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At least 739 records · Page 41Linked to original sources
PubMed2000

Intervertebral disc cell death is dependent on the magnitude and duration of spinal loading.

STUDY DESIGN: An in vivo study of the toxic consequences of static compressive stress on the intervertebral disc. OBJECTIVES: To determine whether disc cell death is correlated with the magnitude and duration of spinal compressive loading. SUMMARY OF BACKGROUND DATA: Static compression in vivo has been demonstrated to induce cell death. Cell death, in turn, has been associated with disc degeneration in humans. There are currently no tolerance criteria for the intervertebral disc that combine both biomechanical and biologic factors, although both have been implicated in cases of accelerated degeneration. METHODS: Mouse tail discs were loaded in vivo with an external compression device. Compressive stress was applied at one of two magnitudes (0.4 and 0.8 MPa) for 7 days, and at one additional magnitude (1.3 MPa) for 1, 3, and 7 days. Midsagittal sections of the discs were stained for apoptosis using the TdT-dUTP terminal nick-end labeling (TUNEL) reaction. Quantal analysis was used to correlate the extent of cell death to the magnitude and duration of loading. RESULTS: The probit transformation of the percentage of dying cells was proportional to the sum of the logarithmic transformations of the compressive stress and the time of loading. CONCLUSIONS: The results of this study demonstrate the feasibility of developing a quantitative correlation between spinal loading and disc degeneration. Such a correlation may be coupled in the future to existing engineering models that predict spinal loading in response to physical exposures and lead to improved definition of the bounds of healthy and unhealthy spinal loading, and ultimately, refined guidelines for low back safety.

Animals↗
PubMed2003

Diurnal T2 value changes in the lumbar intervertebral discs.

AIM: To investigate if there is any in vivo diurnal T2 value changes in the nucleus pulposus in normal and degenerated lumbar intervertebral discs. MATERIALS AND METHODS: Eighteen volunteers (16 men, two women) with no symptoms related to lumbar disease were imaged in the morning before beginning daily work and in the evening after finishing work. Sagittal fast spin-echo T2-weighted images were obtained, following spin-echo transverse imaging for T2 analysis. RESULTS: The normal disc group (n=71) showed statistically significant diurnal T2 value changes (p<0.001), whilst the degenerating disc group (n=19) showed no significant diurnal changes. The normal disc group up to age 34 years showed statistically significant diurnal T2 value changes. However no significant changes were demonstrated after the age 35 years. CONCLUSION: Statistically significant diurnal T2 value changes in the normal lumbar intervertebral discs were demonstrated. Disappearance of the diurnal T2 value changes in the normal discs after the age 35 years was revealed for the first time and thought to be an aspect of aging, not caused by degeneration.

Adult↗
PubMed2006

[Control study on analgesic effect of single-point electroacupuncture on prolapse of lumbar intervertebral disc].

OBJECTIVE: To explore an effective method for electroacupuncture treatment of pain in waist and lower extremities due to prolapse of lumbar intervertebral disc. METHODS: All 98 cases of such disease were randomly divided into a treatment group (n = 53) and a control group (n = 45). The treatment group were treated with local single-point electroacupuncture stimulation, and the control group with routine electroacupuncture stimulation for 8 sessions. The pain in waist and lower extremities in the two groups were continuously evaluated with short-form of McGill pain questionnaire (SF-MPQ). RESULTS: After first treatment, SF-MPQ scores in the two groups were significantly different from those before treatment (P < 0.001), and there were significant differences between the two groups respectively (P < 0.001) at the each time points. CONCLUSION: Local singly-point electroacupuncture has a better analgesic effect on pain in waist and lower extremities due to prolapse of lumbar intervertebral disc.

Acupuncture Analgesia↗
PubMedDate not supplied

Percent spinal canal compromise on MRI utilized for predicting the need for surgical treatment in single-level lumbar intervertebral disc herniation.

BACKGROUND CONTEXT: There is limited information describing the correlation between the initial quantitative measurements on magnetic resonance imaging (MRI) scans of disc herniation area, canal cross-section areas, percent canal compromise, and disc herniation location to the need for surgery. PURPOSE: Our aim is to determine if the size of disc herniation area, canal cross-section area, percent canal compromise, and disc herniation location taken from MRI images of patients with symptomatic single-level lumbar herniated intervertebral discs upon initial presentation to a spine surgeon, were predictive of the need for surgical treatment. STUDY DESIGN/SETTING: This is a retrospective case matched study of patient MRI images in the senior author's private practice. PATIENT SAMPLE: From a pool of 332 patients with sciatica caused by lumbar intervertebral disc herniations at our institution, 65 patients had surgery, of which MRI images were available and analyzed on 44 patients. Forty-four additional patients were randomly selected from the remaining 267 original group as nonoperative controls. METHODS: The axial MRI image showing the largest canal compromise by the herniated disc was selected for measurements. Using T1- and T2-weighted images, the areas of interest were digitally scanned at high resolution. The canal area and disc herniation area measurement were calculated from the total number of pixels per cross-sectional area, multiplied by a scan correction factor, mm(2) /pixel. Disc herniation locations were classified into either central or paracentral. The percent canal compromise was obtained by disc herniation area divided by canal cross-section area and multiplied by 100. RESULTS: The surgical group's overall mean herniated disc area was 219.6 square millimeter (mm(2)), 179.8 at L4-5, and 267.4 at L5-S1. The nonoperative group's overall mean herniated disc area was 178.4 mm(2), 135.1 at L2-3, 160.3 at L4-5, and 207.4 at L5-S1. The surgical group's overall mean canal cross-sectional area was 471.8 mm(2), 418.6 at L4-5, and 535.6 at L5-S1. The nonoperative group's overall mean canal cross-sectional area was 541.3 mm(2), 518.1 at L2-3, 446.8 at L4-5, and 669.9 at L5-S1. The overall percent canal compromise ratio in the surgery group was 46.7%, 44.1% at L4-5, and 49.8% at L5-S1. The overall percent canal compromise in the nonoperative group was 34.2%, 34.1% at L2-3, 36.1% at L4-5, and 31.8% at L5-S1. The percent canal compromise in central herniations at L4-5 level was 53.0% in the surgical group, and 32.8% in the nonoperative group; at the L5-S1 level surgical group percent canal compromise was 64.1% and in the nonoperative group canal compromise was 27%. L4-L5 level paracentral herniations canal compromise was 36.7% in the surgical group compared with 42.5% canal compromise in the nonoperative group. At the L5-S1 level the canal compromise was 45% in the surgical group and 34.8% in the nonoperative group. CONCLUSIONS: Our findings show a trend for patients treated with surgery to have larger disc herniation areas and smaller canal cross-section areas, corresponding to larger percent canal compromise than the nonoperative group. Centrally located herniations followed this trend closely at all levels studied. However, the paracentral herniation at the L4-5 level does not follow this trend, possibly because paracentral disc herniation clinical course is determined more by herniation location rather than the overall herniation size.

Adult↗
PubMed2000

The influence of human intervertebral disc tissue on the metabolism of osteoblast-like cells.

Extensive studies have been performed to evaluate different factors that may affect on spinal interbody fusion, but the role of intervertebral disc tissue in the fusion process remains unclear. To study the influence of intervertebral disc tissue on osteoblast metabolism, we harvested disc tissue from patients who had undergone spinal surgery. The nucleus pulposus and annulus fibrosus were separately co-cultured with osteoblast-like cells SaOS-2 by means of culture inserts or organ culture. We assayed alkaline phosphoatase activity, 3H-thymidine incorporation into the DNA, and production of collagen type I, IL-1beta, IL-6, IL-10, and TNF-alpha. Exposure of the nucleus pulposus (NP) to osteoblast-like cells revealed stimulation of alkaline phosphatase production, 3H-thymidine incorporation and collagen type I production. Exposure of the annulus fibrosus (AF) stimulated 3H-thymidine incorporation and collagen type I production, but did not affect ALP activity. IL-6 was detected after application of NP and AF. Interleukin IL-10, IL-1beta and TNF-alpha were all below detection levels after application of disc tissue. Our findings show that frozen disc tissue stimulates the metabolism of osteoblast-like cells in vitro.

Adolescent↗
PubMed1992

MRI and discography of annular tears and intervertebral disc degeneration. A prospective clinical comparison.

We attempted to correlate the findings of MRI and discography in patients with low back pain, examining 108 lumbar intervertebral discs in 33 consecutive patients. MRI results were assessed from the intensity and shape of the signal obtained from the central part of the disc. Discography was classified according to the pattern of contrast material, the pressure accepted and the pain reproduced. All discs which were abnormal on MRI had altered patterns on discography, but 18 of the 60 discs with normal MRI had abnormal discograms. Of 39 asymptomatic discs, 33 had normal MRI signals and 24 had normal discograms. None of the 15 discs showing severe degeneration on MRI sustained high levels of intradiscal pressure, but only six of the 60 discs giving normal MRI had low pressure. With current techniques, discography is more accurate than MRI for the detection of annular pathology: a normal MRI does not exclude significant changes in the peripheral structure of the intervertebral disc which can produce low back pain.

Adult↗
PubMed1997

Facet joint asymmetry as a radiologic feature of lumbar intervertebral disc herniation in children and adolescents.

STUDY DESIGN: This study compared the incidence of facet joint asymmetry between adult and juvenile patients with lumbar intervertebral disc herniation. OBJECTIVES: To determine the different distribution of the facet joint asymmetry between the adult and juvenile patients. SUMMARY OF BACKGROUND DATA: As early as 1967, it was suggested that asymmetry of the facet joints is correlated with the development of disc herniation. There have been numerous arguments for and against Farfan's hypothesis, however, most studies were carried out on adult patients, and this hypothesis has not been verified in juvenile patients. METHODS: The study group consisted of 29 levels of 25 patients aged 12-20 years (juvenile group) and 50 levels of 33 patients aged 30-49 years (adult group) who underwent posterior discectomy. The shape of facet joints, the facet joint angle, and the moment arm angle and length were measured for each facet joint using computed tomography. Facet joint asymmetry was defined as the difference in facet joint shape or a difference of more than 10 degrees in facet joint angles between the right and left sides. The incidence of facet joint asymmetry and the relationships among the facet joint asymmetry and the location, type of disc herniation, and disc degeneration were examined in juvenile and adult groups. RESULTS: The overall incidence of facet joint asymmetry was significantly higher in the juvenile group (12 levels, 41%) than in the adult group (four levels, 8%; P < 0.01). There were no significant relationships among the facet joint asymmetry, the location, type of disc herniation, and disc degeneration. CONCLUSIONS: This study revealed that the frequency of facet joint asymmetry in the juvenile group was five times higher than that in the adult group. This result indicates that facet joint asymmetry is a radiologic feature of lumbar intervertebral disc herniation in children and adolescents.

Adolescent↗
PubMed1994

Effects of axial traction stress on solute transport and proteoglycan synthesis in the porcine intervertebral disc in vitro.

The effects of axial traction stress on intradiscal hydration, solute transport and proteoglycan synthesis were examined in 658 porcine coccygeal intervertebral discs in vitro. Measurements were performed in three tissue fractions: nucleus pulposus, inner and outer annulus fibrosus. At 0.80 MPa traction stress, the equilibrium hydration did not change in the nucleus pulposus. However, in the inner and outer annulus, the equilibrium hydration was reduced, and the change led to an increase of the effective fixed charge density. Diffusion of solute to the nucleus pulposus was significantly suppressed at 0.80 MPa traction stress. The fluid flow of the intervertebral disc tended to be suppressed during the creep recovery process after compression. The proteoglycan synthesis rate in the outer annulus was markedly suppressed by traction stress of 0.80 MPa for 4 h, but not that in the nucleus pulposus. These results suggest that a prolonged excessive axial traction stress induces a decrease in tissue hydration in the annulus fibrosus, and this may lead to an increase in the fractional volume of solid in the matrix and tissue osmotic pressure, resulting in diffusion inhibition of solute and suppression of proteoglycan synthesis. Thus, prolonged and excessive spinal traction may accelerate disc degeneration.

Animals↗
PubMed1997

Biomechanics of load-bearing of the intervertebral disc: an experimental and finite element model.

This paper presents an experimental and finite element study of the biomechanical response of the intervertebral disc to static-axial loading in which classical consolidation theory was used to analyse its time-dependent response. A newly developed experimental technique was employed to load the disc in compression and measure simultaneously the matrix internal pressure and creep strain for the full consolidation process. It is shown that, upon loading, the disc develops a maximum hydrostatic excess pore pressure which gradually decays as water is exuded from the matrix. During this decay process, the applied load is progressively transferred to the solid components of the matrix until the load is borne in full by the solid at the end of consolidation. Material properties for the tissue were then obtained from the experimental stress-strain data and used in the finite element study in the development of a finite element solution based on Biot's theory of coupled solid-fluid interaction. An axisymmetric formulation was employed and the disc modelled as an anisotropic, non-linear poroelastic solid. A sensitivity analysis of the material properties for the structural components of the disc was carried out and the biomechanical response to compressive loading evaluated and compared to experimental data. The results show that the matrix permeability plays a significant role in determining the transient response of the tissue. Annular disruptions of the disc were shown to result in an increase in the nuclear principal stresses suggesting that disrupted regions of the annulus fibrosus play a reduced role in load bearing.

Animals↗
PubMed1991

Electrochemical method for direct measurement of oxygen concentration and diffusivity in the intervertebral disc: electrochemical characterization and tissue-sensor interactions.

A method was developed for the in vivo measurement of oxygen concentration and diffusivity in the intervertebral disc using a bare gold cathode. The effects of surface adsorption were quantified using electrochemical methods and it was demonstrated that valid data can be obtained despite interactions between the electrode and the macromolecules of the intervertebral disc. The technique is used to show the dependence of the oxygen transport properties on tissue water content.

Adsorption↗
PubMed2002

High-frequency ultrasound imaging of the intervertebral disc.

In vitro investigation of the detailed structure of the intervertebral disc has been reliant upon microdissection and histological techniques. However, these techniques are laborious and destructive; the latter aspect is important because it precludes repetitive testing of the disc during in vitro experimentation. The aim of the present study was to investigate the potential of using scanning acoustic microscopy (SAM) to image the detailed structure of the intact disc. A mechanically scanned 46-MHz transducer operating in pulse-echo mode was used to obtain images of porcine coccygeal and lumbar discs; scanned regions-of-interest (ROIs) were marked using permanent dye and small surface cuts, respectively. SAM images were compared with corresponding images obtained using conventional histological techniques. The annulus fibrosus was characterised by alternate light and dark bands; the former represent the boundary between adjacent lamellae. Lamellar discontinuities and pathologic abnormalities were observed in specimens. SAM is a novel, nondestructive method for detailed visualisation of the internal structure of the disc in vitro.

Acoustics↗
PubMed1996

Histology and histochemistry of intervertebral discs of rats participated in spaceflight.

The qualitative and quantitative histological and histochemical changes in the structure and macromolecular composition of lumbar intervertebral discs of rat during a 12.5-day space flight (Cosmos 1887 biosatellite) were determined using light and polarization microscopy. Semiquantitative histochemical, topo-optical reactions were measured and evaluated by retardation values of birefringence. (a) Lateral expansion and accumulation of the notochordal cells in the nucleus pulposus was observed in contrast with the vivarium control, where the chondroid cells dominated. (b) The cartilage and plate showed a swelling, which consisted mainly of hypertrophied cells sometimes with mild extracellular mineralization. (c) In the external zone of annulus fibrosus and cartilage end plate a mild decrease of orientation of collagen fibers was found. (d) A significant increase of orientation of hyase sensible glycosaminoglycans in the internal zone of annulus fibrosus and nucleus pulposus was observed. (e) In the external and internal zones of annulus fibrosus an increase of orientation of glycoproteids was revealed. The alterations of macromolecular components of intervertebral discs, cartilage end plates, and the osteoporotic changes of the lumbar vertebral bodies producing the looser structure of vertebral column after 12.5 day space flight suggest the necessity of the common evaluation of these structures, and may explain the heavy spinal pains of astronauts.

Animals↗
PubMed2002

Expression and localization of estrogen receptor-beta in annulus cells of the human intervertebral disc and the mitogenic effect of 17-beta-estradiol in vitro.

BACKGROUND: Recent evidence suggests that estrogens exert effects in different tissues throughout the body, and that the estrogen receptor beta (ERbeta) may be important for the action of estrogen (17-beta-estradiol) on the skeleton. The cellular localization of ERbeta in the human intervertebral disc, however, has not yet been explored. METHODS: Human disc tissue and cultured human disc cells were used for immunocytochemical localization of ERbeta. mRNA was isolated from cultured human disc cells, and RT-PCR amplification of ERbeta was employed to document molecular expression of this receptor. Cultured human disc cells were tested to determine if 17-beta-estradiol stimulated cell proliferation. RESULTS: In this report data are presented which provide evidence for ERbeta gene expression in human intervertebral disc cells in vivo and in vitro. Culture of annulus cells in the presence of 10-7 M 17-beta-estradiol significantly increased cell proliferation. CONCLUSIONS: These data provide new insight into the biology of cells in the annulus of the intervertebral disc.

Journal Article↗
PubMed1979

[Clinical evaluation on patients with lumbar intervertebral disc hernia treated in our clinic (author's transl)].

A few reports are available on the results of conservative therapy of lumbar intervertebral disc hernia. In our Department, conservative therapy of 3 month course is carried out under a determined guideline. The cure rate obtained from this conservative therapy is 83.1% so far as the results reviewed by us concern. In order to determine the indication of nucleous pulposus resection, the remote results have been traced on patients in whom the myelography, which had been performed for the purpose of operation, gave positive findings but operation was not carried out. It was found that in all cases ADL and employment were disturbed. In the group of patients, where resection of nuclear pulposus were carried out by the same surgeon by osteoplastic partial leminectomy, the results were found to be excellent in 72.1% and good in 21.2% of all cases. When excellent and good results are combined, the positive effects have been obtained in as many as 93.3%, indicating an extremely favourable results. In 6.7% of the cases, ADL and employment were restricted, with persistent complaints and clinical symptoms. In none of the cases aggravation through operation was noted. As described above, in patients with lumbar intervertebral disc hernia, better results of operation can be expected if resections of nucleus pulposus are carried out only on patients selected strictly after a careful conservative therapy, with a broad field through osteoplastic partial laminectomy by a skilled surgeon, minimizing the difference in technique.

Activities of Daily Living↗