showed a statistically significant higher enhancement than Pfirrmann 1, 2 and 3 at all time points but the first one, possibly due to vascularization. Disc height collapse and Modic changes significantly increased enhancement. Presence of endplate defects did not show any significant influence on post contrast enhancement, but the lack of a clear classification of endplate defects as seen on magnetic resonance scans may be shadowing some effects. In conclusion, disc height, high level of degeneration and presence of Modic changes are factors which increase post contrast enhancement in the intervertebral disc. The effect of age could not be demonstrated.

  6. INNERVATION OF SENSORY NERVE TERMINALS IN RAT LUMBAR INTERVERTEBRAL DISC AND POSTERIOR LONGITUDINAL LIGAMENT

    Institute of Scientific and Technical Information of China (English)

    韩学哲; 王民; 刘淼; 赵昌松

    2002-01-01

    Objective To investigate the distribution of sen sory nerve terminals in the lumbar intervertebral disc and posterior longitudina l ligament (PLL) in an animal model. Methods Immunohistochemical method was used to visualize nerve terminals with antibodies of substance P(SP) and calcitonin gene-related pepti de(CGRP), and to characterize sensory nerve terminals on sections from lumbar in tervertebral disc and posterior longitudinal ligament(PLL) of the Sprague Dawley rats.Results The immunostaining revealed an extensive distribution o f SP and CGRP immunoreactive nerve fibers in the surface and most superficial po rtions of all annulus fibrosus and PLL. Most immunoreactions were observed in ve ntral and lateral regions of the annulus fibrosus. Morphologically, both thin va ricose nerve fibers and tiny punctate nerve terminals could be observed. Conclusion This study demonstrates an extensive distribution o f SP and CGRP immunoreactive nerve fibers throughout the PLL and the peripheral annulus fibrosus and provides an illustration of this distribution. This finding supports a role for the disc as a source of low back pain and provides the neur oanatomic foundation of the disc-genic pain.

  7. Are the determinants of vertebral endplate changes and severe disc degeneration in the lumbar spine the same? A magnetic resonance imaging study in middle-aged male workers

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    Korpelainen Raija

    2008-04-01

    Full Text Available Abstract Background Modic changes are bone marrow lesions visible in magnetic resonance imaging (MRI, and they are assumed to be associated with symptomatic intervertebral disc disease, especially changes located at L5-S1. Only limited information exists about the determinants of Modic changes. The objective of this study was to evaluate the determinants of vertebral endplate (Modic changes, and whether they are similar for Modic changes and severe disc degeneration focusing on L5-S1 level. Methods 228 middle-aged male workers (159 train engineers and 69 sedentary factory workers from northern Finland underwent sagittal T1- and T2-weighted MRI. Modic changes and disc degeneration were analyzed from the scans. The participants responded to a questionnaire including items of occupational history and lifestyle factors. Logistic regression analysis was used to evaluate the associations between selected determinants (age, lifetime exercise, weight-related factors, fat percentage, smoking, alcohol use, lifetime whole-body vibration and Modic type I and II changes, and severe disc degeneration (= grade V on Pfirrmann's classification. Results The prevalences of the Modic changes and severe disc degeneration were similar in the occupational groups. Age was significantly associated with all degenerative changes. In the age-adjusted analyses, only weight-related determinants (BMI, waist circumference were associated with type II changes. Exposure to whole-body vibration, besides age, was the only significant determinant for severe disc degeneration. In the multivariate model, BMI was associated with type II changes at L5-S1 (OR 2.75 per one SD = 3 unit increment in BMI, and vibration exposure with severe disc degeneration at L5-S1 (OR 1.08 per one SD = 11-year increment in vibration exposure. Conclusion Besides age, weight-related factors seem important in the pathogenesis of Modic changes, whereas whole-body vibration was the only significant determinant

  8. Stress - Strain Response of the Human Spine Intervertebral Disc As an Anisotropic Body. Mathematical Modeling and Computation

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    Minárová Mária

    2016-01-01

    Full Text Available The paper deals with the biomechanical investigation on the human lumbar intervertebral disc under the static load. The disc is regarded as a two - phased ambient consisting of a fibrous outer part called annulus fibrosis and a liquid inner part nucleus pulposus. Due to the fibrous structure, the annulus fibrosis can be treated by using a special case of anisotropy - transversal isotropy.

  9. Suppression of adverse angiogenesis in an albumin-based hydrogel for articular cartilage and intervertebral disc regeneration

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    B Scholz

    2010-07-01

    Full Text Available An injectable polyethylene glycol-crosslinked albumin gel (AG supplemented with hyaluronic acid as a matrix for autologous chondrocyte implantation was evaluated with regard to its impact on angiogenesis. Healthy articular cartilage and intervertebral discs (IVD are devoid of blood vessels, whereas pathological blood vessel formation augments degeneration of both theses tissues. In contrast to human endothelial cells, primary human articular chondrocytes encapsulated in the AG retained their viability. Endothelial cells did not adhere to the gel surface to a significant extent nor did they proliferate in vitro. The AG did not release any diffusible toxic components. Contrary to MatrigelTM employed as positive control, the AG prevented endothelial chemoinvasion in Transwell filter assays even in the presence of a chemotactic gradient of vascular endothelial growth factor. In ovo, the AG exhibited a barrier function for blood vessels of the chick chorioallantoic membrane. Subcutaneous implantation of human IVD chondrocytes enclosed in the albumin gel into immunodeficient mice revealed a complete lack of angiogenesis inside the gel after two weeks. At the same time, the IVD chondrocytes within the gel remained vital and displayed a characteristic gene expression pattern as judged from aggrecan, collagen type I and type II mRNA levels. In summary, aiming at articular cartilage and IVD regeneration the albumin gel promises to be a beneficial implant matrix for chondrocytes simultaneously exhibiting non-permissive properties for adverse endothelial cells.

  10. The three-dimensional architecture of the notochordal nucleus pulposus: novel observations on cell structures in the canine intervertebral disc.

    Science.gov (United States)

    Hunter, Christopher J; Matyas, John R; Duncan, Neil A

    2003-03-01

    Cells from the nucleus pulposus of young ( 5 years) non-chondrodystrophoid dogs were studied using routine histology, confocal laser scanning microscopy and transmission electron microscopy. The architecture of cell structures--from the tissue scale down to subcellular scale--was reported. Clusters of notochordal cells were observed in young nuclei pulposi, ranging from 10 to 426 cells each. These clusters resisted mechanical disruption and showed evidence of cell-cell signalling via gap junctions. Cells (30-40 microm in diameter) within the clusters had a physaliferous appearance, containing numerous large inclusions which ranged from 1 to 20 microm in diameter. The inclusions were surrounded by a dense actin cortex but were not contained by a lipid bilayer. The contents of the inclusions were determined not to be predominantly carbohydrate or neutral lipid as assessed by histochemical staining, but the exact composition of the contents remained uncertain. There were striking differences in the cell architecture of young vs. old nuclei pulposi, with a loss of both cell clusters and physaliferous cells during ageing. These observations demonstrate unique cell structures, which may influence our understanding of the differences between notochordal and chondrocytic cells in the nucleus pulposus. Such differences could have substantial impact upon how we think about development, degeneration and repair of the intervertebral disc.

  11. Lumbar intervertebral disc abnormalities: comparison of quantitative T2 mapping with conventional MR at 3.0 T

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    Trattnig, Siegfried [Medical University of Vienna, Department of Radiology, MR Centre-Highfield MR, Vienna (Austria); Ludwig Boltzmann Institute for Clinical and Experimental Traumatology, Austrian Cluster for Tissue Regeneration, Vienna (Austria); Stelzeneder, David; Goed, Sabine; Reissegger, Michael [Medical University of Vienna, Department of Radiology, MR Centre-Highfield MR, Vienna (Austria); Mamisch, Tallal C. [Inselspital Berne, Orthopedic Surgery Department, Berne (Switzerland); Paternostro-Sluga, Tatjana [Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Vienna (Austria); Weber, Michael [Medical University of Vienna, Department of Radiology, Vienna (Austria); Szomolanyi, Pavol [Medical University of Vienna, Department of Radiology, MR Centre-Highfield MR, Vienna (Austria); Slovak Academy of Sciences, Department of Imaging Methods, Institute of Measurement Science, Bratislava (Slovakia); Welsch, Goetz H. [Medical University of Vienna, Department of Radiology, MR Centre-Highfield MR, Vienna (Austria); University Hospital of Erlangen, Department of Trauma Surgery, Erlangen (Germany)

    2010-11-15

    To assess the relationship of morphologically defined lumbar disc abnormalities with quantitative T2 mapping. Fifty-three patients, mean age 39 years, with low back pain were examined by MRI at 3 T (sagittal T1-fast spin echo (FSE), three-plane T2-FSE for morphological MRI, multi-echo spin echo for T2 mapping). All discs were classified morphologically. Regions of interest (ROIs) for the annulus were drawn. The space in between was defined as the nucleus pulposus (NP). To evaluate differences between the classified groups, univariate ANOVA with post hoc Games-Howell and paired two-tailed t tests were used. In 265 discs we found 39 focal herniations, 10 annular tears, 123 bulging discs and 103 ''normal discs''. T2 values of the NP between discs with annular tear and all other groups were statistically significantly different (all p {<=} 0.01). Discs with annular tears showed markedly lower NP T2 values than discs without. The difference in NP T2 values between discs with focal herniation and normal discs (p = 0.005) was statistically significant. There was no difference in NP T2 values between bulging and herniated discs (p = 0.11) Quantitative T2 mapping of the nucleus pulposus of the intervertebral disc in the lumbar spine at 3 T reveals significant differences in discs with herniation and annular tears compared with discs without these abnormalities. (orig.)

  12. The role of cryopreservation in the biomechanical properties of the intervertebral disc

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    SKL Lam

    2011-12-01

    Full Text Available Implantation of intervertebral disc (IVD allograft or tissue engineered disc constructs in the spine has emerged as an alternative to artificial disc replacement for the treatment of severe degenerative disc disease (DDD. Establishment of a bank of cryopreserved IVD allografts enables size matching and facilitates logistics for effective clinical management. However, the biomechanical properties of cryopreserved IVDs have not been previously reported. This study aimed to assess if cryopreservation with different concentrations of cryopreservant agents (CPA would affect the dynamic viscoelastic properties of the IVD. Whole porcine lumbar IVDs (n = 40 were harvested and processed using various concentrations of CPA, 0 % CPA, 10 % CPA and 20 % CPA. The discs were cryopreserved using a stepwise freezing protocol and stored in liquid nitrogen. After four weeks of storage, the cryopreserved IVDs were quickly thawed at 37 °C for dynamic viscoelastic testing. The apparent modulus, elastic modulus (G’, viscous modulus (G” and loss modulus (G”/G’ were calculated and compared to a fresh control group. Cryopreserved IVD without cryopreservants was significantly stiffer than the control. In the dynamic viscoelastic testing, cryopreservation with the use of CPA was able to preserve both G’ and G” of an IVD. No significant differences were found between fresh IVD and IVD cryopreserved with 10 % CPA or 20 % CPA. This study demonstrated that CPAs at an optimal concentration could preserve the mechanical properties of the IVD allograft and can provide further credence for the application of long-term storage of IVD allografts for disc transplantation or tissue engineered construct applications.

  13. OZONE NUCLEOLYSIS IN LUMBAR INTERVERTEBRAL DISC HERNIATION: NON - RANDOMIZED PROSPECTIVE ANALYSIS

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    Vivekananda S

    2015-05-01

    Full Text Available STUDY DESI GN: Non - randomized, prospective analysis of 68 patients of lumbar disc herniation treated with ozone nucleolysis. OBJECTIVE: To assess the patients with lumbar disc herniation treated with intradiscal ozone, pre and post ozone nucleolysis, for pain using Visual Analog Scale (VAS functional & disability score using Japanese Orthopedic Association (JOA Clinical Symptom Score. SUMMARY OF BACKGROUN D DATA: Ozone therapy for disc herniation is becoming popu lar because of its minimal invasive, lesser recurrences and remarkably fewer side effects. Successful outcomes of ozone therapy have been reported from various European & Indian centers. METHODS: A series of 68 patients were treated with ozone therapy for lumbar disc herniation from January 2009 to January 2012. The procedure is done under C - arm guidance under local anesthesia by “Single sitting double injection technique”. All patients were assessed using VAS for radiation pain & back pain, Clinical Symptom Score of the Japanese Orthopaedic Association (JOA for a Patient with Lumbar Disc Herniation, pre op and post op, on day one, after a week, two weeks, first month, third months, sixth month one year second year. Were classified them as Good, Moder ate & Poor outcome. RESULTS: Out of 68 patients 89.7% (61/68 patients had good outcome, 7.35% (5/68 patients had moderate outcome, 2.95% (2/68 had poor outcome. Intra - op in 1 patient where ozone spread in Para spinal muscles but had no postoperative pro blem.4 patients had mild nausea, 2 had mild headache & No infection. CONCLUSIONS: Ozone nucleolysis is a new, minimally invasive procedure done under local anesthesia & has shown effective results in the treatment of contained intervertebral disc herniatio n with no side effects.

  14. A Combined Treatment of Scalp Acupuncture and Traction in 108 Cases of Prolapse of the Lumbar Intervertebral Disc

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Prolapse of the lumbar intervertebral disc is a syndrome commonly seen in clinic. The main manifestation is pain in the lumbar region radiating to the lower limbs. In the treatment of this disease, the author has employed traction together with scalp needling, and obtained quite good therapeutic effects. A report follows.

  15. Is there a role for endothelial dysfunction in the pathogenesis of lumbar disc degeneration? A hypothesis that needs to be tested.

    Science.gov (United States)

    Papalia, Rocco; Albo, Erika; Vadalà, Gianluca; D'Adamio, Stefano; Lanotte, Angela; Di Martino, Alberto; Denaro, Vincenzo

    2015-03-01

    Low back pain is a painful condition affecting most people at least once in their life. It can be the expression of lumbar disc degeneration, a condition whose progression is influenced by environmental, individual and genetic factors. The pathogenesis of this condition implies the reduction of sustenance for the tissues within the intervertebral disc (ID) due to a decreased blood flow in the local microcirculation. In fact, it is known that the ID is an avascular structure that receives nutritive molecules and exchanges waste products through a process of osmotic diffusion from the capillaries located at the ID-vertebral body interface. The maintenance of a correct oxygen supply is essential for the health of disc cells also because ID is subjected to continuous compression stress due to its bearing function between vertebral bodies. This vital condition is guaranteed by proper dilation of blood vessels in response to mechanical stress, thanks to a finely balanced homeostasis between vasodilatory factors, such as nitric oxide, and vasoconstrictive substances produced by the endothelium. Endothelial dysfunction may disrupt this delicate equilibrium, causing a reduced oxygen supply eventually resulting in ID degeneration. Our hypothesis is that endothelial dysfunction, a systemic condition of reduced vessel dilation in response to mechanical stress, should be considered as an important pathological factor implicated intervertebral disc degeneration. This relationship may pave the way for a change in therapeutic approach to low back pain, especially in the early stages.

  16. Effect of Static Load on the Nucleus Pulposus of Rabbit Intervertebral Disc Motion Segment in Ex vivo Organ Culture

    Institute of Scientific and Technical Information of China (English)

    Li-Guo Zhu; Min-Shan Feng; Jia-Wen Zhan; Ping Zhang; Jie Yu

    2016-01-01

    Background:The development of mechanically active culture systems helps increase the understanding of the role of mechanical stress in intervertebral disc (IVD) degeneration.Motion segment cultures allow for preservation of the native IVD structure,and adjacent vertebral bodies facilitate the application and control of mechanical loads.The purpose of this study was to establish loading and organ culture methods for rabbit IVD motion segments to study the effect of static load on the whole disc organ.Methods:IVD motion segments were harvested from rabbit lumbar spines and cultured in no-loading 6-well plates (control conditions) or custom-made apparatuses under a constant,compressive load (3 kg,0.5 MPa) for up to 14 days.Tissue integrity,matrix synthesis,and the matrix gene expression profile were assessed after 3,7,and 14 days of culturing and compared with those of fresh tissues.Results:The results showed that ex vivo culturing of motion segments preserved tissue integrity under no-loading conditions for 14 days whereas the static load gradually destroyed the morphology after 3 days.Proteoglycan contents were decreased under both conditions,with a more obvious decrease under static load,and proteoglycan gene expression was also downregulated.However,under static load,immunohistochemical staining intensity and collagen Type Ⅱ alpha 1 (COL2A 1) gene expression were significantly enhanced (61.54 ± 5.91,P =0.035) and upregulated (1.195 ± 0.040,P =0.000),respectively,compared with those in the controls (P < 0.05).In contrast,under constant compression,these trends were reversed.Our initial results indicated that short-term static load stimulated the synthesis of collagen Type Ⅱ alpha l;however,sustained constant compression led to progressive degeneration and specifically to a decreased proteoglycan content.Conclusions:A loading and organ culture system for ex vivo rabbit IVD motion segments was developed.Using this system,we were able to study the effects of

  17. Effect of siRNA interference on nerve growth factor in intervertebral disc inflammation rats

    Institute of Scientific and Technical Information of China (English)

    Ming-Lei Lang; Ai-Lin Qin; Jian-Min Li; Peng Fu

    2014-01-01

    Objective:To investigate the inhibition effect of siRNA interference onNGF induced by inflammatory factorIL-6, andIL-1 so as to provide novel targets for clinical treatment of discogenic low back pain.Methods:The intervertebral disc nucleus and annulus fibrosus cells of rats were separated .The cells were co-cultured with different concentrations(10 nmol/L,20 nmol/L,50 nmol/L,100 nmol/L) ofIL-6 andIL-1β.TheNGF- siRNA was leaded into the co-cultured cells with its import ability assessed by flow cytometry instrument tests,before and after which theNGF mRNA expression was detected by real-timeQ-PCR and theNGF content was detected byELISA.Results:Flow cytometry instrument test results showed that theNGF-siRNA cell conversion rate was99.8%.Real-timeQ-PCR detection results showed that compared with negative control group, theNGF mRNA expression of co-cultured cells treated by10 nmol/L,20 nmol/L,50 nmol/L,100 nmol/LIL-6 andIL-1β were respectively raised3.4,3.7,4.7, 3.7 times which were all significantly down-regulated after the import ofNGF- siRNA.EILSA detection results showed that compared with negative control group, theNGF content of co-cultured medium treated by10 nmol/L,20 nmol/L,50 nmol/L,100 nmol/LI-L6 andIL-1β were respectively raised2.9,3.3,4.5,7.4 times which were all significantly decreased after the import ofNGF- siRNA.Conclusions:These molecular biological results suggest that inflammatory factorIL-6 andIL-1β could stimulateNGF on intervertebral disc cells in vitro culture model and its efficiency is concentration dependent, while siRNA interference can inhibit the stimulation effect ofIL-6 andIL-1β on intervertebral disc cell, which provides a new targets for the clinical treatment of discogenic low back pain.

  18. Collagen fibrillogenesis in the development of the annulus fibrosus of the intervertebral disc

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    AJ Hayes

    2011-10-01

    Full Text Available The annulus fibrosus of the intervertebral disc is a complex, radial-ply connective tissue consisting of concentric lamellae of oriented collagen. Whilst much is known of the structure of the mature annulus, less is known of how its complex collagenous architecture becomes established; an understanding of which could inform future repair/regenerative strategies. Here, using a rat disc developmental series, we describe events in the establishment of the collagenous framework of the annulus at light and electron microscopic levels and examine the involvement of class I and II small leucine rich proteoglycans (SLRPs in the matrix assembly process. We show that a period of sustained, ordered matrix deposition follows the initial cellular differentiation/orientation phase within the foetal disc. Fibrillar matrix is deposited from recesses within the plasma membrane into compartments of interstitial space within the outer annulus – the orientation of the secreted collagen reflecting the initial cellular orientation of the laminae. Medially, we demonstrate the development of a reinforcing ‘cage’ of collagen fibre bundles around the foetal nucleus pulpous. This derives from the fusion of collagen bundles between presumptive end-plate and inner annulus. By birth, the distinct collagenous architectures are established and the disc undergoes considerable enlargement to maturity. We show that fibromodulin plays a prominent role in foetal development of the annulus and its attachment to vertebral bodies. With the exception of keratocan, the other SLRPs appear associated more with cartilage development within the vertebral column, but all become more prominent within the disc during its growth and differentiation.

  19. Genipin-crosslinked fibrin hydrogels as a potential adhesive to augment intervertebral disc annulus repair.

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    Schek, R M; Michalek, A J; Iatridis, J C

    2011-04-18

    Treatment of damaged intervertebral discs is a significant clinical problem and, despite advances in the repair and replacement of the nucleus pulposus, there are few effective strategies to restore defects in the annulus fibrosus. An annular repair material should meet three specifications: have a modulus similar to the native annulus tissue, support the growth of disc cells, and maintain adhesion to tissue under physiological strain levels. We hypothesized that a genipin crosslinked fibrin gel could meet these requirements. Our mechanical results showed that genipin crosslinked fibrin gels could be created with a modulus in the range of native annular tissue. We also demonstrated that this material is compatible with the in vitro growth of human disc cells, when genipin:fibrin ratios were 0.25:1 or less, although cell proliferation was slower and cell morphology more rounded than for fibrin alone. Finally, lap tests were performed to evaluate adhesion between fibrin gels and pieces of annular tissue. Specimens created without genipin had poor handling properties and readily delaminated, while genipin crosslinked fibrin gels remained adhered to the tissue pieces at strains exceeding physiological levels and failed at 15-30%. This study demonstrated that genipin crosslinked fibrin gels show promise as a gap-filling adhesive biomaterial with tunable material properties, yet the slow cell proliferation suggests this biomaterial may be best suited as a sealant for small annulus fibrosus defects or as an adhesive to augment large annulus repairs. Future studies will evaluate degradation rate, fatigue behaviors, and long-term biocompatibility.

  20. Cervical intervertebral disc herniation treatment via radiofrequency combined with low-dose collagenase injection into the disc interior using an anterior cervical approach.

    Science.gov (United States)

    Wang, Zhi-Jian; Zhu, Meng-Ye; Liu, Xiao-Jian; Zhang, Xue-Xue; Zhang, Da-Ying; Wei, Jian-Mei

    2016-06-01

    This study aimed to determine the therapeutic effect of radiofrequency combined with low-dose collagenase injected into the disc interior via an anterior cervical approach for cervical intervertebral disc herniation.Forty-three patients (26-62-year old; male/female ratio: 31/12) with cervical intervertebral disc herniation received radiofrequency combined with 60 to 100 U of collagenase, injected via an anterior cervical approach. The degree of nerve function was assessed using the current Japanese Orthopaedic Association (JOA) scoring system at 3 and 12 months postoperation. A visual analogue scale (VAS) was used to evaluate the degree of pain preoperation and 7 days postoperation. The preoperative and 3 month postoperative protrusion areas were measured and compared via magnetic resonance imaging (MRI) and picture archiving and communication systems (PACS).Compared with the preoperative pain scores, the 7-day postoperative pain was significantly reduced (P <0.01). The excellent and good rates of nerve function amelioration were 93.0% and 90.7% at 3 and 12 months postoperation, respectively, which was not significantly different. Twenty-seven cases exhibited a significantly reduced protrusion area (P <0.01) at 3 months postoperation. No serious side effects were noted.To our knowledge, this is the first study to demonstrate that the use of radiofrequency combined with low-dose collagenase injection into the disc interior via an anterior cervical approach is effective and safe for the treatment of cervical intervertebral disc herniation.

  1. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  2. Intra- and inter-observer reliability of MRI examination of intervertebral disc abnormalities in patients with cervical myelopathy

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    Braga-Baiak, Andresa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Post-graduation Program, Department of Radiology, University of Sao Paulo (Brazil); Shah, Anand [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Pietrobon, Ricardo [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Department of Surgery, Duke University Medical Center, Durham, NC (United States); Braga, Larissa [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); University of Nebraska Medical Center, Lincoln NE (United States); Neto, Arnolfo Carvalho [Clinica DAPI, Curitiba (Brazil); Section of Diagnostic Radiology, Department of Internal Medicine, Universidade Federal do Parana (Brazil); Cook, Chad [Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC (United States); Division of Physical Therapy, Duke University Medical Center, Durham, NC (United States)], E-mail: chad.cook@duke.edu

    2008-01-15

    Purpose: Intervertebral cervical disc herniation (CDH) is a relatively common disorder that can coexist with degenerative changes to worsen cervicogenic myelopathy. Despite the frequent disc abnormalities found in asymptomatic populations, magnetic resonance imaging (MRI) is considered excellent at detecting cervical spine myelopathy (CSM) associated with disc abnormality. The objective of this study was to investigate the intra- and inter-observer reliability of MRI detection of CSM in subjects who also had co-existing intervertebral disc abnormalities. Materials and methods: Seven experienced radiologists reviewed twice the MRI of 10 patients with clinically and/or imaging determined myelopathy. MRI assessment was performed individually, with and without operational guidelines. A Fleiss Kappa statistic was used to evaluate the intra- and inter-observer agreement. Results: The study found high intra-observer percent agreement but relatively low Kappa values on selected variables. Inter-observer reliability was also low and neither observation was improved with operational guidelines. We believe that those low values may be associated with the base rate problem of Kappa. Conclusion: In conclusion, this study demonstrated high intra-observer percent agreement in MR examination for intervertebral disc abnormalities in patients with underlying cervical myelopathy, but differing levels of intra- and inter-observer Kappa agreement among seven radiologists.

  3. Quantitative in vivo MRI evaluation of lumbar facet joints and intervertebral discs using axial T2 mapping

    Energy Technology Data Exchange (ETDEWEB)

    Stelzeneder, David; Messner, Alina; Scheurecker, Georg; Goed, Sabine; Friedrich, Klaus M.; Trattnig, Siegfried [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); Vlychou, Marianna [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); University Hospital of Larissa, Department of Radiology, Larissa (Greece); Welsch, Goetz H. [Medical University of Vienna, Department of Radiology, MR Centre-High Field MR, Vienna (Austria); University of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Pieber, Karin; Pflueger, Verena [Medical University of Vienna, Department of Physical Medicine and Rehabilitation, Vienna (Austria)

    2011-11-15

    To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3.0 Tesla. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs (nucleus pulposus, anterior and posterior annulus fibrosus). The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading (''normal'' vs. ''abnormal'' discs). The inter-rater agreement was excellent for the facet joint T2 evaluation (r = 0.85), but poor for the morphological Weishaupt grading (kappa = 0.15). The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores. There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. Facet joint T2 values showed a weak correlation with T2 values of the posterior annulus (r = 0.32) This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab. (orig.)

  4. A study of sodium alginate and calcium chloride interaction through films for intervertebral disc regeneration uses

    Energy Technology Data Exchange (ETDEWEB)

    Laia, Andreia Grossi Santos de; Costa Junior, Ezequiel de Souza; Costa, Hermes de Souza, E-mail: andreiagrossi@yahoo.com.br [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET-MG), Belo Horizonte, MG (Brazil)

    2014-07-01

    The injured intervertebral disc (IVD) requires some measures in order to promote its regeneration. The sodium alginate in conjunction with CaCl{sub 2} forms a net, potentiating its mechanical properties so it may be an alternative for IVD treatment. In this work, the viability of films of sodium alginate crosslinked with CaCl{sub 2} and submitted to variations in their solutions' preparations is verified, comparing the effects of the addition of CaCl{sub 2} through their immersions, before and after drying the films. The films had their physicochemical properties analyzed by FTIR, DSC and XRD. The results indicated that films with a greater proportion of CaCl{sub 2} were more stable in the DSC analysis when compared to films with smaller proportions of CaCl{sub 2}. These results indicate alginate's modulation capacity which may be useful for IVD regeneration. (author)

  5. Conservative therapy for lumbar intervertebral disc hernia. Intradiscal compressive injection and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Tohru; Nanba, Hiromichi; Kasai, Tsutomu; Ohta, Susumu [Yoshida Orthopaedic Hospital, Toyota, Aichi (Japan)

    1996-01-01

    To herniating intervertebral discs, 3-20 ml physiological saline was pressurized and injected. To avoid excessive force, the injection pressure was set at less than 3 kg/cm{sup 2}. Between January 1993 and December 1994, 380 cases were studied (286 men and 94 women with a mean age of 45.5 years). After the compressive injection there were 259 (68.2%) effective cases in which symptoms were relieved and 121 ineffective cases (31.8%). The proportion of effective cases was higher in women than in men and in older than in younger patients. After intradiscal pressurized injection, the effective cases were investigated with MRI and a tendency to relatively early shrinkage of herniated mass was noted. (author).

  6. Hydrogel-Based Platforms for the Regeneration of Osteochondral Tissue and Intervertebral Disc

    Directory of Open Access Journals (Sweden)

    Luigi Ambrosio

    2012-09-01

    Full Text Available Hydrogels currently represent a powerful solution to promote the regeneration of soft and hard tissues. Primarily, they assure efficient bio-molecular interactions with cells, also regulating their basic functions, guiding the spatially and temporally complex multi-cellular processes of tissue formation, and ultimately facilitating the restoration of structure and function of damaged or dysfunctional tissues. In order to overcome basic drawbacks of traditional synthesized hydrogels, many recent strategies have been implemented to realize multi-component hydrogels based on natural and/or synthetic materials with tailored chemistries and different degradation kinetics. Here, a critical review of main strategies has been proposed based on the use of hydrogels-based devices for the regeneration of complex tissues, i.e., osteo-chondral tissues and intervertebral disc.

  7. The Effect of Expectations on Treatment Outcome for Lumbar Intervertebral Disc Herniation

    Science.gov (United States)

    Lurie, Jon D.; Henderson, Eric R.; McDonough, Christine M.; Berven, Sigurd H.; Scherer, Emily A.; Tosteson, Tor D.; Tosteson, Anna N. A.; Hu, Serena S.; Weinstein, James N.

    2015-01-01

    Study Design Secondary analysis of randomized and non-randomized prospective cohorts. Objective To examine the effect of patient treatment expectations on treatment outcomes for patients with intervertebral disc herniation. Summary of Background Data Patient expectations about treatment effectiveness may have important relationships with clinical outcomes. Methods Sub-group and re-analysis of the Spine Patient Outcomes Research Trial, a randomized trial and comprehensive cohort study enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in 11 US states. Overall 501 randomized and 744 observational patients (1244 total) who were surgical candidates with radiculopathy and imaging confirmed lumbar intervertebral disc herniation were enrolled. The primary study compared surgical discectomy to usual non-operative care; this sub-group analysis reassessed outcomes based on treatment expectations at baseline. Expectations about symptomatic and functional improvement for both surgery and non-operative care were assessed on 5-point scales (1="No Chance (0%)" to 5="Certain (100%)"). Outcomes were assessed using longitudinal regression models analyzed by treatment received. Results Among 1244 IDH SPORT participants, 1168 provided data on both outcomes and baseline expectations and were included in the current analysis: 467 from the randomized and 701 from the observational cohort. Low expectations of outcomes with surgery predicted poorer outcome regardless of treatment. High expectations of outcomes with non-operative care predicted better non-operative outcomes but did not affect surgical results. These differences were of similar magnitude to the difference in outcomes between surgery and non-operative care. Conclusions High expectations of treatment benefit had clinically significant positive associations with outcomes. PMID:26641853

  8. The expression of aquaporin-1 in various degenerative human intervertebral discs and its significance%水通道蛋白1在不同程度退变腰椎间盘中的表达及意义

    Institute of Scientific and Technical Information of China (English)

    林世洲; 杨少华; 张博; 陈微

    2013-01-01

    Objective To observe the changes of the expression of aquaporin -4 ( AQP-1 ) in various degenerative human intervertebral discs , and to investigate its relationship with intervertebral disk degeneration. Methods Thirty intervertebral disc samples were collected from patients with prolapse of lumbar intervertebral disc during operation , including protrusion , extrusion and sequestration type and 10 samples for each type. Ten intervertebral disc samples in control group were collected from patients who had lumbar vertebral fractures. The expression of AQP-1 in lumbar intervertebral disc was detected using immunohistochemistry method. Results The result of hematoxylin and eosin staining showed that the intervertebral disc tissue in control group still maintained a dense lamellar structure, while the intervertebral disc tissue in study group presented fibrotic changes . The expression of AQP-1 in nucleus cells in both groups was significantly higher than that in fibrous ring cells ( P ≤0. 01 ). The expression of AQP-1 in the protrusion specimen, including nucleus cells and fibrous ring cells , in study group was significantly lower than that in control group ( P < 0. 01 ). And the expression of AQP-1 in both extrusion type and sequestration type specimen was significantly lower than that in protrusion type specimen (P < 0. 01 ). Conclusion The expression of AQP-1 decreases along with protrusion , extrusion, and sequestration stages of the intervertebral disc degeneration .%目的 观察水通道蛋白1在退变腰椎间盘组织中的表达变化,研究其与椎间盘退变的关系.方法 实验组取材于经手术治疗腰椎间盘突出症患者椎间盘标本30例,突出型、脱出型、游离型各10例;对照组取材于腰椎损伤致椎体骨折患者切除椎间盘10例.应用免疫组织化学法检测水通道蛋白1在椎间盘组织中的表达.结果 (1)苏木精-伊红染色显示,对照组椎间盘组织仍保持着致密的板层结构,实

  9. The influence of the intervertebral disc on stress distribution of the thoracolumbar vertebrae under destructive load

    Institute of Scientific and Technical Information of China (English)

    刘雷; 裴福兴; 宋跃明; 邹力; 张聪; 周宗科

    2002-01-01

    Objective: To compare the influence of normal and degenerative discs on stress distribution of the thoracolumbar vertebrae under destructive load, explore the biomechanical background and clinical meaning and provide theoretical basis for clinical diagnosis and treatment.Methods: A mechanical model of thoracolumbar motion segment of normal and degenerative discs was built with a three dimensional finite element method and three stresses of vertical compression, compressive flexion and distractive flexion were comparatively analyzed.Results: With vertical compression and compressive flexion loads, the thoracolumbar motion segment of the normal disc showed that the central part of the upper and lower end-plates of the vertebrae and the central part of the trabecular bone adjacent to the end-plate were loaded with the most intensive stresses, meanwhile, the postero-lateral part of the annulus fibrosus was concentrated with stresses. Degenerative disc showed that the stress distribution of the trabecular bone was relatively averaged, the stresses of the central part adjacent to the end-plate were low, while at the same time, the stresses of the peripheral part were elevated relatively. With distraction flexion load, the stresses of the cortex bone, trabecular bone, end-plate and annulus fibrosus of the thoracolumbar vertebrae of degenerative discs were low, meanwhile, the stresses of the posterior structure of the vertebral body were relatively elevated compared with that of normal discs.Conclusions: There is difference in influence between normal and degenerative discs on the stress distribution of the thoracolumbar vertebrae with destructive load. The transferring way of load is changed after disc degeneration.

  10. Shock Absorbing Function Study on Denucleated Intervertebral Disc with or without Hydrogel Injection through Static and Dynamic Biomechanical Tests In Vitro

    Directory of Open Access Journals (Sweden)

    Zhiyu Zhou

    2014-01-01

    Full Text Available Hydrogel injection has been recently proposed as a novel therapy for disc degenerative diseases, with the potential to restore the spine motion and the intervertebral disc height. However, it remains unknown whether the new technique could also maintain the shock absorbing property of the treated intervertebral disc. In this study, 18 porcine lumbar bone-disc-bone specimens were collected and randomly divided into three groups: the normal with intact intervertebral discs, the mimic for the injection of disulfide cross-linked hyaluronan hydrogels following discectomy, and the control disc with discectomy only. In the static compression test, specimens in the mimic group exhibited displacements similar to those in the normal discs, whereas the control group showed a significantly larger displacement range in the first two steps (P<0.05. With the frequency increasing, all specimens generally displayed an increasing storage modulus, decreasing loss modulus, and tanδ. At any frequency point, the control group exhibited the largest value in all the three parameters among three groups while the normal group was the lowest, with the mimic group being mostly close to the normal group. Therefore, the hydrogel injection into the intervertebral discs greatly restored their shock absorbing function, suggesting that the technique could serve as an effective approach to maintaining biomechanical properties of the degenerative intervertebral disc.

  11. Localized strain measurements of the intervertebral disc annulus during biaxial tensile testing.

    Science.gov (United States)

    Karakolis, Thomas; Callaghan, Jack P

    2015-01-01

    Both inter-lamellar and intra-lamellar failures of the annulus have been described as potential modes of disc herniation. Attempts to characterize initial lamellar failure of the annulus have involved tensile testing of small tissue samples. The purpose of this study was to evaluate a method of measuring local surface strains through image analysis of a tensile test conducted on an isolated sample of annular tissue in order to enhance future studies of intervertebral disc failure. An annulus tissue sample was biaxial strained to 10%. High-resolution images captured the tissue surface throughout testing. Three test conditions were evaluated: submerged, non-submerged and marker. Surface strains were calculated for the two non-marker conditions based on motion of virtual tracking points. Tracking algorithm parameters (grid resolution and template size) were varied to determine the effect on estimated strains. Accuracy of point tracking was assessed through a comparison of the non-marker conditions to a condition involving markers placed on tissue surface. Grid resolution had a larger effect on local strain than template size. Average local strain error ranged from 3% to 9.25% and 0.1% to 2.0%, for the non-submerged and submerged conditions, respectively. Local strain estimation has a relatively high potential for error. Submerging the tissue provided superior strain estimates.

  12. Ranges of Cervical Intervertebral Disc Deformation during an In-Vivo Dynamic Flexion-Extension of the Neck.

    Science.gov (United States)

    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B; Li, Guoan; Cha, Thomas D

    2017-03-23

    While abnormal loading is widely believed to cause cervical spine disc diseases, in-vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in-vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system and MRI based 3D modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6 and C6/7). Five points (anterior, center, posterior, left and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

  13. Ultrastructure of Intervertebral Disc and Vertebra-Disc Junctions Zones as a Link in Etiopathogenesis of Idiopathic Scoliosis

    Directory of Open Access Journals (Sweden)

    Evalina L. Burger

    2014-01-01

    Full Text Available Background Context. There is no general accepted theory on the etiology of idiopathic scoliosis (IS. An important role of the vertebrae endplate physes (VEPh and intervertebral discs (IVD in spinal curve progression is acknowledged, but ultrastructural mechanisms are not well understood. Purpose. To analyze the current literature on ultrastructural characteristics of VEPh and IVD in the context of IS etiology. Study Design/Setting. A literature review. Results. There is strong evidence for multifactorial etiology of IS. Early wedging of vertebra bodies is likely due to laterally directed appositional bone growth at the concave side, caused by a combination of increased cell proliferation at the vertebrae endplate and altered mechanical properties of the outer annulus fibrosus of the adjacent IVD. Genetic defects in bending proteins necessary for IVD lamellar organization underlie altered mechanical properties. Asymmetrical ligaments, muscular stretch, and spine instability may also play roles in curve formation. Conclusions. Development of a reliable, cost effective method for identifying patients at high risk for curve progression is needed and could lead to a paradigm shift in treatment options. Unnecessary anxiety, bracing, and radiation could potentially be minimized and high risk patient could receive surgery earlier, rendering better outcomes with fewer fused segments needed to mitigate curve progression.

  14. Genipin-crosslinked fibrin hydrogels as a potential adhesive to augment intervertebral disc annulus repair

    Directory of Open Access Journals (Sweden)

    RM Schek

    2011-04-01

    Full Text Available Treatment of damaged intervertebral discs is a significant clinical problem and, despite advances in the repair and replacement of the nucleus pulposus, there are few effective strategies to restore defects in the annulus fibrosus. An annular repair material should meet three specifications: have a modulus similar to the native annulus tissue, support the growth of disc cells, and maintain adhesion to tissue under physiological strain levels. We hypothesized that a genipin crosslinked fibrin gel could meet these requirements. Our mechanical results showed that genipin crosslinked fibrin gels could be created with a modulus in the range of native annular tissue. We also demonstrated that this material is compatible with the in vitro growth of human disc cells, when genipin:fibrin ratios were 0.25:1 or less, although cell proliferation was slower and cell morphology more rounded than for fibrin alone. Finally, lap tests were performed to evaluate adhesion between fibrin gels and pieces of annular tissue. Specimens created without genipin had poor handling properties and readily delaminated, while genipin crosslinked fibrin gels remained adhered to the tissue pieces at strains exceeding physiological levels and failed at 15-30%. This study demonstrated that genipin crosslinked fibrin gels show promise as a gap-filling adhesive biomaterial with tunable material properties, yet the slow cell proliferation suggests this biomaterial may be best suited as a sealant for small annulus fibrosus defects or as an adhesive to augment large annulus repairs. Future studies will evaluate degradation rate, fatigue behaviors, and long-term biocompatibility.

  15. The in vitro effects of dexamethasone, insulin and triiodothyronine on degenerative human intervertebral disc cells under normoxic and hypoxic conditions

    Directory of Open Access Journals (Sweden)

    A Bertolo

    2011-02-01

    Full Text Available Degeneration of intervertebral discs (IVD is one of the main causes of back pain and tissue engineering has been proposed as a treatment. Tissue engineering requires the use of highly expensive growth factors, which might, in addition, lack regulatory approval for human use. In an effort to find readily available differentiation factors, we tested three molecules – dexamethasone, triiodothyronine (T3 and insulin – on human IVD cells isolated after surgery, expanded in vitro and transferred into alginate beads. Triplicates containing 40 ng/ml dexamethasone, 10 nM T3 and 10 µg/ml insulin, together with a positive control (10 ng/mL transforming growth factor (TGF-beta 1, were sampled weekly over six weeks and compared to a negative control. Furthermore, we compared the results to cultures with optimized chondrogenic media and under hypoxic condition (2% O2. Glycosaminoglycan (GAG determination by Alcian Blue assay and histological staining showed dexamethasone to be more effective than T3 and insulin, but less than TGF-beta1. DNA quantification showed that only dexamethasone stimulated cell proliferation. qPCR demonstrated that TGF-beta1 and the optimized chondrogenic groups increased the expression of collagen type II, while aggrecan was stimulated in cultures containing dexamethasone. Hypoxia increased GAG accumulation, collagen type II and aggrecan expression, but had no effect on or even lowered cell number. In conclusion, dexamethasone is a valuable and cost-effective molecule for chondrogenic and viability induction of IVD cells under normoxic and hypoxic conditions, while insulin and T3 did not show significant differences.

  16. Effects of Ge Gen Decoction on PGE2 Content and COX Activity in the Degenarated Cervical Intervertebral Discs of Rats

    Institute of Scientific and Technical Information of China (English)

    Zhou Jun; Fang Suping; Huo Hairu; Qi Yun; Guo Shuying; Jiang Tingliang; Shi Qi; Wang Youjing

    2005-01-01

    After the rat model of cervical spondylosis was developed for 6 months, the PGE2 content and COX activity in the cervical intervertebral discs were determined respectively by radioimmunoassay and catalytic activity assay.The results indicated that the PGF2 content and COX activity in the model rat increased significantly, and that Ge Gen Decoction could down-regulate the PGE2 content and inhibit COX activity. This is possibly one of the mechanisms of Ge Gen Decoction for treating cervical spondylosis.

  17. Penetrating Annulus Fibrosus Injuries Affect Dynamic Compressive Behaviors of the Intervertebral Disc Via Altered Fluid Flow: An Analytical Interpretation

    OpenAIRE

    Michalek, Arthur J.; Iatridis, James C.

    2011-01-01

    Extensive experimental work on the effects of penetrating annular injuries indicated that large injuries impact axial compressive properties of small animal intervertebral discs, yet there is some disagreement regarding the sensitivity of mechanical tests to small injury sizes. In order to understand the mechanism of injury size sensitivity, this study proposed a simple one dimensional model coupling elastic deformations in the annulus with fluid flow into and out of the nucleus through both ...

  18. Elastic, permeability and swelling properties of human intervertebral disc tissues: A benchmark for tissue engineering.

    Science.gov (United States)

    Cortes, Daniel H; Jacobs, Nathan T; DeLucca, John F; Elliott, Dawn M

    2014-06-27

    The aim of functional tissue engineering is to repair and replace tissues that have a biomechanical function, i.e., connective orthopaedic tissues. To do this, it is necessary to have accurate benchmarks for the elastic, permeability, and swelling (i.e., biphasic-swelling) properties of native tissues. However, in the case of the intervertebral disc, the biphasic-swelling properties of individual tissues reported in the literature exhibit great variation and even span several orders of magnitude. This variation is probably caused by differences in the testing protocols and the constitutive models used to analyze the data. Therefore, the objective of this study was to measure the human lumbar disc annulus fibrosus (AF), nucleus pulposus (NP), and cartilaginous endplates (CEP) biphasic-swelling properties using a consistent experimental protocol and analyses. The testing protocol was composed of a swelling period followed by multiple confined compression ramps. To analyze the confined compression data, the tissues were modeled using a biphasic-swelling model, which augments the standard biphasic model through the addition of a deformation-dependent osmotic pressure term. This model allows considering the swelling deformations and the contribution of osmotic pressure in the analysis of the experimental data. The swelling stretch was not different between the disc regions (AF: 1.28±0.16; NP: 1.73±0.74; CEP: 1.29±0.26), with a total average of 1.42. The aggregate modulus (Ha) of the extra-fibrillar matrix was higher in the CEP (390kPa) compared to the NP (100kPa) or AF (30kPa). The permeability was very different across tissue regions, with the AF permeability (64 E(-16)m(4)/Ns) higher than the NP and CEP (~5.5 E(-16)m(4)/Ns). Additionally, a normalized time-constant (3000s) for the stress relaxation was similar for all the disc tissues. The properties measured in this study are important as benchmarks for tissue engineering and for modeling the disc's mechanical

  19. Poly(γ-glutamic acid) and poly(γ-glutamic acid)-based nanocomplexes enhance type II collagen production in intervertebral disc.

    Science.gov (United States)

    Antunes, Joana C; Pereira, Catarina Leite; Teixeira, Graciosa Q; Silva, Ricardo V; Caldeira, Joana; Grad, Sibylle; Gonçalves, Raquel M; Barbosa, Mário A

    2017-01-01

    Intervertebral disc (IVD) degeneration often leads to low back pain, which is one of the major causes of disability worldwide, affecting more than 80% of the population. Although available treatments for degenerated IVD decrease symptoms' progression, they fail to address the underlying causes and to restore native IVD properties. Poly(γ-glutamic acid) (γ-PGA) has recently been shown to support the production of chondrogenic matrix by mesenchymal stem/stromal cells. γ-PGA/chitosan (Ch) nanocomplexes (NCs) have been proposed for several biomedical applications, showing advantages compared with either polymer alone. Hence, this study explores the potential of γ-PGA and γ-PGA/Ch NCs for IVD regeneration. Nucleotomised bovine IVDs were cultured ex vivo upon injection of γ-PGA (pH 7.4) and γ-PGA/Ch NCs (pH 5.0 and pH 7.4). Tissue metabolic activity and nucleus pulposus DNA content were significantly reduced when NCs were injected in acidic-buffered solution (pH 5.0). However, at pH 7.4, both γ-PGA and NCs promoted sulphated glycosaminoglycan production and significant type II collagen synthesis, as determined at the protein level. This study is a first proof of concept that γ-PGA and γ-PGA/Ch NCs promote recovery of IVD native matrix, opening new perspectives on the development of alternative therapeutic approaches for IVD degeneration.

  20. Association of abdominal obesity with lumbar disc degeneration--a magnetic resonance imaging study.

    Directory of Open Access Journals (Sweden)

    Jani Takatalo

    Full Text Available PURPOSE: To evaluate whether midsagittal (abdominal obesity in magnetic resonance imaging (MRI, waist circumference (WC and body fat percentage are associated with lumbar disc degeneration in early adulthood. METHODS: We obtained the lumbar MRI (1.5-T scanner of 325 females and 233 males at a mean age of 21 years. Lumbar disc degeneration was evaluated using Pfirrmann classification. We analysed the associations of MRI measures of obesity (abdominal diameter (AD, sagittal diameter (SAD, ventral subcutaneous thickness (VST, and dorsal subcutaneous thickness (DST, WC and body fat percentage with disc degeneration sum scores using ordinal logistic regression. RESULTS: A total of 155 (48% females and 147 (63% males had disc degeneration. AD and SAD were associated with a disc degeneration sum score of ≥3 compared to disc degeneration sum score of 0-2 (OR 1.67; 95% confidence interval (CI 1.20-2.33 and OR 1.40; 95% CI 1.12-1.75, respectively among males, but we found no association among females. WC was also associated with disc degeneration among males (OR 1.03 per one cm; 95% CI 1.00-1.05, but not among females. CONCLUSION: Measures of abdominal obesity in MRI and waist circumference were associated with disc degeneration among 21-year-old males.

  1. Current Research Status and Progress of Stem Cells Therapy for Degenerative Intervertebral Disc Regeneration%干细胞治疗退变椎间盘组织再生的研究现状及进展

    Institute of Scientific and Technical Information of China (English)

    谢光友; 吕富荣

    2014-01-01

    Low back pain caused by intervertebral disc degeneration is a common clinical chronic disease.The regenerative ability of intervertebral disc tissue is extremely poor.Meanwhile,current treating methods can not fundamentally solve such problems.With the increasing awareness of the mechanism of disc degeneration and the rapid development of the fields of cellular and molecular biology,gene and materials engineering,using stem cells and tissue engineering technology to slow down or reverse the progress of disc degeneration may become possible.The author reviewed the application of stem cells for treating degenerative discs from present researching status and concepts for the future in the combination of researches reported both at home and abroad.%椎间盘退变所引起的下腰痛是常见的临床慢性病,椎间盘组织自身无再生修复能力,目前临床治疗不能从根本上解决病因.随着对椎间盘退变机制的认识不断深入,以及细胞分子生物学、基因及材料工程的迅速发展,运用干细胞与组织工程技术延缓或逆转退变椎间盘成为可能.笔者结合国内外的研究报道对采用干细胞技术治疗退变椎间盘的研究现状及进展作一概述.

  2. Application of the polynomial chaos expansion to approximate the homogenised response of the intervertebral disc.

    Science.gov (United States)

    Karajan, N; Otto, D; Oladyshkin, S; Ehlers, W

    2014-10-01

    A possibility to simulate the mechanical behaviour of the human spine is given by modelling the stiffer structures, i.e. the vertebrae, as a discrete multi-body system (MBS), whereas the softer connecting tissue, i.e. the softer intervertebral discs (IVD), is represented in a continuum-mechanical sense using the finite-element method (FEM). From a modelling point of view, the mechanical behaviour of the IVD can be included into the MBS in two different ways. They can either be computed online in a so-called co-simulation of a MBS and a FEM or offline in a pre-computation step, where a representation of the discrete mechanical response of the IVD needs to be defined in terms of the applied degrees of freedom (DOF) of the MBS. For both methods, an appropriate homogenisation step needs to be applied to obtain the discrete mechanical response of the IVD, i.e. the resulting forces and moments. The goal of this paper was to present an efficient method to approximate the mechanical response of an IVD in an offline computation. In a previous paper (Karajan et al. in Biomech Model Mechanobiol 12(3):453-466, 2012), it was proven that a cubic polynomial for the homogenised forces and moments of the FE model is a suitable choice to approximate the purely elastic response as a coupled function of the DOF of the MBS. In this contribution, the polynomial chaos expansion (PCE) is applied to generate these high-dimensional polynomials. Following this, the main challenge is to determine suitable deformation states of the IVD for pre-computation, such that the polynomials can be constructed with high accuracy and low numerical cost. For the sake of a simple verification, the coupling method and the PCE are applied to the same simplified motion segment of the spine as was used in the previous paper, i.e. two cylindrical vertebrae and a cylindrical IVD in between. In a next step, the loading rates are included as variables in the polynomial response functions to account for a more

  3. The effects of short-term load duration on anabolic and catabolic gene expression in the rat tail intervertebral disc.

    Science.gov (United States)

    MacLean, Jeffery J; Lee, Cynthia R; Alini, Mauro; Iatridis, James C

    2005-09-01

    The goal of this study was to determine the time-dependent response of the intervertebral disc cells to in vivo dynamic compression. Forty-seven skeletally mature Wistar rats (>12 months old) were instrumented with an Ilizarov-type device spanning caudal disc 8-9. Using a load magnitude (1 MPa) and frequency (1.0 Hz) that were previously shown to significantly alter mRNA levels in the disc, the effects of 0.5 and 4 h of loading were investigated and compared to a sham group and our previous 2 h results. Annulus and nucleus tissue of loaded (c8-9) and internal control discs (c6-7 and c10-11) were separately analyzed by real-time RT-PCR for levels of mRNA coding for various anabolic (collagen-1A1, collagen-2A1, aggrecan) and catabolic (MMP-3, MMP-13, ADAMTs-4) proteins. In the annulus, mRNA levels increased for Collagen types I & II, and MMP 3 & 13 with increasing load duration. In contrast, the nucleus had the largest increases in aggrecan, ADAMTs-4, MMP-3 and MMP-13 after 2 h of loading, with aggrecan and MMP-13 mRNA levels returning to control values after 4 h of loading. Taken in context with our previous studies, we conclude that intervertebral disc cells from the nucleus and annulus have distinct responses to dynamic mechanical compression in vivo with sensitivity to compression magnitude, frequency and duration.

  4. 颈椎前路融合致邻近节段椎间盘退变的原因探讨%Causes of adjacent segments disc degeneration caused by anterior cervical fusion

    Institute of Scientific and Technical Information of China (English)

    张克非; 刘伟; 于长水; 袁绍辉; 潘琦

    2011-01-01

    目的 探讨颈椎前路融合后邻近节段椎间盘退变的原因及其防治办法.方法 对实施颈椎前路融合术的126例颈椎间盘突出症患者进行回顾性分析,归纳可能导致颈椎前路融合术后临近椎间盘退变突出的原因.结果 随访时间最短10个月,最长10年,平均7.8年.37例颈椎间盘突出症患者发生临近节段椎间盘退变加重,其中7例患者再次手术.结论 颈椎前路融合后邻近节段椎间盘退变的原因可能为临近节段原有退变加重,椎间融合后生物力学改变,临近节段应力集中.%To investigate the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine and search for the way of prevention.Methods A retrospective study was given to 126 patients who underwent an anterior decompression and interbody fusion of C-spine, the causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine were analyzed. Results The follow-up time was from 10 months to 10 years, average 7.8 years. Thirty-seven patients occurred the aggravation of adjacent intervertebral discs degeneration, in which 7 patients underwent reoperation. Conclusion The possible causes of the adjacent intervertebral disc degeneration after anterior decompression and interbody fusion of C-spine is that the aggravation of original degeneration of adjacent intervertebral disc, the alteration of biomechanics after anterior decompression and interbody fusion of C-spine induces the stress concentration of the adjacent intervertebral disc.

  5. The effect of disc degeneration on anterior shear translation in the lumbar spine.

    Science.gov (United States)

    Melnyk, Angela D; Kelly, Adrienne; Chak, Jason D; Wen, Tian Lin; Cripton, Peter A; Dvorak, Marcel F; Oxland, Thomas R

    2015-04-01

    Many pathologies involving disc degeneration are treated with surgery and spinal implants. It is important to understand how the spine behaves mechanically as a function of disc degeneration. Shear loading is especially relevant in the natural and surgically stabilized lumbar spine. The objective of our study was to determine the effect of disc degeneration on anterior translation of the lumbar spine under shear loading. We tested 30 human cadaveric functional spinal units (L3-4 and L4-5) in anterior shear loading. First, the specimens were imaged in a 1.5 T magnetic resonance scanner. The discs were graded according to the Pfirrmann classification. The specimens were then loaded up to 250 N in anterior shear with an axial compression force of 300 N. Motion of the vertebrae was captured with an optoelectronic camera system. Inter- and intra-observer reliability for disc grading was determined (Cohen's and Fleiss' Kappa), and a non-parametric test was performed on the translation data to characterize the effect of disc degeneration on this parameter. We found fair to moderate agreement between and within observers for the disc grading. We found no significant effect of disc degeneration on anterior shear translation (Kruskal-Wallis ANOVA). Our results indicate that disc degeneration, as classified with the Pfirrmann scale, does not predict lumbar spinal motion in shear.

  6. A developmental transcriptomic analysis of Pax1 and Pax9 in embryonic intervertebral disc development

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    V. Sivakamasundari

    2017-02-01

    Full Text Available Pax1 and Pax9 play redundant, synergistic functions in the patterning and differentiation of the sclerotomal cells that give rise to the vertebral bodies and intervertebral discs (IVD of the axial skeleton. They are conserved in mice and humans, whereby mutation/deficiency of human PAX1/PAX9 has been associated with kyphoscoliosis. By combining cell-type-specific transcriptome and ChIP-sequencing data, we identified the roles of Pax1/Pax9 in cell proliferation, cartilage development and collagen fibrillogenesis, which are vital in early IVD morphogenesis. Pax1 is up-regulated in the absence of Pax9, while Pax9 is unaffected by the loss of Pax1/Pax9. We identified the targets compensated by a single- or double-copy of Pax9. They positively regulate many of the cartilage genes known to be regulated by Sox5/Sox6/Sox9 and are connected to Sox5/Sox6 by a negative feedback loop. Pax1/Pax9 are intertwined with BMP and TGF-B pathways and we propose they initiate expression of chondrogenic genes during early IVD differentiation and subsequently become restricted to the outer annulus by the negative feedback mechanism. Our findings highlight how early IVD development is regulated spatio-temporally and have implications for understanding kyphoscoliosis.

  7. In-situ photopolymerized and monitored implants: successful application to an intervertebral disc replacement

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    Schmocker, Andreas M.; Khoushabi, Azadeh; Bourban, Pierre-Etienne; Schizas, Constantin; Pioletti, Dominique; Moser, Christophe

    2016-02-01

    Photopolymerization is a common method to harden materials initially in a liquid state. A surgeon can directly trigger the solidification of a dental implant or a bone or tissue filler by using ultra-violet light. Traditionally, photopolymerization has been used mainly in dentistry. Over the last decade advances in material development including a wide range of biocompatible gel- and cement-systems open up a new avenue for in-situ photopolymerization. We designed a miniaturized light probe where a photoactive material can be 1) mixed, pressurized and injected 2) photopolymerized or photoactivated and 3) monitored during the chemical reaction. The device enables surgeries to be conducted through a hole smaller than 500 μm in diameter. Using a combination of Raman and fluorescence spectroscopy, the current state of the photopolymerization was inferred and monitored in real time within an in-vitro tissue model. It was also possible to determine roughly the position of the probe within the tissue cavity by analysing the fluorescence signal. Using the technique hydrogels were successfully implanted into a bovine intervertebral disc model. Mechanical tests could not obstruct the functionality of the implant. Finally, the device was also used for other application such as the implantation of a hydrogel into an aneurysm tissue cavity which will be presented at the conference.

  8. Longitudinal changes in the structure and inflammatory response of the intervertebral disc due to stab injury in a murine organ culture model.

    Science.gov (United States)

    Abraham, Adam C; Liu, Jennifer W; Tang, Simon Y

    2016-08-01

    Despite the significant public health impact of intervertebral disc (IVD) degeneration and low back pain, it remains challenging to investigate the multifactorial molecular mechanisms that drive the degenerative cascade. Organ culture model systems offer the advantage of allowing cells to live and interact with their native extracellular matrix, while simultaneously reducing the amount of biological variation and complexity present at the organismal level. Murine organ cultures in particular also allow the use of widely available genetically modified animals with molecular level reporters that would reveal insights on the degenerative cascade. Here, we utilize an organ culture system of murine lumbar functional spinal units where we are able to maintain the cellular, metabolic, and structural, and mechanical stability of the whole organ over a 21-day period. Furthermore, we describe a novel approach in organ culture by using tissues from animals with an NF-κB-luc reporter in combination with a mechanical injury model, and are able to show that proinflammatory factors and cytokines such as NF-κB and IL-6 produced by IVD cells can be monitored longitudinally during culture in a stab injury model. Taken together, we utilize a murine organ culture system that maintains the cellular and tissue level behavior of the intervertebral disc and apply it to transgenic animals that allow the monitoring of the inflammatory profile of IVDs. This approach could provide important insights on the molecular and metabolic mediators that regulate the homeostasis of the IVD. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1431-1438, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  9. 腰椎间盘突出症术后康复治疗%Postoperative rehabilitation treatment of patients with prolapse of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background:Now,transcutaneous lumbar removal of vertebral disc,a kind of effective treatments for prolapse of lumbar intervertebral disc is widely used in clinic .Postoperative rehabilitation training has been recepted in clinic. Objective:In order to strengthen stability of spine,oppression and stimulation for nerve root were removed. Unit:General Hospital of Shenyang Military Region.

  10. Targeting the annulus fibrosus of the intervertebral disc: Col1a2-Cre(ER)T mice show specific activity of Cre recombinase in the outer annulus fibrosus.

    Science.gov (United States)

    Bedore, Jake; Quesnel, Katherine; Quinonez, Diana; Séguin, Cheryle A; Leask, Andrew

    2016-06-01

    Degeneration of the intervertebral disc (IVD) is a major underlying contributor to back pain-the single leading cause of disability worldwide. However, we possess a limited understanding of the etiology underlying IVD degeneration. To date, there are a limited number of mouse models that have been used to target proteins in specific compartments of the IVD to explore their functions in disc development, homeostasis and disease. Furthermore, the majority of reports exploring the composition and function of the outer encapsulating annulus fibrosus (AF) of the IVD have considered it as one tissue, without considering the numerous structural and functional differences existing between the inner and outer AF. In addition, no mouse models have yet been reported that enable specific targeting of genes within the outer AF. In the current report, we discuss these issues and demonstrate the localized activity of Cre recombinase in the IVD of Col1a2-Cre(ER)T;ROSA26mTmG mice possessing a tamoxifen-dependent Cre recombinase driven by a Cola2 promoter and distal enhancer and the mTmG fluorescent reporter. Following tamoxifen injection of 3-week-old Col1a2-Cre(ER)T;ROSA26mTmG mice, we show Cre activity specifically in the outer AF of the IVD, as indicated by expression of the GFP reporter. Thus, Col1a2-Cre(ER)T;ROSA26mTmG mice may prove to be a valuable tool in delineating the function of proteins in this unique compartment of the IVD, and in further exploring the compositional differences between the inner and outer AF in disc homeostasis, aging and disease.

  11. Effect of Capsaicin Cream on Chronic Low Back Pain in Patients With Inter-Vertebral Disc Herniation

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    Fayazi

    2015-07-01

    Full Text Available Background Low back pain is one of the most common debilitating disorders worldwide and the third cause of visiting a physician. One of the most common causes of low back pain is spinal disc herniation. Still there is no general agreement on the most effective treatment for it. Objectives This study aimed to determine the effect of Capsaicin cream on low back pain in patients with inter-vertebral disc herniation in Ahvaz. Patients and Methods This was a double blind clinical trial in which 43 patients with chronic low back pain, according to characteristics of the subjects, were randomly divided into two groups of treatment (n = 23 and control (n = 20. Data collection instruments included demographic specifications and visual analogue scale (VAS questionnaire completed on arrival and at the first, second and third weeks after intervention. The treatment and placebo groups used the ointment for three weeks and three times a day as a thin layer on the painful position. Data entered SPSS (version 18 and analyzed using the analytical descriptive statistics. Results There was a significant difference in the average pain intensity between the groups of study pre-and post-intervention (P = 0.0001 and the rate of using analgesics in the treatment group significantly decreased (P = 0.008. Also patients’ satisfaction was significantly different between the two groups using the ointment (P = 0.0001. Conclusions Capsaicin cream has beneficial effects on pain relieving and reducing analgesic use in patients with inter-vertebral disc herniation. Therefore, the ointment can be recommended in the treatment of low back pain caused by inter-vertebral disc herniation.

  12. Nonviral Gene Delivery of Growth and Differentiation Factor 5 to Human Mesenchymal Stem Cells Injected into a 3D Bovine Intervertebral Disc Organ Culture System

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    Christian Bucher

    2013-01-01

    Full Text Available Intervertebral disc (IVD cell therapy with unconditioned 2D expanded mesenchymal stem cells (MSC is a promising concept yet challenging to realize. Differentiation of MSCs by nonviral gene delivery of growth and differentiation factor 5 (GDF5 by electroporation mediated gene transfer could be an excellent source for cell transplantation. Human MSCs were harvested from bone marrow aspirate and GDF5 gene transfer was achieved by in vitro electroporation. Transfected cells were cultured as monolayers and as 3D cultures in 1.2% alginate bead culture. MSC expressed GDF5 efficiently for up to 21 days. The combination of GDF5 gene transfer and 3D culture in alginate showed an upregulation of aggrecan and SOX9, two markers for chondrogenesis, and KRT19 as a marker for discogenesis compared to untransfected cells. The cells encapsulated in alginate produced more proteoglycans expressed in GAG/DNA ratio. Furthermore, GDF5 transfected MCS injected into an IVD papain degeneration organ culture model showed a partial recovery of the GAG/DNA ratio after 7 days. In this study we demonstrate the potential of GDF5 transfected MSC as a promising approach for clinical translation for disc regeneration.

  13. Matrix stiffness promotes cartilage endplate chondrocyte calcification in disc degeneration via miR-20a targeting ANKH expression.

    Science.gov (United States)

    Liu, Ming-Han; Sun, Chao; Yao, Yuan; Fan, Xin; Liu, Huan; Cui, You-Hong; Bian, Xiu-Wu; Huang, Bo; Zhou, Yue

    2016-05-04

    The mechanical environment is crucial for intervertebral disc degeneration (IDD). However, the mechanisms underlying the regulation of cartilage endplate (CEP) calcification by altered matrix stiffness remain unclear. In this study, we found that matrix stiffness of CEP was positively correlated with the degree of IDD, and stiff matrix, which mimicked the severe degeneration of CEP, promoted inorganic phosphate-induced calcification in CEP chondrocytes. Co-expression analysis of the miRNA and mRNA profiles showed that increasing stiffness resulted in up-regulation of miR-20a and down-regulation of decreased ankylosis protein homolog (ANKH) during inorganic phosphate-induced calcification in CEP chondrocytes. Through a dual luciferase reporter assay, we confirmed that miR-20a directly targets 3'-untranslated regions of ANKH. The inhibition of miR-20a attenuated the calcium deposition and calcification-related gene expression, whereas the overexpression of miR-20a enhanced calcification in CEP chondrocytes on stiff matrix. The rescue of ANKH expression restored the decreased pyrophosphate efflux and inhibited calcification. In clinical samples, the levels of ANKH expression were inversely associated with the degeneration degree of CEP. Thus, our findings demonstrate that the miR-20a/ANKH axis mediates the stiff matrix- promoted CEP calcification, suggesting that miR-20a and ANKH are potential targets in restraining the progression of IDD.

  14. The intravertebral distribution of bone density: correspondence to intervertebral disc health and implications for vertebral strength

    Science.gov (United States)

    Jackman, T. M.; Morgan, S. R.; Barest, G. D.; Morgan, E. F.

    2015-01-01

    Summary This study's goal was to determine associations among the intravertebral heterogeneity in bone density, bone strength, and intervertebral disc (IVD) health. Results indicated that predictions of vertebral strength can benefit from considering the magnitude of the density heterogeneity and the congruence between the spatial distribution of density and IVD health. Introduction This study aims to determine associations among the intravertebral heterogeneity in bone density, bone strength, and IVD health Methods Regional measurements of bone density were performed throughout 30 L1 vertebral bodies using microcomputed tomography (μCT) and quantitative computed tomography (QCT). The magnitude of the intravertebral heterogeneity in density was defined as the interquartile range and quartile coefficient of variation in regional densities. The spatial distribution of density was quantified using ratios of regional densities representing different anatomical zones (e.g., anterior to posterior regional densities). Cluster analysis was used to identify groups of vertebrae with similar spatial distributions of density. Vertebral strength was measured in compression. IVD health was assessed using two scoring systems. Results QCT- and μCT-based measures of the magnitude of the intravertebral heterogeneity in density were strongly correlated with each other (p<0.005). Accounting for the interquartile range in regional densities improved predictions of vertebral strength as compared to predictions based only on mean density (R2=0.59 vs. 0.43; F-test p-value=0.018). Specifically, after adjustment for mean density, vertebral bodies with greater heterogeneity in density exhibited higher strength. No single spatial distribution of density was associated with high vertebral strength. Analyses of IVD scores suggested that the health of the adjacent IVDs may modulate the effect of a particular spatial distribution of density on vertebral strength. Conclusions Noninvasive

  15. To analyse the effects of massage on severe prolapse of intervertebral discs of the lower back%推拿手法整复重症腰椎间盘突出症的疗效分析

    Institute of Scientific and Technical Information of China (English)

    李加斌

    2001-01-01

    @@ Background: The prolapse of intervertebral disc is not only damage of the local intervertebral disc, but a comprehensive damage tightly related with factors as damages of the pyramidal ligament, nerve, muscle and posterior joints and aseptic inflammation. The dura mater or the nerve root are stimulated, compassed or extracted and ischemia and inflammation caused increased sensitivity.

  16. Effects of bound versus soluble pentosan polysulphate in PEG/HA-based hydrogels tailored for intervertebral disc regeneration.

    Science.gov (United States)

    Frith, Jessica E; Menzies, Donna J; Cameron, Andrew R; Ghosh, P; Whitehead, Darryl L; Gronthos, S; Zannettino, Andrew C W; Cooper-White, Justin J

    2014-01-01

    increased matrix formation when compared to the addition of soluble PPS to the hydrogel, or the hydrogel alone. We believe that this new generation injectable, degradable hydrogel, incorporating now a covalently bound-PPS, when combined with MPCs, has the potential to assist cartilage regeneration in a multitude of therapeutic targets, including for intervertebral disc (IVD) degeneration.

  17. On TCM Therapy for Lumbar Intervertebral Disc Protrusion%腰椎间盘突出症的中医药治疗概述

    Institute of Scientific and Technical Information of China (English)

    张海清; 赵继荣; 陈文

    2012-01-01

    Curative effects of internal treatment, external treatment, traction, massage, small needle-knife in treating lumbar Intervertebral disc protrusion were summarized through analyzing related literature of TCM in treating lumbar Intervertebral disc protrusion, therefore to illustrate the effectiveness of TCM in treating lumbar Intervertebral disc protrusion.%通过分析中医药治疗腰椎间盘突出症的相关文献,就中药内治法、中药外治法、牵引、推拿、小针刀等方法治疗腰椎间盘突出症的临床疗效进行概述,进一步说明中医药在治疗腰椎间盘突出症的有效性.

  18. Changes in nuclear composition following cyclic compression of the intervertebral disc in an in vivo rat-tail model.

    Science.gov (United States)

    Ching, Congo T S; Chow, Daniel H K; Yao, Fiona Y D; Holmes, Andrew D

    2004-09-01

    While in vitro studies have shown that mechanical loading can result in changes in the composition of intervertebral disc matrix, the effects of cyclic loading in vivo have not been considered. The objective of this study was to assess the effect of static and cyclic compression of different frequencies on the nuclear composition of the intervertebral disc. Thirty-six Sprague-Dawley rats were randomly divided into a control group (no pin insertion, no loading), a sham group (pins inserted in sixth and seventh caudal vertebrae, no loading), a static loading group (compression applied via pins) and cyclic loading groups (loading at 0.5, 1.5 or 2.5 Hz). Loading was applied for 1 h each day from the third to 17th day following pin insertion, and the caudal 5-6, 6-7 and 7-8 discs harvested to quantify proteoglycan content, collagen content and chondrocyte density in the nucleus pulposus. Static compression resulted in a significant reduction in total proteoglycan content as compared with the adjacent control disc, but this effect was not seen in any of the cyclic loading groups. However, comparison with the sham group appears to indicate an overall decrease in total proteoglycan content at the targeted and adjacent levels following cyclic loading. The 0.5 Hz loading group showed a significantly greater total proteoglycan content than all other compression groups, and also showed a lower total collagen content than the sham group. Results suggest that frequency dependent changes in composition occur in response to cyclic loading, but are not limited to the directly loaded disc alone. Further studies are required to verify this, but the choice of control appears to need careful consideration in all studies of this nature.

  19. Treatment of Multiple Thoracolumbar Intervertebral Disc Disease using Electro-acupuncture and Oriental Herbal Medicine in a Dog

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    S. H. Kim, N. S. Kim, K. C. Lee, H. B. Lee and M. S. Kim*

    2012-10-01

    Full Text Available A 4-year-old male Pekingese dog was admitted to the veterinary medical center, Chonbuk National University for evaluation of severe hind limbs ataxia, atrophy and paresis. Diagnosis based on physical examination, neurological assessment and computed tomogram (CT indicated multiple thoracolumbar intervertebral disc disease (IVDD throughout the thoracic and cranial lumbar spine. Traditional veterinary medicine (TVM based diagnosis was kidney yang deficiency syndrome. Initial high dose prednisolone therapy (1.5 mg/kg PO, twice daily did not show any significant improvement. The dog was then treated with electroacupuncture (EA and oriental herbal medicine for 6 months, which significantly improved mobility, proprioception and spinal posture of the patient.

  20. The matrikine N-acetylated proline-glycine-proline induces premature senescence of nucleus pulposus cells via CXCR1-dependent ROS accumulation and DNA damage and reinforces the destructive effect of these cells on homeostasis of intervertebral discs.

    Science.gov (United States)

    Feng, Chencheng; Zhang, Yang; Yang, Minghui; Lan, Minghong; Liu, Huan; Wang, Jian; Zhou, Yue; Huang, Bo

    2017-01-01

    Intervertebral disc (IVD) cell senescence is a recognized mechanism of intervertebral disc degeneration (IDD). Elucidating the molecular mechanisms underlying disc cell senescence will contribute to understanding the pathogenesis of IDD. We previously reported that N-acetylated proline-glycine-proline (N-Ac-PGP), a matrikine, is involved in the process of IDD. However, its roles in IDD are not well understood. Here, using rat nucleus pulposus (NP) cells, we found that N-Ac-PGP induced premature senescence of NP cells by binding to CXCR1. N-Ac-PGP induced DNA damage and reactive oxygen species accumulation in NP cells, which resulted in activation of the p53-p21-Rb and p16-Rb pathways. Moreover, the RT(2) profiler PCR array showed that N-Ac-PGP down-regulates the expression of antioxidant genes in NP cells, suggesting a decline in the antioxidants of NP cells. On the other hand, N-Ac-PGP up-regulated the expression of matrix catabolic genes and inflammatory genes in NP cells. Concomitantly, N-Ac-PGP reinforced the destructive effects of senescent NP cells on the homeostasis of the IVDs in vivo. Our study suggests that N-Ac-PGP plays critical roles in the pathogenesis of IDD through the induction of premature senescence of disc cells and via the activation of catabolic and inflammatory cascades in disc cells. N-Ac-PGP also deteriorates the redox environment of disc cells. Hence, N-Ac-PGP is a new potential therapeutic target for IDD.

  1. The catabolic effect of TNFα on bovine nucleus pulposus intervertebral disc cells and the restraining role of glucosamine sulfate in the TNFα-mediated up-regulation of MMP-3.

    Science.gov (United States)

    Mavrogonatou, Eleni; Angelopoulou, Maria T; Kletsas, Dimitris

    2014-12-01

    Glucosamine is an endogenous amino monosaccharide naturally occurring in the cartilage. We have recently shown that glucosamine sulfate promotes the biosynthesis of glycosaminoglycans in intervertebral disc cells. Here we assessed the role of glucosamine sulfate in the response of bovine nucleus pulposus cell monolayers to TNFα that constitutes an early signal of disc degeneration. TNFα was not found to affect nucleus pulposus cells' viability, while it resulted in a ∼2.5-fold increase of the intracellular ROS levels, a rapid transient phosphorylation of p38 MAPK and a ROS-dependent activation of JNKs. In addition, TNFα had a prominent inflammatory effect on nucleus pulposus cells by up-regulating MMP-3 expression that was reversed when inhibiting the kinase activity of p38 MAPK. Glucosamine sulfate also diminished the increased by TNFα MMP-3 mRNA levels, but this was unrelated to the p38 MAPK or ROS-mediated JNK activation. Even though the mode of action of glucosamine towards TNFα remains to be elucidated, to the best of our knowledge, this is the first report providing evidence for the protective role of glucosamine against this early mediator of disc degeneration that could support the potential usage of this molecule as a treatment for preventing disc degenerative disorders.

  2. Fifty-six cases of protrusion of lumbar intervertebral disc treated by penetration and oral administration of Chinese decoction plus traction.

    Science.gov (United States)

    Zhong, Q

    2000-12-01

    Fifty-six cases of the protrusion of the lumbar intervertebral disc in the treatment group were treated by drug-penetration and oral administration of traditional Chinese decoction plus traction, and the other 35 cases in the control group by oral administration of Chinese decoction and traction. The results showed that the cure rate in the treatment group was 83.9%, and that in the control group was 57.1%, with a statistically significant difference between the two groups (P lumbar intervertebral disc.

  3. Geometrical aspects of patient-specific modelling of the intervertebral disc: collagen fibre orientation and residual stress distribution.

    Science.gov (United States)

    Marini, Giacomo; Studer, Harald; Huber, Gerd; Püschel, Klaus; Ferguson, Stephen J

    2016-06-01

    Patient-specific modelling of the spine is a powerful tool to explore the prevention and the treatment of injuries and pathologies. Albeit several methods have been proposed for the discretization of the bony structures, the efficient representation of the intervertebral disc anisotropy remains a challenge, especially with complex geometries. Furthermore, the swelling of the disc's nucleus pulposus is normally added to the model after geometry definition, at the cost of changes of the material properties and an unrealistic description of the prestressed state. The aim of this study was to develop techniques, which preserve the patient-specific geometry of the disc and allow the representation of the system anisotropy and residual stresses, independent of the system discretization. Depending on the modelling features, the developed approaches resulted in a response of patient-specific models that was in good agreement with the physiological response observed in corresponding experiments. The proposed methods represent a first step towards the development of patient-specific models of the disc which respect both the geometry and the mechanical properties of the specific disc.

  4. Retroperitoneal oblique corridor to the L2-S1 intervertebral discs in the lateral position: an anatomic study.

    Science.gov (United States)

    Davis, Timothy T; Hynes, Richard A; Fung, Daniel A; Spann, Scott W; MacMillan, Michael; Kwon, Brian; Liu, John; Acosta, Frank; Drochner, Thomas E

    2014-11-01

    Access to the intervertebral discs from L2-S1 in one surgical position can be challenging. The transpsoas minimally invasive surgical (MIS) approach is preferred by many surgeons, but this approach poses potential risk to neural structures of the lumbar plexus as they course through the psoas. The lumbar plexus and iliac crest often restrict the L4-5 disc access, and the L5-S1 level has not been a viable option from a direct lateral approach. The purpose of the present study was to investigate an MIS oblique corridor to the L2-S1 intervertebral disc space in cadaveric specimens while keeping the specimens in a lateral decubitus position with minimal disruption of the psoas and lumbar plexus. Twenty fresh-frozen full-torso cadaveric specimens were dissected, and an oblique anatomical corridor to access the L2-S1 discs was examined. Measurements were taken in a static state and with mild retraction of the psoas. The access corridor was defined at L2-5 as the left lateral border of the aorta (or iliac artery) and the anterior medial border of the psoas. The L5-S1 corridor of access was defined transversely from the midsagittal line of the inferior endplate of L-5 to the medial border of the left common iliac vessel and vertically to the first vascular structure that crosses midline. The mean access corridor diameters in the static state and with mild psoas retraction, respectively, were as follows: at L2-3, 18.60 mm and 25.50 mm; at L3-4, 19.25 mm and 27.05 mm; and at L4-5, 15.00 mm and 24.45 mm. The L5-S1 corridor mean values were 14.75 mm transversely, from midline to the left common iliac vessel and 23.85 mm from the inferior endplate of L-5 cephalad to the first midline vessel. The oblique corridor allows access to the L2-S1 discs while keeping the patient in a lateral decubitus position without a break in the table. Minimal psoas retraction without significant tendon disruption allowed for a generous corridor to the disc space. The L5-S1 disc space can be

  5. CLINICAL OBSERVATION ON TREATMENT OF 80 CASES OF PROLAPSE OF LUMBAR INTERVERTEBRAL DISC BY COMBINATION OF ACUPUNCTURE AND MEDICINE

    Institute of Scientific and Technical Information of China (English)

    RUAN Yongdui; ZHOU Weixiong; ZHENG Zhi; HE Xuewu

    2002-01-01

    150 cases of prolapse of lumbar intervetebral disc were randomly divided into treatment and control groups. 80 cases in treatment group were treated with combination of acupuncture, oral administration of Chinese medicinal herbs, traction, point-injection and intravenous drip of energy dehydration mixture; 70 cases in control group were managed by combination of acupuncture, oral administration of herbal medicines, traction, acupoint-injection (without energy dehydration mixture). The results showed that the curative rate and the total effective rate of the treatment group were 91.25 % and 98.75% separately, while those of the control group 62.86 % and 92.86 % respectively. Comparison of the curative rate between the 2 groups showed a remarkable significance ( P < 0.01 ). The observation demonstrated that combined treatment of prolapse of lumbar intervertebral disc with traditional Chinese and Western medicine is an effective approach.

  6. Strain distribution in the intervertebral disc under unconfined compression and tension load by the optimized digital image correlation technique.

    Science.gov (United States)

    Liu, Qing; Wang, Tai-Yong; Yang, Xiu-Ping; Li, Kun; Gao, Li-Lan; Zhang, Chun-Qiu; Guo, Yue-Hong

    2014-05-01

    The unconfined compression and tension experiments of the intervertebral disc were conducted by applying an optimized digital image correlation technique, and the internal strain distribution was analysed for the disc. It was found that the axial strain values of different positions increased obviously with the increase in loads, while inner annulus fibrosus and posterior annulus fibrosus experienced higher axial strains than the outer annulus fibrosus and anterior annulus fibrosus. Deep annulus fibrosus exhibited higher compressive and tensile axial strains than superficial annulus fibrosus for the anterior region, while there was an opposite result for the posterior region. It was noted that all samples demonstrated a nonlinear stress-strain profile in the process of deforming, and an elastic region was shown once the sample was deformed beyond its toe region.

  7. Clinical and magnetic resonance imaging features of compressive cervical myelopathy with traumatic intervertebral disc herniation in cynomolgus macaque (Macaca fascicularis)

    Science.gov (United States)

    Choi, Yun-Jung; Park, Hye-Jin; Sohn, Chul-Ho; Jung, Kyeong Cheon; Park, Seong Hoe

    2016-01-01

    Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord. Histopathologic findings showed a large number of inflammatory cells infiltrated at sites of spinal cord injury (SCI). This case is the first report of compressive cervical SCI caused by IVDH associated with blunt trauma. PMID:28053621

  8. Comparison of apparent diffusion coefficient and T2 relaxation time variation patterns in assessment of age and disc level related intervertebral disc changes.

    Science.gov (United States)

    Wu, Nan; Liu, Hao; Chen, Jun; Zhao, Luo; Zuo, Wei; Ming, Yue; Liu, Sen; Liu, Jiaqi; Su, Xinlin; Gao, Baoxiang; Tang, Zhiquan; Qiu, Guixing; Ma, Guolin; Wu, Zhihong

    2013-01-01

    To compare the variation patterns of ADC and T2 values in different age and intervertebral disc (IVD) levels, thus to identify their sensitivities in assessing age and disc level related IVDs changes. The T2 and ADC values were recorded from 345 IVDs of 69 volunteers. Kendall's correlation analysis was used to identify the relationship between age and T2/ADC mean values respectively. The one-way analysis of variance (ANOVA) with post hoc analysis was then applied to test the differences of T2 and ADC values among different IVD levels and age groups, followed by linear regression analysis between age (45 years) and T2/ADC mean values. This study was approved by the Ethics Committee of the Chinese Academy of Medical Sciences and the Peking Union Medical College Hospital. Significant negative correlation was observed between age and T2/ADC mean values. The T2 and ADC values showed significant differences among IVD levels and among age groups except for T2 values in age group 1 (25-34 years) and group 2 (35-44 years), and for ADC values at L1-2 level. Both T2 and ADC values showed significant differences between young (age45 years) at each IVD level. A linear relationship was observed between age and T2/ADC mean values in the elderly group as well as in the young group for the ADC mean values, while no such tendency was identified in the young group for the T2 mean values. ADC values may be a more sensitive parameter than T2 in assessing age and disc level related intervertebral disc changes.

  9. Comparison of apparent diffusion coefficient and T2 relaxation time variation patterns in assessment of age and disc level related intervertebral disc changes.

    Directory of Open Access Journals (Sweden)

    Nan Wu

    Full Text Available PURPOSE: To compare the variation patterns of ADC and T2 values in different age and intervertebral disc (IVD levels, thus to identify their sensitivities in assessing age and disc level related IVDs changes. MATERIALS AND METHODS: The T2 and ADC values were recorded from 345 IVDs of 69 volunteers. Kendall's correlation analysis was used to identify the relationship between age and T2/ADC mean values respectively. The one-way analysis of variance (ANOVA with post hoc analysis was then applied to test the differences of T2 and ADC values among different IVD levels and age groups, followed by linear regression analysis between age (45 years and T2/ADC mean values. This study was approved by the Ethics Committee of the Chinese Academy of Medical Sciences and the Peking Union Medical College Hospital. RESULTS: Significant negative correlation was observed between age and T2/ADC mean values. The T2 and ADC values showed significant differences among IVD levels and among age groups except for T2 values in age group 1 (25-34 years and group 2 (35-44 years, and for ADC values at L1-2 level. Both T2 and ADC values showed significant differences between young (age45 years at each IVD level. A linear relationship was observed between age and T2/ADC mean values in the elderly group as well as in the young group for the ADC mean values, while no such tendency was identified in the young group for the T2 mean values. CONCLUSIONS: ADC values may be a more sensitive parameter than T2 in assessing age and disc level related intervertebral disc changes.

  10. Temporomandibular joint disc; a proposed histopathological degeneration grading score system

    OpenAIRE

    2010-01-01

    Summary. Aims: The purpose of this study was to draw up a TMJ disc histopathological score that is a semiquantitative transcription of the entire spectrum of TMJ disc degenerative diseases related to changes in disc tissue, and then validate the proposed grading, in order to contribute to a standardized histopathological diagnosis. Methods: Sections from sixty two temporomandibular joint disc specimens affected by tissue degenerative changes and stained with Hematox...

  11. Symptomatic Epidural Gas-containing Cyst from Intervertebral Vacuum Phenomenon.

    Science.gov (United States)

    Yun, Sung Min; Suh, Bumn Suk; Park, Jin Su

    2012-12-01

    Vacuum disc phenomenon is a collection of gas in the intervertebral disc space but rarely causes nerve compression. However, some rare type of vacuum phenomenon in the spinal canal may bring about posterior gas displacement within the epidural space. The authors describe two patients with symptomatic epidural gas-containing cyst that seem to be originating from vacuum phenomenon in the intervertebral disc, causing lumbosacral radiculopathy. Radiographic studies demonstrated intervertebral vacuum phenomenon and accumulation of gas in the lumbar epidural space compressing the dural sac and the nerve root. The nerve root in both patients was compressed by gas containing cyst that was surrounded by thin walled capsule separable from the gaseous degenerated disc space. The speculative mechanism of the nerve root compression is discussed. The possibility of gas containing cyst should be considered in case of the nerve root compression in which epidural gas is present.

  12. Electroacupuncture improves microcirculation and neuronal morphology in the spinal cord of a rat model of intervertebral disc extrusion

    Directory of Open Access Journals (Sweden)

    Dai-xun Jiang

    2015-01-01

    Full Text Available Most studies on spinal cord neuronal injury have focused on spinal cord tissue histology and the expression of nerve cell damage and repair-related genes. The importance of the microcirculation is often ignored in spinal cord injury and repair research. Therefore, in this study, we established a rat model of intervertebral disc extrusion by inserting a silica gel pad into the left ventral surface of T 13 . Electroacupuncture was used to stimulate the bilateral Zusanli point (ST36 and Neiting point (ST44 for 14 days. Compared with control animals, blood flow in the first lumbar vertebra (L 1 was noticeably increased in rats given electroacupuncture. Microvessel density in the T 13 segment of the spinal cord was increased significantly as well. The number of normal neurons was higher in the ventral horn of the spinal cord. In addition, vacuolation in the white matter was lessened. No obvious glial cell proliferation was visible. Furthermore, hindlimb motor function was improved significantly. Collectively, our results suggest that electroacupuncture can improve neuronal morphology and microcirculation, and promote the recovery of neurological functions in a rat model of intervertebral disc extrusion.

  13. Treatment of 96 Cases of Prolapse of Lumbar Intervertebral Disc of Posterior Protrusion Type by the Comprehensive Therapy

    Institute of Scientific and Technical Information of China (English)

    LIU Kong-jiang; LU Jian-hu; SONG Ling

    2004-01-01

    选择腰椎间盘突出症后凸型患者96例,随机分为观察组50例和对照组46例,观察组采用针刺牵引推拿综合治疗,对照组仅用针刺治疗,对患者治疗后进行疗效评定.治疗组和对照组治疗后的疗效有显著差异(P<0.05).综合治疗腰椎间盘突出症后凸型疗效确切,方法简便,具有一定的临床指导意义.%s: Ninety-six cases of prolapse of lumbar intervertebral disc of posterior protrusion type were divided randomly into observation group including 50 cases and control group including 46 cases.Patients in observation group were treated with combined use of acupuncture, traction and Tuina, and patients in control group were only treated with acupuncture. After treatment, the significant difference was found between the observation group and control group in therapeutic affect. The comprehensive therapy is definitely effective and simple in the treatment of prolapse of lumbar intervertebral disc of posterior protrusion type, which has guiding significance to the clinical practice.

  14. PGE1 Attenuates IL-1β-induced NGF Expression in Human Intervertebral Disc Cells.

    Science.gov (United States)

    Murata, Kazuma; Sawaji, Yasunobu; Alimasi, Wuqikun; Suzuki, Hidekazu; Endo, Kenji; Tanaka, Hidetoshi; Yorifuji, Makiko; Kosaka, Taiichi; Shishido, Takaaki; Yamamoto, Kengo

    2016-06-01

    In vitro study using isolated human intervertebral disc (IVD) cells. To investigate the effects of prostaglandin (PG)E1 and its orally available derivative limaprost on the regulation of nerve growth factor (NGF) expression and to compare their actions with other prostanoids using interleukin (IL)-1-stimulated human IVD cells. We previously reported that a selective COX-2 inhibitor enhanced, whereas PGE2 suppressed the induction of NGF by IL-1 in human IVD cells, and proposed that PGE2 can suppress NGF expression by a negative feedback mechanism. Isolated human IVD cells were stimulated with IL-1 in the presence or absence of increasing concentrations of PGE2, PGE1, limaprost, PGI2, PGD2, or PGF2α (10-10,000 nM). For some experiments, an E-series prostanoid receptor (EP)4 antagonist (L-161,982) was added prior to the stimulation. NGF expression was determined by real-time polymerase chain reaction and its protein level was quantified by enzyme-linked immunosorbent assay. PGE2, PGE1, and limaprost inhibited the IL-1-mediated induction of NGF in a concentration-dependent manner, with IC50 values of 9.9, 10.6, and 70.9 nM, respectively. PGI2 also suppressed NGF expression but to a much less extent. PGD2, on the other hand, significantly enhanced NGF expression, whereas PGF2α had no effect. Protein expression levels of NGF mirrored its mRNA levels. The suppression of NGF expression by PGE2 and PGE1 was partly reversed by L-161,982. PGE1 and limaprost exhibited a novel pharmacological action that suppresses NGF expression in human IVD cells, and other prostanoids differentially regulated NGF expression. Limaprost has been used to treat patients with lumbar spinal stenosis in Japan and was proved to be effective in relieving symptoms. Our in vitro results may explain, in part, the mechanism of action of limaprost for low back pain. N/A.

  15. Degeneration of the cervical disc: histology compared with radiography and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Christe, A.; Vock, P. [University of Berne, Department of Radiology, Inselspital, Berne (Switzerland); Laeubli, R.; Berlemann, U. [University of Berne, Department of Orthopaedic Surgery, Inselspital, Berne (Switzerland); Guzman, R.; Schroth, G. [University of Berne, Department of Neuroradiology, Inselspital, Berne (Switzerland); Moore, R.J. [Institute of Medical and Veterinary Science, Adelaide (Australia); Loevblad, K.O. [University of Berne, Department of Neuroradiology, Inselspital, Berne (Switzerland); Geneva University Hospital, Neuroradiology SRRI, Geneva 14 (Switzerland)

    2005-10-01

    Decisions about the treatment of neck pain are largely made on the basis of information gained from plain X-rays and magnetic resonance imaging (MRI), which are used routinely as part of preliminary investigation. We performed a descriptive cadaveric study to compare histology with radiography and MRI. We correlated plain radiography, disc height [Farfan index (FI)] and MRI findings with histology to assess the ability of radiology to detect significant pathologic lesions. The study included 52 motion segments from nine subjects over the age of 50, who underwent routine hospital autopsy. Disc degeneration was assessed by histology, radiography, disc height (FI: anterior disc height plus posterior disc height divided by anterioposterior diameter) and MRI using established grading systems. Most of the discs were classified radiologically as grade 1 (19/52), grade 2 (13/52), grade 3 (9/52) or grade 4 (3/52). Eight of the discs were graded as normal. The distribution of MRI grades was grade 0 (9/36), grade 1 (9/36), grade 2 (7/36), grade 3 (8/36) and grade 4 (3/36). Half of the discs (26/52) showed advanced (grade 4) degeneration histologically. FI correlated with histological grade (P=0.013), MRI grade (P=0.02) and radiological grade (P<0.001) of degeneration. Radiological and histological grade of degeneration showed a weak correlation (r=0.3, P=0.033). MRI correlated with overall histological grade (r=0.41, P=0.015, n=34). Histological features (e.g., tears, rim lesions, prolapse of nucleus material) were poorly recognised by MRI, which had a sensitivity for disc material prolapse and annulus tears of less than 40%. Our study showed that discs from patients over 50 years are histologically severely degenerated; however, these changes may not be detected by conventional radiography and MRI. (orig.)

  16. Análise radiológica da degeneração discal experimental em coelhos Radiological analysis of experimental disc degeneration in rabbits

    Directory of Open Access Journals (Sweden)

    Emiliano Vialle

    2009-01-01

    Full Text Available OBJETIVO: Validar a avaliação radiográfica da degeneração discal experimental em coelhos. MÉTODOS: Os discos intervertebrais lombares de coelhos New Zealand foram puncionados três vezes com uma agulha 18G com profundidade limitada de 5mm, através de abordagem lateral. Foram realizadas radiografias seriadas pré e pós-operatórias imediatas, e depois de quatro, oito e 12 semanas do procedimento, com posterior análise da altura discal, formação de osteófito, esclerose da placa vertebral e presença de degeneração discal. A análise estatística dos dados foi validada pelo coeficiente de concordância Kappa, com intervalo de confiança (IC de 95%. RESULTADOS: Observou-se diminuição significativa do espaço discal nas radiografias em AP após 12 semanas de pós-operatório, com Kappa = 0,489 para IC 95% (0,25-0,72 com p OBJECTIVE: To validate radiographic evaluation of a rabbit model for disc degeneration. METHODS: Lumbar intervertebral discs of New Zealand rabbits were stabbed three times with a 18G needle at a limited depth of 5mm, through lateral approach. Serial radiographic images were taken on the early pre-and postoperative periods, and after four, eight and 12 weeks of the procedure, with subsequent analysis of disc height, osteophyte formation, endplate sclerosis, and presence of disc degeneration. The statistical analysis of data was validated by the Kappa coefficient, with a confidence interval (CI of 95%. RESULTS: A significant reduction of disc space was found on AP X-ray images after 12 postoperative weeks, with Kappa = 0.489 for CI 95% (0.25-0.72 with p < 0.001. X-ray signs of disc degeneration also presented Kappa = 0.63 for CI 95% (0.39-0.86 with p < 0.001. The remaining assessed criteria showed positive results, but with a lower Kappa value. CONCLUSION: The disc degeneration model using rabbits as proposed in this study was shown to be feasible, with positive X-ray correlation between pre- and postoperative images

  17. MRI quantification of human spine cartilage endplate geometry: Comparison with age, degeneration, level, and disc geometry.

    Science.gov (United States)

    DeLucca, John F; Peloquin, John M; Smith, Lachlan J; Wright, Alexander C; Vresilovic, Edward J; Elliott, Dawn M

    2016-08-01

    Geometry is an important indicator of disc mechanical function and degeneration. While the geometry and associated degenerative changes in the nucleus pulposus and the annulus fibrosus are well-defined, the geometry of the cartilage endplate (CEP) and its relationship to disc degeneration are unknown. The objectives of this study were to quantify CEP geometry in three dimensions using an MRI FLASH imaging sequence and evaluate relationships between CEP geometry and age, degeneration, spinal level, and overall disc geometry. To do so, we assessed the MRI-based measurements for accuracy and repeatability. Next, we measured CEP geometry across a larger sample set and correlated CEP geometric parameters to age, disc degeneration, level, and disc geometry. The MRI-based measures resulted in thicknesses (0.3-1 mm) that are comparable to prior measurements of CEP thickness. CEP thickness was greatest at the anterior/posterior (A/P) margins and smallest in the center. The CEP A/P thickness, axial area, and lateral width decreased with age but were not related to disc degeneration. Age-related, but not degeneration-related, changes in geometry suggest that the CEP may not follow the progression of disc degeneration. Ultimately, if the CEP undergoes significant geometric changes with aging and if these can be related to low back pain, a clinically feasible translation of the FLASH MRI-based measurement of CEP geometry presented in this study may prove a useful diagnostic tool. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1410-1417, 2016.

  18. A Novel Catechol-O-Methyltransferase Variant Associated with Human Disc Degeneration

    Science.gov (United States)

    Gruber, Helen E.; Sha, Wei; Brouwer, Cory R.; Steuerwald, Nury; Hoelscher, Gretchen L.; Hanley, Edward N. Jr.

    2014-01-01

    Background: Disc degeneration and its associated low back pain are a major health care concern causing disability with a prominent role in this country's medical, social and economic structure. Low back pain is devastating and influences the quality of life for millions. Low back pain lifetime prevalence approximates 80% with an estimated direct cost burden of $86 billion per year. Back pain patients incur higher costs, greater health care utilization, and greater work loss than patients without back pain. Methods: Research was performed following approval of our Institutional Review Board. DNA was isolated, processed and amplified using routine techniques. Amplified DNA was hybridized to Affymetrix Genome-Wide Human SNP Arrays. Quality control and genotyping analysis were performed using Affymetrix Genotyping Console. The Birdseed v2 algorithm was used for genotyping analysis. 2589 SNPs were selected a priori to enter statistical analysis using lotistic regression in SAS. Results: Our objective was to search for novel single nucleotide polymorphisms (SNPs) associated with disc degeneration. Four SNPs were found to have a significant relationship to disc degeneration; three are novel. Rs165656, a new SNP found to be associated with disc degeneration, was in catechol-O-methyltransferase (COMT), a gene with well-recognized pain involvement, especially in female subjects (p=0.01). Analysis confirmed the previously association between COMT SNP rs4633 and disc degeneration. We also report two novel disc degeneration-related SNPs (rs2095019 and rs470859) located in intergenic regions upstream to thrombospondin 2. Conclusions: Findings contribute to the challenging field of disc degeneration and pain, and are important in light of the high clinical relevance of low back pain and the need for improved understanding of its fundamental basis. PMID:24904231

  19. 3D characterization of morphological changes in the intervertebral disc and endplate during aging: A propagation phase contrast synchrotron micro-tomography study.

    Science.gov (United States)

    Cao, Yong; Liao, Shenghui; Zeng, Hao; Ni, Shuangfei; Tintani, Francis; Hao, Yongqiang; Wang, Lei; Wu, Tianding; Lu, Hongbin; Duan, Chunyue; Hu, Jianzhong

    2017-03-07

    A better understanding of functional changes in the intervertebral disc (IVD) and interaction with endplate is essential to elucidate the pathogenesis of IVD degeneration disease (IDDD). To date, the simultaneous depiction of 3D micro-architectural changes of endplate with aging and interaction with IVD remains a technical challenge. We aim to characterize the 3D morphology changes of endplate and IVD during aging using PPCST. The lumbar vertebral level 4/5 IVDs harvested from 15-day-, 4- and 24-month-old mice were initially evaluated by PPCST with histological sections subsequently analyzed to confirm the imaging efficiency. Quantitative assessments of age-related trends after aging, including mean diameter, volume fraction and connectivity of the canals, and endplate porosity and thickness, reached a peak at 4 months and significantly decreased at 24 months. The IVD volume consistently exhibited same trend of variation with the endplate after aging. In this study, PPCST simultaneously provided comprehensive details of 3D morphological changes of the IVD and canal network in the endplate and the interaction after aging. The results suggest that PPCST has the potential to provide a new platform for attaining a deeper insight into the pathogenesis of IDDD, providing potential therapeutic targets.

  20. 颈椎间盘突出症合并腰椎间盘突出症的非手术治疗效果分析%Effect of non-operative treatments on herniation of cervical disc complicated by prolapse of lumbar intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Background: There are many reports about the operative or non- operative treatments of herniation of cervical disc or prolapse of lumbar intervertebral disc, but few about the non- operative treatments curative effect and attentive affairs of their combination. Objective: To study the non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Design: To make retrospective survey and study of non- operative treatments' curative effect of herniation of cervical disc combined with prolapse of lumbar intervertebral disc. Unit: First Affiliated Hospital of Anhui Medical University. Subject: From February 1990 to February 1998, 55 patients were with the complication, occupied 15. 41% of the simple cervical disc, and 9. 34% of the simple lumbar intervertebral disc.

  1. Treatment of Prolapse of Lumbar Intervertebral Disc by Tuina Massotherapy Combined with Oral Administration of Buyang Huanwu Tang——A Report of 75 Cases

    Institute of Scientific and Technical Information of China (English)

    Du Deli; Wang Xinzhong

    2007-01-01

    @@ Prolapse of lumbar intervertebral disc is a commonly encountered disease. From Feb. 2003 - Feb. 2005, a series of 75 cases had been treated by Tuina massotherapy combined with oral administration of Buyang Huanwu Tang (补阳还五汤 Decoction for Invigorating Yang and Recuperation), with satisfactory therapeutic results reported as follows.

  2. Evaluation of different laser wavelengths on ablation lesion and residual thermal injury in intervertebral discs of the lumbar spine.

    Science.gov (United States)

    Plapler, Hélio; Mancini, Marília W; Sella, Valéria R G; Bomfim, Fernando R C

    2016-04-01

    Laser discectomy or nucleotomy is an increasingly important method for less invasive procedures of column, but the ideal kind of laser is still not established. As the wavelength is an important parameter for water absorption, this study was performed to investigate the action of the laser emission in the near infrared (808 to 1908 nm) region in the context of surgical procedures for percutaneous intervertebral disc decompression (nucleotomy). Forty intervertebral discs from pigs lumbar spines were irradiated with laser (λ = 808, 980, 1470 and 1908 nm), 1-s on/off time cycles, for 120 cycles and 10 W of power (808, 980, and 1470 nm) or 240 cycles and 5 W of power (1908 nm), with total power of 1200 J, and subjected to microscopic evaluation through hematoxylin-eosin (HE) staining in order to measure the ablation lesions and the residual thermal injury. Ten other discs were not irradiated and worked as controls. The ablation lesions were measured (in mm) at 1.08 ± 1.25, 1.70 ± 0.63, 2.23 ± 1.02, 1.37 ± 0.39, and 0.94 ± 0.41 (median ± SD) for the control, 808, 980, 1470, and 1908 nm groups, respectively. The difference between 1908 nm and all the other groups was statistically significant (p < 0.05). The residual thermal injury was less evident in 1908 nm laser and sharper in 980 nm laser wavelengths. The laser at a wavelength of 1908 nm was considered the most efficient for the vaporization of the nucleus pulposus, followed by the laser wavelengths of 1470, 808, and 980 nm, and proved to be useful for laser nucleotomy procedure.

  3. Effects of follower load and rib cage on intervertebral disc pressure and sagittal plane curvature in static tests of cadaveric thoracic spines.

    Science.gov (United States)

    Anderson, Dennis E; Mannen, Erin M; Sis, Hadley L; Wong, Benjamin M; Cadel, Eileen S; Friis, Elizabeth A; Bouxsein, Mary L

    2016-05-03

    The clinical relevance of mechanical testing studies of cadaveric human thoracic spines could be enhanced by using follower preload techniques, by including the intact rib cage, and by measuring thoracic intervertebral disc pressures, but studies to date have not incorporated all of these components simultaneously. Thus, this study aimed to implement a follower preload in the thoracic spine with intact rib cage, and examine the effects of follower load, rib cage stiffening and rib cage removal on intervertebral disc pressures and sagittal plane curvatures in unconstrained static conditions. Intervertebral disc pressures increased linearly with follower load magnitude. The effect of the rib cage on disc pressures in static conditions remains unclear because testing order likely confounded the results. Disc pressures compared well with previous reports in vitro, and comparison with in vivo values suggests the use of a follower load of about 400N to approximate loading in upright standing. Follower load had no effect on sagittal plane spine curvature overall, suggesting successful application of the technique, although increased flexion in the upper spine and reduced flexion in the lower spine suggest that the follower load path was not optimized. Rib cage stiffening and removal both increased overall spine flexion slightly, although with differing effects at specific spinal locations. Overall, the approaches demonstrated here will support the use of follower preloads, intact rib cage, and disc pressure measurements to enhance the clinical relevance of future studies of the thoracic spine. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Reprodutibilidade intra e interobservadores da classificação de Fujiwara para degeneração do ligamento interespinhoso por meio de ressonância magnética e relação entre as lesões degenerativas do disco intervertebral e do ligamento interespinhoso Reproducibilidad intra e interobservador de la clasificación de la degeneración de ligamento interespinoso Fujiwara por imágenes de resonancia magnética y la relación entre las lesiones degenerativas del disco intervertebral y del ligamento interespinoso Intraobserver and interobserver reproducibility of Fujiwara rating of interspinous ligament by magnetic resonance imaging and relationship between lumbar disc degeneration and interspinous ligament degeneration

    Directory of Open Access Journals (Sweden)

    Rafael de Carvalho Jorgetti

    2010-12-01

    se mostró reproductiva para la evaluación del ligamento interespinoso. Sin embargo, la difusión más amplia y el uso de este tipo pueden hacer que sea una buena herramienta para comparar resultados de diferentes estudios.OBJECTIVE: to assess the clinical applicability of Fujiwara rating by intraobserver and interobserver analysis and to compare it to Pfirrmann rating of disc degeneration. METHODS: eighty-seven interspinous ligaments and lumbar intervertebral discs of 29 patients (13 males and 16 females with mean age of 49 years (24 to 81 years were evaluated by magnetic resonance imaging by Fujiwara and Pfirrmann rating system. The assessment of Fujiwara rating was done by three observers in two occasions, with a minimal interval of 15 days. The assessment of Pfirrmann rating was done by three observers at the same time. Statistical analyses were done by Kappa index to compare the intraobserver and interobserver variation. RESULTS: the intraobserver agreement was considered to be good; however, the interobserver agreement was poor, with Kappa index lower than 0,2. CONCLUSION: the Fujiwara rating system showed no reproducibility to assess interspinous ligament. However, a larger disclosure and application of this rating system can turn this rating into a good instrument of comparison between an outcome of different studies.

  5. Autologous nucleus pulposus transplantation to lumbar 5 dorsal root ganglion after epineurium discission in rats: a modified model of non-compressive lumbar herniated intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin-jun; SONG Wu; LUO Wen-ying; WEI Ming; SUN Lai-bao; ZOU Xue-nong; LIAO Wei-ming

    2011-01-01

    Background Nucleus pulposus of intervertebral discs has proinflammatory characteristics that play a key role in neuropathic pain in lumbar herniated intervertebral disc. One of the most commonly used animal models (the traditional model) of non-compressive lumbar hemiated intervertebral disc is created by L4-L5 hemilaminectomy and the application of autologous nucleus pulposus to cover the left L4 and L5 nerve roots in rats. However, such procedures have the disadvantages of excessive trauma and low success rate. We proposed a modified model of non-compressive lumbar herniated intervertebral disc in which only the left L5 dorsal root ganglion is exposed and transplanted with autologous nucleus pulposus following incision of epineurium. We aimed to compare the modified model with the traditional one with regard to trauma and success rate.Methods Thirty Sprague-Dawley male rats were randomized into three groups: sham operation group (n=6). traditional group (n=12), and modified group (n=12). The amount of blood loss and operative time for each group were analyzed. The paw withdrawal threshold of the left hind limb to mechanical stimuli and paw withdrawal latency to heat stimuli were examined from the day before surgery to day 35 after surgery.Results Compared with the traditional group, the modified group had shorter operative time, smaller amount of blood loss, and higher success rate (91.7% versus 58.3%, P <0.05). There was no decrease in paw withdrawal latency in any group. The sham operation group had no decrease in postoperative paw withdrawal threshold, whereas the modified and traditional groups had significant reduction in paw withdrawal threshold after surgery (mechanical hyperalgesia).Conclusions Transplantation of nucleus pulposus onto the L5 dorsal root ganglion following incision of epineurium in rats established an improved animal model of non-compressive lumbar herniated intervertebral disc with less trauma and more stable pain ethology.

  6. Quantitative analysis of disc degeneration using axial T2 mapping in a percutaneous annular puncture model in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Chai, Jee Won; Kim, Su Jin [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); Kang, Heung Sik; Lee, Joon Woo [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Hong, Sung Hwan [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of)

    2016-02-15

    To evaluate T2 relaxation time change using axial T2 mapping in a rabbit degenerated disc model and determine the most correlated variable with histologic score among T2 relaxation time, disc height index, and Pfirrmann grade. Degenerated disc model was made in 4 lumbar discs of 11 rabbits (n = 44) by percutaneous annular puncture with various severities of an injury. Lumbar spine lateral radiograph, MR T2 sagittal scan and MR axial T2 mapping were obtained at baseline and 2 weeks and 4 weeks after the injury in 7 rabbits and at baseline and 2 weeks, 4 weeks, and 6 weeks after the injury in 4 rabbits. Generalized estimating equations were used for a longitudinal analysis of changes in T2 relaxation time in degenerated disc model. T2 relaxation time, disc height index and Pfirrmann grade were correlated with the histologic scoring of disc degeneration using Spearman's rho test. There was a significant difference in T2 relaxation time between uninjured and injured discs after annular puncture. Progressive decrease in T2 relaxation time was observed in injured discs throughout the study period. Lower T2 relaxation time was observed in the more severely injured discs. T2 relaxation time showed the strongest inverse correlation with the histologic score among the variables investigated (r = -0.811, p < 0.001). T2 relaxation time measured with axial T2 mapping in degenerated discs is a potential method to assess disc degeneration.

  7. Enhancement of Lumbar Fusion and Alleviation of Adjacent Segment Disc Degeneration by Intermittent PTH(1-34) in Ovariectomized Rats.

    Science.gov (United States)

    Zhou, Zhuang; Tian, Fa-Ming; Gou, Yu; Wang, Peng; Zhang, Heng; Song, Hui-Ping; Shen, Yong; Zhang, Ying-Ze; Zhang, Liu

    2016-04-01

    Osteoporosis, which is prevalent in postmenopausal or aged populations, is thought to be a contributing factor to adjacent segment disc degeneration (ASDD), and the incidence and extent of ASDD may be augmented by osteopenia. Parathyroid hormone (PTH) (1-34) has already been shown to be beneficial in osteoporosis, lumbar fusion and matrix homeostasis of intervertebral discs. However, whether PTH(1-34) has a reversing or retarding effect on ASDD in osteopenia has not been confirmed. In the present study, we evaluated the effects of intermittent PTH(1-34) on ASDD in an ovariectomized (OVX) rat model. One hundred 3-month-old female Sprague-Dawley rats underwent L4 -L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation 4 weeks after OVX surgery. Control groups were established accordingly. PTH(1-34) was intermittently administered immediately after PLF surgery and lasted for 8 weeks using the following groups (n = 20) (V = vehicle): Sham+V, OVX+V, Sham+PLF+V, OVX+PLF+V, OVX+PLF+PTH. The fused segments showed clear evidence of eliminated motion on the fusion-segment based on manual palpation. Greater new bone formation in histology was observed in PTH-treated animals compared to the control group. The extent of ASDD was significantly increased by ovariotomy. Intermittent PTH(1-34) significantly alleviated ASDD by preserving disc height, microvessel density, relative area of vascular buds, endplate thickness and the relative area of endplate calcification. Moreover, protein expression results showed that PTH(1-34) not only inhibited matrix degradation by decreasing MMP-13, ADAMTS-4 and Col-I, but also promote matrix synthesis by increasing Col-II and Aggrecan. In conclusion, PTH(1-34), which effectively improves lumbar fusion and alleviates ASDD in ovariectomized rats, may be a potential candidate to ameliorate the prognosis of lumbar fusion in osteopenia.

  8. [Case-control study on Zero-profile implant for anterior cervical discectomy and fusion and conventional cage plate internal fixation for the treatment of single segmental cervical intervertebral disc herniation].

    Science.gov (United States)

    Shao, Hai-yu; Zhang, Jun; Yang, Di; Chen, Jin-ping; Huang, Ya-zeng

    2016-06-01

    To compare clinical efficacy of Zero-profile implant for anterior cervical discectomy and fusion and conventional titanium plate with cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation. From August 2011 to March 2014, clinical data of 139 patients with single cervical disc herniation treated with anterior cervical discectomy and interbody fusion with internal fixation were retrospectively analyzed. The patients were divided into two groups according to its operation method. There were 63 patients in group A which performed anterior discectomy and interbody fusion with Zero-profile;76 patients in group B which performed anterior cervical discectomy and cage plate internal fixation. JOA score and Odom functional rating between two groups were compared before and after operation. Videofluorographic swallowing study (VFSS) were used to evaluate thickness of prevertebral soft tissue. Bazaz dysphagia score were used to assess incidence of dysphagia. Postoperative AP X-ray and CT of cervical vertebra at 12 months were applied for evaluating bone graft fusion. Postoperative MRI was applied for evaluating the incidence of adjacent segment degeneration. Blood loss,operative time, preoperative and postoperative JOA score, Odom functional rating and VFSS score, Bazaz score, fusion rate between vertebral bodies and incidence of adjacent segment degeneration were compared between two groups. There were no statistical meaning between two groups in JOA score, Odom functional rating before and after operation (P > 0.05); and no significant meaning in VFSS score between two groups before operation (P > 0.05); There were no significant difference in operative time and blood loss. There was statistical meaning in VFSS, Bazaz dysphagia score at 2 days, and 6 months after operation (P 0.05). Eight patients (12.7%) in group A occurred adjacent segment degeneration and 19 patients (25%) in group B occurred adjacent segment degeneration

  9. Efficacy of intervertebral disc regeneration with stem cells - a systematic review and meta-analysis of animal controlled trials.

    Science.gov (United States)

    Wang, Zhen; Perez-Terzic, Carman M; Smith, Jay; Mauck, William D; Shelerud, Randy A; Maus, Timothy P; Yang, Tai-Hua; Murad, Mohammad Hassan; Gou, Shanmiao; Terry, Marisa J; Dauffenbach, Jason P; Pingree, Mathew J; Eldrige, Jason S; Mohammed, Khaled; Benkhadra, Khalid; van Wijnen, Andre J; Qu, Wenchun

    2015-06-10

    Management of intervertebral disc (IVD) degenerative disease is challenging, as it is accompanied by irreversible loss of IVD cells. Stem cell transplantation to the disc has shown promise in decelerating or arresting the degenerative process. Multiple pre-clinical animal trials have been conducted, but with conflicting outcomes. To assess the effect of stem cell transplantation, a systematic review and meta-analysis was performed. A comprehensive literature search was conducted through Week 3, 2015. Inclusion criteria consisted of controlled animal trials. Two reviewers screened abstracts and full texts. Disagreements were resolved by a third reviewer. Random effects models were constructed to pool standardized mean difference (SMD). Twenty two studies were included; nine of which were randomized. Statistically significant differences were found with the stem cell group exhibiting increased disc height index (SMD=3.64, 95% confidence interval (CI): 2.49, 4.78; panimal species, study designs, and transplanted cell types. Stem cells transplanted to the IVD in quadruped animals decelerate or arrest the IVD degenerative process. Further studies in human clinical trials will be needed to understand if such benefit can be translated to bipedal humans. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Penetrating annulus fibrosus injuries affect dynamic compressive behaviors of the intervertebral disc via altered fluid flow: an analytical interpretation.

    Science.gov (United States)

    Michalek, Arthur J; Iatridis, James C

    2011-08-01

    Extensive experimental work on the effects of penetrating annular injuries indicated that large injuries impact axial compressive properties of small animal intervertebral discs, yet there is some disagreement regarding the sensitivity of mechanical tests to small injury sizes. In order to understand the mechanism of injury size sensitivity, this study proposed a simple one dimensional model coupling elastic deformations in the annulus with fluid flow into and out of the nucleus through both porous boundaries and through a penetrating annular injury. The model was evaluated numerically in dynamic compression with parameters obtained by fitting the solution to experimental stress-relaxation data. The model predicted low sensitivity of mechanical changes to injury diameter at both small and large sizes (as measured by low and high ratios of injury diameter to annulus thickness), with a narrow range of high sensitivity in between. The size at which axial mechanics were most sensitive to injury size (i.e., critical injury size) increased with loading frequency. This study provides a quantitative hypothetical model of how penetrating annulus fibrosus injuries in discs with a gelatinous nucleus pulposus may alter disc mechanics by changing nucleus pulposus fluid pressurization through introduction of a new fluid transport pathway though the annulus. This model also explains how puncture-induced biomechanical changes depend on both injury size and test protocol.

  11. A comparison between porcine, ovine, and bovine intervertebral disc anatomy and single lamella annulus fibrosus tensile properties.

    Science.gov (United States)

    Monaco, Lauren A; DeWitte-Orr, Stephanie J; Gregory, Diane E

    2016-02-01

    This project aimed to compare gross anatomical measures and biomechanical properties of single lamellae from the annulus fibrosus of ovine and porcine lumbar vertebrae, and bovine tail vertebrae. The morphology of the vertebrae of these species differ significantly both from each other and from human, yet how these differences alter biomechanical properties is unknown. Geometric parameters measured in this study included: 1) absolute and relative intervertebral (IVD) and vertebral body height and 2) absolute and relative intervertebral disc (IVD) anterior-posterior (AP) and medial-lateral (ML) widths. Single lamella tensile properties included toe-region stress and stretch ratio, stiffness, and tensile strength. As expected, the bovine tail IVD revealed a more circular shape compared with both the ovine and porcine lumbar IVD. The bovine tail also had the largest IVD to vertebral body height ratio (due to having the highest absolute IVD height). Bovine tail lamellae were also found to be strongest and stiffest (in tension) while ovine lumbar lamellae were weakest and most compliant. Histological analysis revealed the greatest proportion of collagen in the bovine corroborating findings of increased strength and stiffness. The observed differences in anatomical shape, connective tissue composition, and tensile properties need to be considered when choosing an appropriate model for IVD research.

  12. Spinal traction promotes molecular transportation in a simulated degenerative intervertebral disc model.

    Science.gov (United States)

    Kuo, Ya-Wen; Hsu, Yu-Chun; Chuang, I-Ting; Chao, Pen-Hsiu Grace; Wang, Jaw-Lin

    2014-04-20

    Biomechanical experiment using an in situ porcine model. To find the effect of traction treatment on annulus microstructure, molecular convection, and cell viability of degraded discs. Spinal traction is a conservative treatment for disc disorders. The recognized biomechanical benefits include disc height recovery, foramen enlargement, and intradiscal pressure reduction. However, the influence of traction treatment on annulus microstructure, molecular transportation, and cell viability of degraded discs has not been fully investigated. A total of 48 thoracic discs were dissected from 8 porcine spines (140 kg, 6-month old) within 4 hours after killing them and then divided into 3 groups: intact, degraded without traction, and degraded with traction. Each disc was incubated in a whole-organ culture system and subjected to diurnal loadings for 7 days. Except for the intact group, discs were degraded with 0.5 mL of trypsin on day 1 and a 5-hour fatigue loading on day 2. From day 4 to day 6, half of the degraded discs received a 30-minute traction treatment per day (traction force: 20 kg; loading: unloading = 30 s: 10 s). By the end of the incubation, the discs were inspected for disc height loss, annulus microstructure, molecular (fluorescein sodium) intensity, and cell viability. Collagen fibers were crimped and delaminated, whereas the pores were occluded in the annulus fibrosus of the degraded discs. Molecular transportation and cell viability of the discs decreased after matrix degradation. With traction treatment, straightened collagen fibers increased within the degraded annulus fibrosus, and the annulus pores were less occluded. Both molecular transportation and cell viability increased, but not to the intact level. Traction treatment is effective in enhancing nutrition supply and promoting disc cell proliferation of the degraded discs. N/A.

  13. CT Image analysis of lumbar intervertebral disc displacement%CT检查在诊断腰椎间盘移位症中的效果分析

    Institute of Scientific and Technical Information of China (English)

    金勇; 赵斌

    2015-01-01

    目的:探讨CT检查在诊断腰椎间盘移位症中的效果。方法:对2012年1月至2013年8月我院收治的3314例腰椎间盘移位患者(4644个椎间盘)的临床资料进行回顾性分析,重点分析其进行CT检查的结果。结果:在本组患者中,有2730例患者发生腰椎间盘膨出,有563例患者发生椎间盘突出,有33例患者发生椎间盘脱出,有817例患者发生椎间盘膨突,有501例患者发生椎间盘膨出并突出,有2332例患者因发生椎间盘移位而导致硬膜外脂肪消失及硬膜囊受压,有626例患者因发生椎间盘移位导致神经根受压,有139例患者的病变椎间盘发生钙化,有253例患者发生侧隐窝填塞及神经根湮没的情况,有203例患者发生椎间盘变性、出现真空征的情况,有173例患者罹患继发性椎管狭窄。结论:CT检查在诊断不同类型的腰椎间盘移位症方面具有重要的临床价值。腰椎间盘移位症患者的CT表现及病理改变各不相同,产生的后果也不尽相同。在临床工作中,我们应根据为此病患者进行CT检查的结果为其设计有针对性的治疗方案。%Objective: To investigate CT manifestation of lumbar intervertebral disc displacement (Generalized hernia of lumbar intervertebral disc). Methods: A retrospective analysis of our hospital in 2012 January -2013 August for CT diagnosis of lumbar intervertebral disc displacement 3314 cases of prolapse and highlight 4644 disc. Results:Bulge of lumbar intervertebral disc 2730;Hernia of lumbar intervertebral disc 563;Prolapse of lumbar intervertebral disc 33;Localized bulge and hernia Lumbar intervertebral disc 817;Bulge and hernia of lumbar intervertebral disc and highlight 501. Conclusions:Has the important value of lumbar intervertebral disc displacement of CT diagnosis of different types of disease.

  14. The Comparison of Effective between Acupuncture and Bee Venom Acupuncture on the Treatment of Acute Lumbar Herniation of Intervertebral Disc

    Directory of Open Access Journals (Sweden)

    Chang So-Young

    2006-06-01

    Full Text Available Objective : Herniation of Intervertebral Disc(HIVD is the most common disease causing low back pain. Acupuncture and Bee Venom Acupuncture has been used for treatment of HIVD. This study is to investigate the effective of Bee Venom Acupuncture for HIVD. Methods : We researched 18 patients who were diagnosed by CT and MRI as having HIVD, and treated them Acupuncture only or Acupuncture and Bee Venom Acupuncture. We compared the VAS and ROM angle of two groups. Results & Conclusions : 1. In admission date, no significant improvement between Acupuncture group and Bee Venom Acupuncture group 2. In variation of flexion and extension, Bee Venom Acupuncture group shows statistically significant improvement 3. In VAS, Bee Venom Acupuncture group shows statistically significant improvement for 1 week and discharge day

  15. SUMMARY OF RESEARCHES ON THE TREATMENT OF PROTRUSION OF LUMBAR INTERVERTEBRAL DISC BY "SHE-BIE" OINTMENT-PARTITION MOXIBUSTION

    Institute of Scientific and Technical Information of China (English)

    蒋松鹤; 郁引飞; 叶天申

    2003-01-01

    In the present paper the authors sum up their research results about "She-Bie" (black-tail snake-ground beetle) Ointment-partition moxibustion for treatment of Iumbar intervertebral disc protrusion (LIDP). Animal ex-perirments showed that when used externally, "She-Bie" Ointment had striking anti-infllammation and pain-relief actionsbut had no irritant and no allergic effects to the skin. In the treatment of mild type of LIDP, "She-Bie" Ointment parti-tion moxibustion could work well in improving clinical symptoms; and in the treatment of moderate type of LIDP, itcould be used as a supplementary measure and raise the excellent and good rates of the therapeutic effect further. Forthis reason, "She-Bie" Ointment partition moxibustion deserves being Popularized in clinical treatment of LIDP.

  16. Adjacent segment degeneration: observations in a goat spinal fusion study

    NARCIS (Netherlands)

    R.J.W. Hoogendoorn; M.N. Helder; P.I.J.M. Wuisman; R.A. Bank; V. Everts; T.H. Smit

    2008-01-01

    Study Design. The adjacent discs of 13 goats, originally used in a lumbar spinal fusion model study, were analyzed for symptoms of intervertebral disc degeneration by means of magnetic resonance imaging (MRI), macroscopy, and histology. These goats were followed for 6 months and the results were com

  17. The Reserch of Electric Acupuncture and Acupuncture Treatment of Lumbar Intervertebral Disc Protrusion in Clinical%电针配合刺法治疗腰椎间盘突出症临床研究进展

    Institute of Scientific and Technical Information of China (English)

    李鑫; 朱栩宏

    2016-01-01

    腰椎间盘突出症是骨科的常见病和多发病,椎间盘突出症主要病因是椎间盘劳损变性、纤维环破裂或髓核脱出等,刺激或压迫脊神经、脊髓等引起的一系列症状群,临床主要以腰背疼痛、下肢疼痛或麻木为主要表现。本病归属于中医“腰痛”“腰腿痛”范畴。目前的中医治疗方法有针灸、推拿、中药内服、封闭、穴位埋线等,针灸疗法对腰椎间盘突出引起的下肢疼痛麻木具有独特疗效。本文就电针配合针灸治疗腰椎间盘突出症研究进展作一综述。%Lumbar disc disease is a common disease and frequently encountered disease in orthopedics, strain of intervertebral disc degeneration is the main cause of herniated intervertebral disc, bulgin or nucleus pulposus prolapse, stimulate or oppression, cause a series of symptoms such as spinal nerve, spinal cord group clinical mainly to lower back pain, leg pain or numbness as the main per-formance.The disease belongs to Chinese medicine “back pain” and “lumbocrural pain” category.At present there are acupuncture and moxibustion, massage, Chinese medicine treatment of traditional Chinese medicine (TCM), closed, acupuncture point bury line take orally, acupuncture and moxibustion therapy on lumbar disc pain caused by lower limb numbness has unique curative effect.This paper summarizes the progress research on acupuncture treatment of lumbar intervertebral disc protrusion.

  18. Modelo experimental para o estudo da hérnia do disco intervertebral Experimental model to study intervertebral disc herniation

    Directory of Open Access Journals (Sweden)

    André Luiz de Souza Grava

    2008-04-01

    Full Text Available OBJETIVO: Apresentar um modelo experimental de hérnia de disco e sua validação para estudo da hiperalgesia mecânica e térmica produzidas pelo contato do núcleo pulposo (NP com as estruturas nervosas envolvidas nessa afecção. MÉTODOS: Foram utilizados ratos Wistar, sendo o NP autólogo retirado da região sacrococcígea e depositado sobre a dura-máter, raiz nervosa ou gânglios das raízes dorsais L4, L5 ou L6. Os experimentos foram divididos em quatro etapas: 1ª determinação da estrutura nervosa mais sensível ao contato com o NP; 2ª identificação do melhor nível lombar para a indução da hiperalgesia; 3ª determinação da ausência de lesão motora; e 4ª determinação da influência do procedimento cirúrgico no desenvolvimento do processo inflamatório. A hiperalgesia foi avaliada nos testes de von Frey eletrônico e de Hargreaves e a função motora, pelo teste de rota-rod. RESULTADOS: O NP induziu hiperalgesia de maior intensidade na pata quando em contato com o gânglio da raiz dorsal (GRD do que em contato com a dura-máter ou a raiz nervosa. Quando em contato com o GRD-L5, o NP induziu hiperalgesia ainda maior que a induzida pelo contato com os GRDs L4 e L6. Não foram observadas lesão motora e influência do processo inflamatório cirúrgico sobre a hiperalgesia. CONCLUSÃO: O GRD é a estrutura mais sensível aos componentes do NP para a produção da hiperalgesia, sendo o quinto nível lombar o que apresentou maior alteração nas sensibilidades mecânica e térmica avaliadas na pata dos animais, de acordo com os métodos utilizados.OBJECTIVE:The purpose of this study is to present an experimental model of disc herniation and to validate such model to study mechanic and thermal hyperalgesia produced by the contact of the nucleus pulposus (NP with nerve structures involved in this condition. METHODS: The authors used Wistar rats, the autologous NP being removed from the sacrococcygeal region and deposited on the

  19. Prevalence and geographic distribution of herniated intervertebral disc in Korean 19-year-old male from 2008 to 2009: a study based on Korean conscription -national and geographic prevalence of herniated intervertebral disc in Korean 19YO male-.

    Science.gov (United States)

    Lee, Sang Hun; Oh, Chang Hyun; Yoon, Seung Hwan; Park, Hyeong-chun; Park, Chong Oon

    2013-09-01

    This study was to determine the prevalence of herniated intervertebral disc (HIVD) among Korean 19-year-old male in a large national sample and to compare the prevalence across geographic regions based on the data of conscription. We analyzed the conscription data of 615508 cases who were 19-year-old male, given an examination for conscription at nationwide Korean Military Manpower Administration from January 2008 to December 2009. Prevalence was determined by dividing the number of cases by the number of persons enrolled for 2 years. The analyses included of a cross-tabulations and nonparametric chi-square to compare the prevalence according to geographic region, disc severity, and conscription year. The prevalence of HIVD among 19-year-old male was 0.47%. Seoul had the highest prevalence of HIVD (total HIVD was 0.60%, and severe HIVD was 0.44%). The prevalence of HIVD was lower in Jeollabuk- do and Jeollanam-do (total HIVD was 0.25-0.27%, and severe HIVD was 0.16-0.17%). Annual prevalence of HIVD was slightly decreased in 2009, but geographic distribution annually was not different. In Korean 19-year-old male, the national prevalence of adolescent HIVD was 0.60%, but different geographic distribution was observed. It is quite possible that secondary contributing factor(s) interfere with the different geographic prevalence of HIVD.

  20. Association Between Lumbar Spine Sagittal Alignment and L4-L5 Disc Degeneration Among Asymptomatic Young Adults.

    Science.gov (United States)

    Menezes-Reis, Rafael; Bonugli, Gustavo Perazzoli; Dalto, Vitor Faeda; da Silva Herrero, Carlos Fernando Pereira; Defino, Helton Luiz Aparecido; Nogueira-Barbosa, Marcello Henrique

    2016-09-15

    Cross-sectional observational study on the relationship between the degrees of disc degeneration and sagittal alignment in asymptomatic healthy individuals. This study sought to determine whether the sagittal spine alignment subtype is related to the prevalence of lumbar disc degeneration. Sagittal balance and spinopelvic parameters might be risk factors for disc degeneration. A total of 70 asymptomatic participants (36 women and 34 men) without regular physical activity were categorized according to the four subtypes of sagittal alignment proposed by Roussouly. All participants underwent magnetic resonance imaging of the lumbar spine (1.5T) and panoramic radiography of the spine. The degree of disc degeneration was graded using T2-weighted images according to the Pfirrmann classification. Spinopelvic parameters and vertebral curvatures were measured on digital panoramic radiographs using Surgimap software. Interobserver analyses for the Pfirrmann classification and spinopelvic parameters were assessed using the weighted Kappa and intraclass correlation coefficient (ICC), respectively. The Kappa associated with disc degeneration classification was 0.79 (95% confidence intervals 0.72-0.87). The ICCs were excellent, with small confidence intervals for all spinopelvic parameters. The type II group (flat lordosis) showed a higher frequency of degenerated discs at L4-L5 (P = 0.03) than the type IV group (long and curved lumbar spine). No significant differences in disc degeneration were observed among the four subtypes at the other disc levels. We found a negative, moderate correlation between the spinopelvic parameters and the occurrence of disc degeneration in the type II group. The Roussouly subtype II sagittal alignment is significantly associated with disc degeneration at L4-L5 in asymptomatic young adults. Our results support the hypothesis that spinal sagittal alignment plays a role in early disc degeneration. 3.

  1. Effect of comprehensive rehabilitation treatment on protrusion of lumbar intervertebral disc%综合康复疗法对腰椎间盘突出症的作用

    Institute of Scientific and Technical Information of China (English)

    陈淑娥

    2003-01-01

    @@ BACKGROUND:Conservative therapy is very important in treatment of lumbar protrusion of lumbar intervertebral disc and symptoms can be alleviated or disappear in most patients by physical therapy,traction and other comprehensive methods.

  2. 以推拿手法为主治疗腰椎间盘突出症 1480例%Treatment of 1480 cases of prolapse of lower back intervertebral disc with massage

    Institute of Scientific and Technical Information of China (English)

    谷万里; 张梅红; 栾光法

    2001-01-01

    @@ Background: Prolapse of lower back intervertebral disc is common clinical diseases, its main manifest includes lower back pain and sciatica. It is mainly treated with massage, to massage points may release spasm of muscle and pain with significant effects

  3. Studies on the effects of aging on the intervertebral discs of cervical spine in asymptomatic subjects in magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Morio [Keio Univ., Tokyo (Japan). School of Medicine

    1997-01-01

    The intervertebral discs of cervical spine were studied by MRI to see their age- and sex-related changes together with roentgenography. Asymptomatic healthy volunteers giving informed consent involved 262 males and 235 females aged 10 ->60 y. MRI apparatuses used were 1.5 T Signa superconducting one (General Electric) and 0.5 T Resona superconducting one (Yokogawa Medical). In the former with phased array coil, T1-weighted sagittal, T2-weighted sagittal and T1-weighted cross sections were imaged with slice thickness of 5 mm by fast spin-echo method for 134 subjects. In the latter apparatus with surface coil for cervical vertebra, the 3 kinds of sections as above were imaged with slice thickness of 5-7 mm by fast spin-echo method for 363 subjects. Scout roentgenography was done from 4 directions. It was found that degenerative changes in the disc more or less occurred in a age-related manner even in asymptomatic subjects. (K.H.)

  4. The significance of removing ruptured intervertebral discs for interbody fusion in treating thoracic or lumbar type B and C spinal injuries through a one-stage posterior approach.

    Directory of Open Access Journals (Sweden)

    Qian-Shi Zhang

    Full Text Available OBJECTIVES: To identify the negative effect on treatment results of reserving damaged intervertebral discs when treating type B and type C spinal fracture-dislocations through a one-stage posterior approach. METHODS: This is a retrospective review of 53 consecutive patients who were treated in our spine surgery center from January 2005 to May 2012 due to severe thoracolumbar spinal fracture-dislocation. The patients in Group A (24 patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression. In Group B (29 patients, the patients underwent long-segment instrumentation laminectomy with pedicle screw-rod fixators for neural decompression evacuating of the ruptured disc and inserting of a bone graft into the evacuated disc space for interbody fusion. The mean time between injury and operation was 4.1 days (range 2-15 days. The clinical, radiologic and complication outcomes were analyzed retrospectively. RESULTS: Periodic follow-ups were carried out until an affirmative union or treatment failure took place. A progressive kyphosis angle larger than 10°, loss of disc height, pseudoarthrosis, recurrence of dislocation or subluxation, or instrument failure before fusion were considered treatment failures. Treatment failures were detected in 13 cases in Group A (failure rate was 54.2%. In Group B, there were 28 cases in which definitive bone fusion was demonstrated on CT scans, and CT scans of the other cases demonstrated undefined pseudoarthrosis without hardware failure. There were statistically significant differences between the two groups (p0.05 Fisher's exact test. CONCLUSION: Intervertebral disc damage is a common characteristic in type B and C spinal fracture-dislocation injuries. The damaged intervertebral disc should be removed and substituted with a bone graft because reserving the damaged disc in situ increases the risk of treatment failure.

  5. Microscale Material Properties of Bone and the Mineralized Tissues of the Intervertebral Disc-Vertebral Body Interface

    Science.gov (United States)

    Paietta, Rachel C.

    The objective of this dissertation is to understand the influences of material structure on the properties, function and failure of biological connective tissues. Biological interfaces are becoming an increasingly studied system within mechanics and tissue engineering as a model for attaching dissimilar materials. The elastic modulus of bone (≈ 20 GPa) and cartilage (≈ 0.1-1 MPa) differ over orders of magnitude, which should intuitively create high stress concentrations and failure at the interface. Yet, these natural interface systems rarely fail in vivo, and the mechanism by which loads are transferred between tissues has not yet been established. Tissue quality is one major contributor to the mechanical behavior of bone and cartilage, and is defined by properties such as collagen orientation, mineral volume fraction, porosity and tissue geometry. These properties have yet to be established at the bone-cartilage interface in the spine, and the lack of quantitative data on material microstructure and behavior limits treatments and tissue engineering construct design. In this dissertation, second harmonic generation imaging, quantitative backscattered scanning electron imaging and nanoindentation are combined to characterize micrometer scale tissue quality and modulus in both bone and calcified cartilage. These techniques are utilized to: 1) determine the hierarchical micrometer to millimeter scale properties of lamellar bone, 2) quantify changes throughout development and aging at the human intervertebral disc-vertebral body junction, and 3) explore compressive fractures at this interface. This work is the first to provide quantitative data on the mineral volume fraction, collagen orientation and modulus from the same, undecalcified sections of tissue to corroborate tissue structure and mineralization and describe quantitative parameters of the interface. The principal findings from this work indicate that the underlying matrix, or collagen, organization in

  6. Novel genetic variants associated with lumbar disc degeneration in northern Europeans: A meta-analysis of 4600 subjects

    NARCIS (Netherlands)

    F.M.K. Williams (Frances); A.T. Bansal (Aruna); J.B.J. van Meurs (Joyce); J.T. Bell (Jordana); I. Meulenbelt (Ingrid); P. Suri (Pradeep); F. Rivadeneira Ramirez (Fernando); P.N. Sambrook (Philip); A. Hofman (Albert); S.M. Bierma-Zeinstra (Sita); C. Menni (Cristina); M. Kloppenburg (Margreet); P.E. Slagboom (Eline); D. Hunter (David); A.J. MacGregor (Alex ); A.G. Uitterlinden (André); T.D. Spector (Timothy)

    2013-01-01

    textabstractObjective: Lumbar disc degeneration (LDD) is an important cause of low back pain, which is a common and costly problem. LDD is characterised by disc space narrowing and osteophyte growth at the circumference of the disc. To date, the agnostic search of the genome by genome-wide associati

  7. Degenerate Hopf bifurcation in a self-exciting Faraday disc dynamo

    Indian Academy of Sciences (India)

    WEIQUAN PAN; LIJIE LI

    2017-06-01

    In order to further understand a self-exciting Faraday disc dynamo (Hide $\\it{et al}$, in $\\it{Proc. R. Soc}.$ A $\\bf{452}$, 1369 1996), showing chaotic attractors with very complicated topological structures, we present codimension one and two (degenerate) Hopf bifurcations and prove the existence of periodic solutions. In addition, numerical simulations are given for confirming the theoretical results.

  8. Effects of unisegmental disc compression on adjacent segments: an in vivo animal model.