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PubMedDate not supplied

The canine intervertebral disk. Part Two: Degenerative changes--nonchondrodystrophoid versus chondrodystrophoid disks.

In the second of a two-part article on the canine intervertebral disk, the morphological changes which occur within the disk during aging and degeneration are described. Degeneration of the intervertebral disk appears to be a self-perpetuating process as a consequence of disruption to the annulus fibrosus, cellular remodeling, altered biomechanical loading, and nutritional deficiencies. In the nonchondrodystrophoid disk, premature acceleration of the aging process can occur following traumatic disruption to the annulus fibrosus. This degeneration usually occurs in isolated disks along the length of the vertebral column. By contrast, disk degeneration in the chondrodystrophoid breeds occurs simultaneously in all disks along the vertebral column and usually is well advanced by two years of age. Ultrastructural differences between the intervertebral disk of the nonchondrodystrophoid dog and that of the chondrodystrophoid dog may explain the rapidity and severity of degenerative changes in the latter breeds.

Aging↗
PubMed2002

In vivo sodium MR imaging of the intervertebral disk at 4 T.

RATIONALE AND OBJECTIVES: The authors performed this study to evaluate whether a semiquantitative method of in vivo sodium imaging of the human intervertebral disk could provide diagnostic quality images in a reasonable time. MATERIALS AND METHODS: In vivo sodium imaging of the human spine was performed with a 4-T whole-body magnetic resonance (MR) unit by using custom-built hardware and software. Short-echo-time images were obtained with a modified three-dimensional gradient-echo sequence, a custom-built surface coil, and receiver modifications to allow for nonproton data acquisition. Corrections for surface coil image intensity were performed with phantom image data. An estimation of the fixed charge density within the intervertebral disk was made with the surface coil-corrected images by using cerebrospinal fluid as an internal reference standard. RESULTS: In vivo sodium images of the spine with high signal-to-noise ratio and resolution were obtained in approximately 10 minutes. Correction of in vivo images for surface coil effects demonstrated that the sodium content of the cerebrospinal fluid in the spinal canal may be used as an internal standard to estimate the proteoglycan content of the intervertebral disk. CONCLUSION: Diagnostic quality in vivo sodium images of the intervertebral disk are technically feasible and may be useful for assessing the proteoglycan content of the intervertebral disk. This would provide a method to detect early degenerative changes in the disk and evaluate the effects of any subsequent therapy.

Adult↗
PubMed2001

The intervertebral disk: a landmark for spinal diseases in children.

The aim of this paper is to describe the diagnostic value of the different radiological modifications of the intervertebral disk in children. Usual disk modifications include: disk-space narrowing; disk space enlargement; intervertebral disk calcifications; intervertebral disc prolapse; and signal modification in MRI. The gamuts (which are provided in the paper) of these different images must take into account the association with bone changes and the possibility of several disks' involvement. Calcifications are usually related to benign disorders.

Child↗
PubMed2005

Low-dose interleukin-1 partially counteracts osteogenic protein-1-induced proteoglycan synthesis by adult bovine intervertebral disk cells.

OBJECTIVE: Low back pain associated with degenerative disk disease is a common clinical problem that has enormous socioeconomic impact in today's aging population. As an alternative to the surgical removal of the diseased intervertebral disk, the direct application of a purified growth factor into the intervertebral disk may provide physiatrists a valuable tool to halt or slow down disk degeneration. Our goal here is to determine if low levels of interleukin-1 (IL-1), a proinflammatory cytokine present in the degenerating disk, could interfere with the potentially beneficial effects of growth factors on proteoglycan synthesis. New knowledge gained from this study will prove useful in the development of new treatment modalities that take advantage of the stimulatory effects of growth factors such as osteogenic protein-1 (OP-1). DESIGN: This was an in vitro study of proteoglycan accumulation and synthesis by cells from the nucleus pulposus, inner annulus fibrosus, and outer annulus fibrosus in the bovine intervertebral disk. RESULTS: In cells cultured with serum and no additional exogenous growth factor, treatment with low-dose IL-1 does not result in a significant decrease in proteoglycan synthesis. However, in the case of cells stimulated with OP-1, treatment with IL-1 resulted in a statistically significant decrease in sulfur-35-proteoglycan synthesis by cells derived from all three zones of the bovine intervertebral disk (nucleus pulposus, 60.3% [P < 0.0001]; inner annulus fibrosus, 18.4% [P = 0.0330]; outer annulus fibrosus, 12.3% [P = 0.0255]). Proteoglycan accumulation over the 12-day culture period also decreased significantly (nucleus pulposus, 26.8% [P < 0.0001]; inner annulus fibrosus, 15.8% [P = 0.0276]; outer annulus fibrosus, 16.8% [P = 0.0102]). It is worth noting that cells cultured in the presence of both OP-1 and IL-1 synthesized proteoglycan at a faster rate than cells cultured in the presence of IL-1 alone (nucleus pulposus, 58.5% [P < 0.0001]; inner annulus fibrosus, 39.7% [P = 0.0055]; outer annulus fibrosus, 45.1% [P = 0.0164]). Likewise, cells treated with OP-1 and IL-1 accumulated more proteoglycan in their newly formed matrix than cells cultured in the presence of IL-1 alone (nucleus pulposus, 65.3% [P < 0.0001]; inner annulus fibrosus, 60.5% [P = 0.0034]; outer annulus fibrosus, 19.4% (P = 0.0840]). CONCLUSIONS: Intervertebral disk cells that are stimulated by the growth factor OP-1, to increase the rate at which they produce a proteoglycan-rich matrix become more susceptible to the inhibitory effects of the proinflammatory cytokine IL-1 on the rate of proteoglycan synthesis and accumulation in the matrix over time. This notwithstanding, IL-1 at the low dose used did not totally obliterate the stimulatory effects of OP-1 on matrix formation. Consequently, this growth factor may remain partially effective in stimulating disk repair in vivo even when proinflammatory cytokines such as IL-1 are present.

Animals↗
PubMedDate not supplied

[Quantitative studies of the "cleared out intervertebral disk space" following nucleotomies].

Operative removal of prolapsed intervertebral disk's tissue combined with nucleotomy represents nowa days a routine operative treatment. It is left to the surgeon to clear out - more ore less totally - the intervertebral disk interspace. It can be proved, that based on operation site's anatomy and the disposal instrumentarium the total "clear out" of intervertebral tissue doesn't succeed.

Cadaver↗
PubMed1979

The aging intervertebral disk.

This paper outlines the structure of the intervertebral disk and the process by which altered cellular mechanisms lead to deterioration with age. A reference list indicates current trends in research that attempt to explain the changing nature of the intervertebral disk and its role in spinal disease.

Aging↗
PubMedDate not supplied

Biomechanics and biochemistry of the intervertebral disks: the need for correlation studies.

The literature on the biomechanics of the intervertebral disk is reviewed with emphasis on biomechanical--biochemical--morphological correlative studies. The deficiency of definitive correlative studies is apparent and an appeal is made to interested investigators to fill in the voids in this extremely important area of study. A comprehensive theory of intervertebral disk failure awaits application of existing biomechanical, biochemical and morphological techniques in a detailed and methodical manner to the normal and early degenerative human intervertebral disks.

Animals↗
PubMed1994

Enhancement of intervertebral disks with gadolinium complexes: comparison of an ionic and a nonionic medium in an animal model.

PURPOSE: To compare MR contrast enhancement of intervertebral disk tissue after intravenous administration of equimolar doses of an ionic and of a nonionic gadolinium complex. METHODS: Contrast enhancement was measured on MR in lumbar intervertebral disks for 120 minutes after intravenous injection of gadoteridol or gadopentetate dimeglumine, 0.3 mmol/kg. MR studies were performed with each contrast medium in four rabbits. Contrast enhancement was measured in intervertebral disks as a function of time and contrast medium. RESULTS: With both contrast media, enhancement of normal intervertebral disks was detected. Enhancement of disks was significantly greater with gadoteridol than with gadopentetate dimeglumine. CONCLUSION: The enhancement of cartilage is influenced by the molecular structure of the gadolinium complex. The negative charge of gadopentetate dimeglumine may give it a slower rate of diffusion into disk cartilage than a nonionic complex.

Animals↗
PubMed1986

Intervertebral disk space infection following translumbar aortography.

After 1,748 translumbar aortograms three cases of intervertebral disk space infection were observed over a five-year period, for an incidence of 0.15%. Cultures suggested that the intervertebral disk had been inoculated with digestive tract organisms by the needle used to puncture the aorta. Diagnosis of this complication can be made early by retrieval of the responsible organisms from the intervertebral disk under CT control. Treatment consists of prolonged immobilization associated with appropriate antibiotic therapy for at least three months.

Adult↗
PubMed1996

[Variation in chemonucleolysis as treatment in herniated intervertebral disk].

OBJECTIVE: To measure the variation of chemonucleolysis in the management of lumbosacral intervertebral disk herniation in the Netherlands. DESIGN: Descriptive. SETTING: Academic Medical Centre, Amsterdam, the Netherlands. METHOD: The use of chymopapain per specialist from 1987 to 1995 was determined by dividing the amount of chymopapain sold, as given by the pharmaceutical company, by the number of specialists as recorded by the specialist associations. Subsequently, variation of chemonucleolysis in time, between specialists and in place was calculated. RESULTS: Between 1987 and 1995 the number of chemonucleolysis treatments decreased gradually from 2084 to 538. Most neurosurgeons, orthopaedic surgeons and neurologists did not treat patients with herniation of a lumbosacral intervertebral disk with chemonucleolysis. Within the group of specialists which did treat patients with chemonucleolysis, a minority accounted for the majority of treatments. Chemonucleolysis was mainly performed in non-academic hospitals outside urban western Holland. CONCLUSIONS: Variation of chemonucleolysis in the management of lumbosacral intervertebral disk herniation in the Netherlands is considerable. Different preferences of specialists are probably the underlying cause.

Humans↗
PubMed2006

The effect of exogenous melatonin administration on trabecular width, ligament thickness and TGF-beta(1) expression in degenerated intervertebral disk tissue in the rat.

Intervertebral disk (IVD) degeneration, a complex pathological condition of varying origins, causes low back pain. Degenerative changes in IVD tissue affect the adjacent vertebral structure, resulting in a decreased vertebral trabecular width. It has been suggested that transforming growth factor-beta 1 (TGF-beta(1)) may have a role in the repair of connective tissue, as it occurs in the IVD degeneration process. In this study, we investigated the effects of exogenous melatonin (MEL) administration on vertebral trabecular width, ligament thickness and TGF-beta(1) expression in degenerated IVD tissue. Fifteen adult male Swiss Albino rats were divided randomly into three groups; nonoperated control, operated degeneration, and MEL treatment groups. In the operated degeneration and MEL treatment groups, cuts were made parallel to the end plates in the posterior annulus fibrosus at the fifth and tenth vertebral segments of the tail to induce IVD degeneration. In each group, TGF-beta(1) immunoreactivity and morphometry of vertebral trabecular width and anterior and posterior ligament thickness were evaluated. Histologically, disorganisation and irregularity of collagen fibres was seen in the degenerated (operated) IVD. Increased TGF-beta(1) expression in multinuclear chondrocytes was also observed as was decreased vertebral trabecular width. Importantly, the reduction of trabecular width observed in the operated degenerated group was reversed after MEL administration (p<0.0001). Similarly, TGF-beta(1) expression in multinuclear chondrocytes was dramatically increased after exogenous MEL application. Thus, there was a regression in histopathological changes after MEL treatment, with disk appearances similar to those of the control group. Based on our findings, we suggest that MEL activates the recovery process in the degenerated IVD tissue, possibly by stimulating TGF-beta(1) activity. This is the first report investigating the involvement of the pineal hormone MEL in the repair of rat IVD.

Animals↗
PubMed2004

Long-term clinical manifestations of retained bullet fragments within the intervertebral disk space.

A retrospective review of 12 patients who were victims of penetrating trauma with a bullet or bullet fragments lodged within the intervertebral disk space was conducted. The objective of the review was to evaluate the potential systemic effects of lead resorption at long-term follow-up. Literature regarding the potential for lead toxicity due to retained bullet fragments within the intervertebral disk space is lacking. Between January 1969 and June 1993, a total of 238 patients with a gunshot wound to the spine were identified. Twelve of the 238 were found to have a bullet or bullet fragments within the intervertebral disk space. All patients were fully screened for evidence of plumbism. The average age at time of gunshot injury was 35.8 years; the average time for follow-up was 7.8 years. One of the 12 patients showed clinical evidence of plumbism. The patient subsequently underwent a partial laminectomy and diskectomy with excision of the bullet fragments. The patient's complaints, specific for plumbism, resolved 2 months postoperatively. We conclude that patients with retained lead-based bullet fragments in the intervertebral disk should be educated about the rare potential for plumbism due to partial bullet fragment resorption and that long-term observation for this disorder is recommended.

Adolescent↗
PubMed1985

Lumbar intervertebral disk: correlative MR and anatomic study.

Exactly corresponding magnetic resonance (MR) images and anatomic sections were obtained of cadaveric lumbar intervertebral disks. MR differentiated two major components of the intervertebral disk, one corresponding to the collagenous fibers in the periphery of the disk, the other corresponding to the combination of nucleus and annulus. The vertebral osseous end plate appears to be faintly resolved, but may be simulated by a chemical shift artifact. More correlative studies and development of additional techniques are needed to characterize completely the MR appearance of the intervertebral disks.

Humans↗
PubMed2002

Relationship between clinical data and urodynamic findings in patients with lumbar intervertebral disk protrusion.

The relationship between voiding disturbances and urodynamic diagnosis in patients with lumbar intervertebral disk protrusion is controversial. The objective of this study was to determine the association between clinical data and urodynamic diagnosis, in order to reveal whether bladder dysfunction can be assessed on the basis of urological symptoms and signs. We prospectively studied 122 patients with lumbar intervertebral disk protrusion. Detrusor areflexia was found in 32 of these patients, while in the remaining 90 detrusor activity was normal. All patients with detrusor areflexia reported difficulty voiding by abdominal straining. The patients with normal urodynamic findings were either free of voiding disturbances (77 patients) or complained of frequent voiding (13 patients). In conclusion, there are cases of lumbar intervertebral disk protrusion in which the presence of bladder dysfunction can be predicted on the basis of clinical urodynamic testing, i.e. clinical neurological alterations, decreased bladder sensation, voiding by straining, increased bladder capacity, residual volume, and intermittent or continuous low flow curve on free uroflowmetry.

Adult↗
PubMedDate not supplied

An experimental model to study contrast enhancement in MR imaging of the intervertebral disk.

MR imaging after IV gadolinium-DTPA administration has demonstrated contrast enhancement in traumatized lumbar intervertebral disks. To characterize the morbid anatomy that correlates with the contrast enhancement, we developed a canine model of traumatized intervertebral disks. Diskectomy was performed with a nucleotome and the spines were imaged biweekly with MR and Gd-DTPA. The spines were studied at necropsy, and their anatomic abnormalities correlated with contrast enhancement detected by MR imaging. Our preliminary results indicate that contrast enhancement occurs where granulation tissue develops in traumatized intervertebral disks.

Animals↗
PubMed1988

Intervertebral disk material: criteria for determining probable prolapse.

To develop histologic criteria that allow distinction of prolapsed from nonprolapsed intervertebral disk material, we reviewed the histologic features of curetted fibrocartilage from 100 consecutive patients having documented disk prolapse into the spinal canal and contrasted our findings to those in 40 intervertebral disks removed at autopsy from 20 patients without prolapse. Neovascularization, occurring at the edges of fibrocartilage fragments, was present in 50% of prolapsed disk specimens and in none of the control autopsy disks (p = 0.0004). Other histologic features sometimes used as evidence of degeneration and/or prolapse (i.e., fibrillation, chondrocyte "cloning," and granular change) were not helpful in distinguishing prolapsed from nonprolapsed control disks. Although this indicator was only 50% sensitive in our series, we propose that edge neovascularization of the fibrocartilage fragments is the only reliable histologic clue that intervertebral disk prolapse has occurred.

Adult↗
PubMed1993

Quantitative MR imaging of lumbar intervertebral disks and vertebral bodies: influence of diurnal water content variations.

The influence of diurnal water content variation on T1 and T2 and relative proton density (Nr) in intervertebral disks and vertebral bodies was studied in 10 healthy adult volunteers. T1, T2, and Nr were calculated from a set of 20 images obtained at 1.5 T with five single-section, multiecho sequences at different repetition times. Volunteers were randomized into study (one measurement in the morning and one in the evening) and control (two consecutive measurements in the morning) groups. In the study group, evening mean T1 and Nr in intervertebral disks and in vertebral bodies were significantly (P < .001) less than measured in the morning. Mean T2 in vertebral bodies significantly (P < .05) increased between morning and evening measurements. Diurnal variations were significantly less pronounced in degenerative than in normal intervertebral disks. No significant changes occurred in the control group. Relaxation time and Nr measurements allow sufficiently accurate estimation of diurnal water content variation in cohorts of vertebral bodies and intervertebral disks.

Adolescent↗