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Biomedical subjects

G B Andersson

Publications and source records attributed to G B Andersson.

At least 19 recordsLinked to original sources

A multicenter, prospective, randomized trial evaluating a new hemostatic agent for spinal surgery.

STUDY DESIGN: A prospective, randomized trial comparing Proceed, a gelatin-based hemostatic sealant (treatment), with Gelfoam-thrombin (control) in stopping intraoperative bleeding during spinal surgery. OBJECTIVES: To determine the effectiveness and safety of Proceed. SUMMARY OF BACKGROUND DATA: Proceed has been tested in animal models to determine its safety and effectiveness as a hemostatic agent. The current study was conducted under a Food and Drug Administration-approved Investigational Device Exemption to evaluate the effectiveness and safety of Proceed in humans. METHODS: For this study, 127 patients undergoing spinal surgery were randomized into either the treatment or control group after standard surgical means to control bleeding had failed. The bleeding site was evaluated at 1, 2, 3, 6, and 10 minutes after the hemostatic agent was applied. The application was considered successful if the bleeding stopped within 10 minutes. Follow-up evaluation was performed at 12 to 36 hours, then at 6 to 8 weeks after surgery. RESULTS: Proceed stopped bleeding in 98% of the patients (first bleeding site only) within 10 minutes, as compared with 90% of the control patients (P = 0.001). At 3 minutes, successful hemostasis had been achieved in 97% of the Proceed group, as compared with 71% of the control group (P = 0.0001). There was no difference in the adverse event profile between the two groups. CONCLUSIONS: A significantly larger number of bleeding sites had achieved hemostasis with Proceed than with Gelfoam-thrombin at 1, 2, and 3 minutes after application. Proceed was as safe as Gelfoam-thrombin when used for hemostasis during spinal surgery procedures.

Administration, Topical↗

Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion.

STUDY DESIGN: Destructive compression tests and finite element analyses were conducted to investigate the biomechanical strength at the graft-endplate interface in anterior cervical fusion. OBJECTIVES: To investigate the effect of endplate thickness, endplate holes, and bone mineral density of the vertebral body on the biomechanical strength of the endplate-graft interface in an anterior interbody fusion of the cervical spine. SUMMARY OF BACKGROUND: Subsidence of the graft into the vertebral body is a well-known complication in anterior cervical fusion. However, there is no information in the literature regarding the compressive strength of the graft-endplate interface in relation to the endplate thickness, holes in the endplate, and bone mineral density of the vertebral body. METHODS: Biomechanical destructive compression tests and finite element analyses were performed in this study. Cervical vertebral bodies (C3-C7) isolated from seven cadaveric cervical spines (age at death 69-86 years, mean 79 years) were used for compression tests. Bone mineral density of each vertebral body was measured using a dual energy radiograph absorptiometry unit. Endplate thickness was measured using three coronal computed tomography images of the middle portion of the vertebral body obtained using a computer-assisted imaging analysis. Then each vertebral body was cut into halves through the horizontal plane. A total of 54 specimens, consisting of one endplate and half of the vertebral body, were obtained after excluding eight vertebrae with gross pathology on plain radiograph. Specimens were assigned to one of three groups with different endplate conditions (Group I, intact; Group II, partial removal; and Group III, complete removal) so that group mean bone mineral density became similar. Each endplate was slowly compressed until failure using an 8-mm-diameter metal indenter, and the load to failure was determined as a maximum force on a recorded force-displacement curve. The effect on the strength of the graft-endplate interface of various hole patterns in the endplate was studied using a finite element technique. The simulatedhole patterns included the following: one large central hole, two lateral holes, two holes in the anterior and posterior portion of the endplate, and four holes evenly distributed from the center of the endplate. Stress distribution in the endplate was predicted in response to an axial compressive force of 110 N, and the elements with von Mises stress greater than 4.0 MPa were determined as failed. RESULTS: The endplate thickness and bone mineral density were similar at all cervical levels, and the superior and inferior endplates had similar thickness at all cervical levels. There was no significant association between bone mineral density and endplate thickness. Load to failure was found to have a significant association with bone mineral density but not with endplate thickness. However, load to failure tends to decrease with incremental removal of the endplate, and load to failure of the specimens with an intact endplate was significantly greater than that of the specimens with no endplate. Finite element model predictions showed significant influence of the hole pattern on the fraction of the upper endplate exposed to fracture stress. A large hole was predicted to be more effective than the other patterns at distributing a compressive load across the remaining area and thus minimizing the potential fracture area. CONCLUSION: Results of this study suggest that it is important to preserve the endplate as much as possible to prevent graft subsidence into the vertebral body, particularly in patients with poor bone quality. It is preferable to make one central hole rather than multiple smaller holes in the endplate for vascularity of the bone graft because it reduces the surface area exposed to fracture stresses.

Aged↗

Comparison of biomechanical response to surgical procedures used for cervical radiculopathy: posterior keyhole foraminotomy versus anterior foraminotomy and discectomy versus anterior discectomy with fusion.

The objective of this study was to compare the change in flexibility of C5-C6 caused by three procedures using a three-dimensional nonlinear finite element model: posterior foraminotomy (keyhole procedure), anterior foraminotomy with discectomy, and anterior discectomy with fusion. The keyhole procedure produced a minor increase in motion. The anterior foraminotomy and discectomy produced one to two times greater motion. Anterior discectomy with fusion produced 50% to 100% reduction in motion. The posterior keyhole foraminotomy has a much lesser effect on the stability of the cervical spine segment than does an anterior procedure, and fusion is a requisite part of the anterior decompression procedure.

Biomechanical Phenomena↗

The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine.

STUDY DESIGN: A biomechanical and imaging study of human cadaveric spinal motion segments. OBJECTIVE: To investigate the effect of both disc degeneration and facet joint osteoarthritis on lumbar segmental motion. SUMMARY OF BACKGROUND DATA: Spinal degeneration includes the osteoarthritic changes of the facet joint as well as disc degeneration. Disc degeneration has been reported to be associated with spinal motion. The association of facet joint osteoarthritis with lumbar segmental motion characteristics and the combined influence of disc degeneration and facet osteoarthritis has not yet been investigated. METHODS: A total of 110 lumbar motion segments (52 female, 58 male) from 44 human lumbar spines were studied (mean age = 69 years). Magnetic resonance images were used to assess the disc degeneration from Grade I (normal) to Grade V (advanced) and the osteoarthritic changes in the facet joints in terms of cartilage degeneration, subchondral sclerosis, and osteophytes. Disc height, endplate size, and facet joint orientation and width also were measured from the computed tomographic images. Rotational movements of the motion segment in response to the flexion, extension, lateral bending, and axial rotational moments were measured using a three-dimensional motion analysis system. RESULTS: Female motion segments showed significantly greater motion (lateral bending: P < 0. 001, flexion: P < 0.01, extension: P < 0.05) and smaller endplate size (P < 0.001) than male ones. The segmental motion increased with increasing severity of disc degeneration up to Grade IV, but decreased in both genders when the disc degeneration advanced to Grade V. In male segments, the disc degeneration-related motion changes were significant in axial rotation (P < 0.001), lateral bending (P < 0.05), and flexion (P < 0.05), whereas female segments showed significant changes only in axial rotation (P < 0.001). With cartilage degeneration of the facet joints, the axial rotational motion increased, whereas the lateral bending and flexion motion decreased in female segments. In male segments, however, motion in all directions increased with Grade 3 cartilage degeneration and decreased with Grade 4 cartilage degeneration. Subchondral sclerosis significantly decreased the motion (female: axial rotation, P < 0. 05; extension, P < 0.05 vs.- male:flexion,P < 0.05). Severity of osteophytes had no significant association with the segmental motion. CONCLUSION: Axial rotational motion was most affected by disc degeneration, and the effects of disc degeneration on the motion were similar between genders. Facet joint osteoarthritis also affected segmental motion, and the influence differed for male and female spines. Further studies are needed to clarify whether the degenerative process of facet joint osteoarthritis differs between genders and how facet joint osteoarthritis affects the stability of the spinal motion segment.

Cadaver↗

Effects of a lifting belt on spine moments and muscle recruitments after unexpected sudden loading.

STUDY DESIGN: Ten men and eight women participated in a repeated-measures experiment in which sudden loads were applied unexpectedly to a container held in the hands. Three independent variables were investigated: lifting belt use, preload, and load symmetry. OBJECTIVES: To determine whether a lifting belt would help protect the spine in sudden symmetric and asymmetric loading situations. SUMMARY OF BACKGROUND DATA: Unexpected loading events have long been associated with the onset of back pain. Based on work showing that lifting belts restrict motion of the torso, the hypothesis was that a lifting belt would stiffen the spine, thereby protecting its supporting tissues. METHODS: A weight, equal to 7.5% of the subjects' trunk extension force, was allowed to fall 1 m before the bottom of a box held by blindfolded subjects was pulled. Kinetic and kinematic data, obtained from two force plates and a magnetic motion measurement system, were used in a three-dimensional, dynamic, linked-segment biomechanical model to calculate spine moments. Electromyogram data were simultaneously obtained from eight trunk muscles. RESULTS: The belt reduced the forward bending of the spine during the symmetric loadings. In the men, the belt also reduced the forward flexion moment acting on the spine. The belt restricted lateral bending in the women and men, when the box was preloaded. The peak electromyogram amplitudes from posterior contralateral erector spinae and latissimus dorsi muscles increased during the asymmetric loadings, whereas three ipsilateral muscles were less active. CONCLUSIONS: The conflicting moment and electromyographic results, combined with the influence of load symmetry, preload, and gender make the benefits of the lifting belt difficult to delineate. Although the data support the hypothesis that the belt stiffens the torso's response to sudden loading, the effects are small, and considerable individual differences exist. The findings show that during unexpected sudden loading, a belt may reduce the net external moment loading. At the same time the belt appears to alter the muscle response strategy so that the belt's overall effect on an individual's safety is hard to determine.

Adult↗

Association between recovery outcomes for work-related low back disorders and personal, family, and work factors.

STUDY DESIGN: Incident cases of work-related low back disorders were identified in an automotive metal stamping plant. Individuals were asked to recall health and work habits at the time of diagnosis of the work-related disorder and to report their current low back pain and physical functioning. OBJECTIVES: To evaluate five measures of health outcomes for work-related low back disorders in an industrial population and to determine potentially modifiable correlates of recovery. SUMMARY OF BACKGROUND DATA: The factors that influence recovery in actively working adults and how to best measure recovery outcome in this population are not well known. METHODS: Eighty-eight hourly employees of a metal stamping plant who experienced a work-related low back disorder were interviewed. Health status, health habits, and family and work relations were assessed with a structured interview to determine their association with various recovery outcomes (low back pain, low back pain disability, physical functioning, general physical health, and lost workdays). Interview information was supplemented with data from the plant's Occupational Safety and Health Administration Form 200 log. RESULTS: The clinical measures of recovery from the work-related low back disorders examined had similar overall predictive ability. However, in multivariate analyses, different potentially modifiable prognostic variables emerged as significant among them. Poorer self-rated health status and high personal stress were correlated with low back pain disability. Higher levels of cigarette smoking were correlated with higher levels of low back pain disability, lower physical functioning, and more severe low back pain at follow-up. CONCLUSION: The choice of measure of recovery from work-related low back disorders should be made in the context of the rehabilitation intervention goal. Interventions designed to modify and promote healthful personal behavior should be given more emphasis in rehabilitation efforts for work-related low back disorders.

Adult↗

Anterior cervical fusion: a finite element model study on motion segment stability including the effect of osteoporosis.

STUDY DESIGN: Three-dimensional, nonlinear finite element models were used to evaluate the stability of the mid cervical spine after anterior fusion in patients with and without osteoporosis. OBJECTIVES: The objective of this study was to compare the change in flexibility of C5-C6 after anterior discectomy with both loose-fitting and tight-fitting fusion graft. SUMMARY OF BACKGROUND DATA: Many factors such as surgical technique, osteoporosis, and excess neck motion during the postoperative period may contribute to fusion failure. Knowledge about changes in biomechanical properties after the surgical procedure is important for selection of grafts with appropriate strength and for guiding patients in postoperative care and rehabilitation. METHODS: Analyses with anterior fusion models with both loose-fitting and tight-fitting graft were performed in a normal and an osteoporotic spine. The motion of the C5 vertebra in relation to the C6 vertebra were calculated, after multidirectional moment loads of 0.5 Nm combined with a compressive preload of 105 N. RESULTS: Loose-fitting graft produced both an increase and a decrease in motion under various external moment loads, with graft compressive stress below the compressive strength of the graft material. A reduction in motion was observed under all moment loads when a tight-fitting graft was used. The compressive stress in the tight-fitting graft was higher than the strength of the graft material. Osteoporosis increased the principal motions with both the loose-fitting graft and tight-fitting graft. Maximum increase in motion with a loose-fitting graft construct was observed under extension and axial torsion moment loads. CONCLUSIONS: Anterior discectomy and insertion of the loose graft resulted in increased motion. A tight-fitting graft is beneficial in reducing motion, but the stress within the graftincreases beyond the graft strength. The presence of osteoporosis was nominally significant when the graft was tight fitting.

Adult↗

Abnormalities in muscle function during gait in relation to the level of lumbar disc herniation.

STUDY DESIGN: A comparison between gait in patients undergoing surgery for L4 and L5 lumbar disc herniations and that in an age- and weight-matched control group. OBJECTIVES: To study whether changes in the moments produced at the ankle and knee joints during walking reflect the neurologic level of a herniated nucleus pulposus. SUMMARY OF BACKGROUND DATA: Lumbar herniated discs often cause muscle weakness, reduced motor function, and change in walking capacity. The specific effects of a disc herniation on muscle function during gait is poorly documented. METHODS: Conventional physical examination and kinetic analysis of gait were performed on 16 patients who subsequently underwent surgery for herniated discs (eight with L4-L5 and eight with L5-S1 disc herniations) and 16 healthy control subjects. The three components of the external moment at the ankle and knee were computed. The peak magnitudes of specific components of the external moments were compared with those of the control group. RESULTS: Reduced external ankle plantar flexion moment, indicating a decreased function of the ankle dorsiflexors, was found in patients with herniated nucleus pulposus of both L4-L5 and L5-S1. Reduced external ankle dorsiflexion moment, indicating a decreased function of the ankle plantar flexors, was found only in patients with a lesion to the L5-S1 disc, but not in those with herniations at L4-L5. CONCLUSIONS: Preoperative gait analysis identified functional deficits of the muscles about the ankle and foot that relate to the level of the herniation. Kinetic measurements can assist in understanding the functional limitations associated with specific levels of a herniation.

Adult↗

A comparison of osteopathic spinal manipulation with standard care for patients with low back pain.

BACKGROUND: The effect of osteopathic manual therapy (i.e., spinal manipulation) in patients with chronic and subchronic back pain is largely unknown, and its use in such patients is controversial. Nevertheless, manual therapy is a frequently used method of treatment in this group of patients. METHODS: We performed a randomized, controlled trial that involved patients who had had back pain for at least three weeks but less than six months. We screened 1193 patients; 178 were found to be eligible and were randomly assigned to treatment groups; 23 of these patients subsequently dropped out of the study. The patients were treated either with one or more standard medical therapies (72 patients) or with osteopathic manual therapy (83 patients). We used a variety of outcome measures, including scores on the Roland-Morris and Oswestry questionnaires, a visual-analogue pain scale, and measurements of range of motion and straight-leg raising, to assess the results of treatment over a 12-week period. RESULTS: Patients in both groups improved during the 12 weeks. There was no statistically significant difference between the two groups in any of the primary outcome measures. The osteopathic-treatment group required significantly less medication (analgesics, antiinflammatory agents, and muscle relaxants) (P< 0.001) and used less physical therapy (0.2 percent vs. 2.6 percent, P<0.05). More than 90 percent of the patients in both groups were satisfied with their care. CONCLUSIONS: Osteopathic manual care and standard medical care had similar clinical results in patients with subacute low back pain. However, the use of medication was greater with standard care.

Adult↗

The influence of lumbar disc height and cross-sectional area on the mechanical response of the disc to physiologic loading.

STUDY DESIGN: The influence of lumbar disc height and cross-sectional area on the mechanical response of the disc to physiologic loading was determined using a finite element model. OBJECTIVES: To identify which geometric characteristics are potentially related to motion segment mechanical response to applied load, such as flexibility, fiber stress, disc bulge, and nucleus pressure. SUMMARY OF BACKGROUND DATA: The height and area of the lumbar disc varies within the disc itself, between disc levels, between people, between men and women, with aging, and during the day. Mechanical theory dictates that the height and area influence the mechanical response of the disc to loading. This could have important consequences in risk of injury. METHODS: Three-dimensional finite-element models representing three disc heights (5.5 mm, 8.5 mm, and 10.5 mm) and three disc areas (1060 mm2, 1512 mm2, and 1885 mm2) were generated. The effect of disc geometry on the mechanical properties of the disc were studied for four moment loads (magnitude, 7.5 Nm) with compressive preload (400 N) and for three different direct forces. Commercially available finite-element software was used. RESULTS: Discs with a ratio of small disc area to disc height were more prone to larger motion, higher anular fiber stresses, and larger disc bulge. When the disc height alone was increased by a factor, its flexibility also increased, either by the same amount or by a much larger ratio. CONCLUSIONS: Discs with the most height and smallest area are exposed to much higher risk of failure than other combinations of disc height and geometry.

Female↗

Epidemiological features of chronic low-back pain.

Although the literature is filled with information about the prevalence and incidence of back pain in general, there is less information about chronic back pain, partly because of a lack of agreement about definition. Chronic back pain is sometimes defined as back pain that lasts for longer than 7-12 weeks. Others define it as pain that lasts beyond the expected period of healing, and acknowledge that chronic pain may not have well-defined underlying pathological causes. Others classify frequently recurring back pain as chronic pain since it intermittently affects an individual over a long period. Most national insurance and industrial sources of data include only those individuals in whom symptoms result in loss of days at work or other disability. Thus, even less is known about the epidemiology of chronic low-back pain with no associated work disability or compensation. Chronic low-back pain has also become a diagnosis of convenience for many people who are actually disabled for socioeconomic, work-related, or psychological reasons. In fact, some people argue that chronic disability in back pain is primarily related to a psychosocial dysfunction. Because the validity and reliability of some of the existing data are uncertain, caution is needed in an assessment of the information on this type of pain.

Epidemiologic Studies↗

Comparison of five methods used to determine low back disorder risk in a manufacturing environment.

STUDY DESIGN: Five methods for quantifying work-related low back disorder (LBD) risk were used to assess 178 autoworkers from 93 randomly selected production jobs. OBJECTIVE: To determine if five occupational LBD risk evaluation methods yielded similar assessments of manual material handling tasks. SUMMARY OF BACKGROUND DATA: Several techniques are available for quantifying LBD risk in the workplace and are used in industry for job evaluation and redesign. It is unknown whether the methods yield similar results. METHODS: The five job evaluation methods were the 1993 National Institute for Occupational Safety and Health model, the Static Strength Prediction Program, the Lumbar Motion Monitor model, and two variations of the United Auto Workers (UAW)-General Motors Ergonomic Risk Factor Checklist. These methods were selected because they represent common practice within the automotive industry, the result of governmental efforts to protect the workforce, or models thought to be the most scientifically advanced. RESULTS: Intercorrelations between methods ranged between 0.21 and 0.80. Pairwise analysis of risk group classifications identified biases on the part of the National Institute for Occupational Safety and Health equation, which considered jobs to be of higher risk relative to other methods, and on the part of the Static Strength Prediction Program, which considered nearly all the jobs sampled to be low risk. CONCLUSIONS: There is little agreement among the five quantitative ergonomic analysis methods used. In part, this may be because of their differential focus on acute versus cumulative trauma, thereby suggesting that greater consideration needs to be given to the underlying causes of LBD within a facility before selecting an ergonomic evaluation method.

Ergonomics↗

The effects of lifting speed on the peak external forward bending, lateral bending, and twisting spine moments.

Lifting tasks that involve twisting have been repeatedly implicated as contributing to the onset of occupational back injuries in epidemiological studies. The objective of this work was to quantify the three directional external moments acting on the spine during a sagittally symmetric and two asymmetric lifting tasks. A total of 15 subjects participated in the three lifting tasks. All tasks were performed at two qualitatively defined lifting speeds, 'slow' and 'fast', and with two load magnitudes: 10 and 20% of the subject's body weight. The mid-sagittal plane lifts were performed using two horizontal reach distances: 40 and 60 cm. A four-camera, two-forceplate motion and force measurement system were used to obtain the kinematic and kinetic data as the lifts were performed. A dynamic link-segment biomechanical model was used to quantify the reaction forces and moments at the ankle, knee, and hip and L5/S1 joints. Results from all tasks showed increased sagittal plane (forward bending) spine moments with the heavier load and at the faster lifting speed (p < 0.001). Spine lateral bending and twisting moments increased during the mid-sagittal plane lifts with the greater reach distance and the faster lifting speed, respectively. The twisting moments on the spine were greatest as subjects lifted from in front and placed the load to the side but were dependent upon the lifting speed and the load magnitude. The lateral bending moments increased during this same task with the heavier load. However, the spine lateral bending moments were greatest when lifting from one side to the other.

Adult↗

Study on effect of graded facetectomy on change in lumbar motion segment torsional flexibility using three-dimensional continuum contact representation for facet joints.

Facet joints provide rigidity to the lumbar motion segment and thus protect the disk, particularly against torsional injury. A surgical procedure that fully or partially removes the facet joints (facetectomy) will decrease the mechanical stiffness of the motion segment, and potentially place the disk at risk of injury. Analytical models can be used to understand the effect of facet joints on motion segment stability. Using a facet joint model that represents the contact area as contact between two surfaces rather than as point contact, it was concluded that a substantial sudden change in rotational motion, due to applied torsion moment, was observed after 75 percent of any one of the facet joints was removed. Applied torsional moment loading produced coupled extension motion in the intact motion segment. This coupled motion also experienced a large change following complete unilateral facetectomy. Clinically, the present study showed that surgical intervention in the form of unilateral or bilateral total facetectomy might require fusion to reduce the primary torsion motion.

Finite Element Analysis↗

Effect of lifting belts on trunk muscle activation during a suddenly applied load.

The National Institute for Occupational Safety and Health suggests there is insufficient biomechanical or epidemiological evidence to recommend the use of back belts in industry. From a biomechanical perspective, previous work suggests that lifting belts stiffen the torso, particularly in the frontal and transverse planes. To determine whether lifting belts stiffen the torso and alter the trunk muscle response during a sudden loading event, we tested the hypotheses that (a) lifting belts alter peak muscle activity recorded with electromyography (EMG) during sudden loading and (b) lifting belts have a larger impact on trunk muscle response when sudden loads are applied asymmetric to the torso's midsagittal plane. A sudden load was delivered to 10 men and 10 women without history of low back disorder via a cable attached to a thoracic harness; motion was restricted to the lumbar spine. Results indicate that gender was not a significant factor in this study. The lifting belt reduced the peak normalized EMG of the erector spinae muscles on average by 3% during asymmetric loading, though peak normalized EMG was increased by 2% during symmetric loading. Lifting belts have been shown to slightly reduce peak erector spinae activity during asymmetric sudden loading events in a constrained paradigm; however, the effects of lifting belts are too small to provide effective protection of workers. Actual or potential applications include the assessment of lifting belts as protective devices in workers based on the effects of lifting belts on the trunk muscle activity.

Adult↗

A new culture system to study the metabolism of the intervertebral disc in vitro.

STUDY DESIGN: This study determined whether entrapment of a rabbit intervertebral disc in alginate gel helped to promote the retention of normal metabolic activities by the nucleus pulposus and anulus fibrosus in tissue culture. OBJECTIVES: To establish an in vitro culture system to study the metabolism of the intervertebral disc as a whole integral organ. SUMMARY OF BACKGROUND DATA: In vitro studies of the metabolism of intervertebral discs have been scarce because of the difficulties involved in maintaining the integrity of the tissues, especially that of the nucleus pulposus, in culture medium. METHODS: Rabbit intervertebral discs were embedded in alginate gel and maintained in culture for as long as 1 month. At weekly intervals, experiments were performed to measure the rate of proteoglycan synthesis and to characterize proteoglycans newly synthesized by cells in the anulus fibrosus and nucleus pulposus. In addition, at these same time intervals, the contents of sulfated proteoglycans, antigenic keratan sulfate, hyaluronan, and collagen in these two intervertebral disc tissues were measured to evaluate tissue integrity. Intervertebral discs cultured in medium alone were used as controls and analyzed in parallel. RESULTS: The anulus fibrosus and nucleus pulposus of intervertebral discs cultured in alginate gel sustained a higher rate of proteoglycan synthesis and maintained a higher content of extracellular matrix components than the respective controls at all times. CONCLUSIONS: This new alginate tissue culture system should prove useful for studying the metabolism of whole intervertebral discs.

Alginates↗

What are the age-related changes in the spine?

Degenerative changes of the spinal column have long been and continue to be confused with the presence of spinal distress and pain. All parts of the spine undergo degenerative changes as we age. The purpose of this chapter is to describe the degenerative process and its clinical consequences. The disc degenerative process will be discussed; its consequences on the facet joint and osteophyte formation are considered. The prevalence of disc degeneration, the role of physically demanding work and leisure and the interference of spinal deformity is clarified. A section particularly important for the clinician deals with the clinical consequences of the degenerative process in disc herniation, degenerative spondylolisthesis, spondylolysis and stenosis. This chapter tries to put the degenerative changes of the spine into the context of a normal ageing process.

Aging↗