PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Intervertebral Disc”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed2004

Localization of degradative enzymes and their inhibitors in the degenerate human intervertebral disc.

The histological and biochemical changes that occur in the extracellular matrix of the intervertebral disc (IVD) during ageing and degeneration have been investigated extensively. However, the mechanisms behind these changes are not fully understood. A number of studies have suggested the involvement of matrix metalloproteinases (MMPs) and ADAMTS in IVD degeneration, but few have localized the site of production of these enzymes to the cells of the degenerate disc. This study uses immunohistochemical techniques to localize and quantify the production of degrading enzymes (MMPs 1, 3, and 13, and ADAMTS 4) and their inhibitors (TIMPS 1, 2, and 3) within non-degenerate and degenerate discs of varying severity of degeneration. In all discs investigated, the cells that produced the enzymes and their inhibitors were the chondrocyte-like cells of the nucleus pulposus and inner annulus fibrosus (AF), with little immunopositivity in the outer AF. Non-degenerate discs showed low numbers of cells expressing the degradative enzymes MMP 1 and ADAMTS 4, suggesting a role for these enzymes in normal homeostasis. No MMP 3 or MMP 13 immunopositivity was observed in non-degenerate discs. In degenerate discs, the number of cells immunopositive for MMPs 1, 3, 13 and ADAMTS 4 increased with the severity of degeneration. This increase in degrading enzymes was also accompanied by increases in the number of cells immunopositive for TIMPs 1 and 2 but not TIMP 3. This study highlights that although the expression of a number of MMPs increases with degeneration, this is accompanied by an increase in their inhibitors. However, the increase in the number of cells immunoreactive for ADAMTS 4 with increasing degeneration was not paralleled by a rise in its inhibitor TIMP 3. This finding indicates that the aggrecanases, rather then the MMPs, are a possible therapeutic target for the inhibition of disc degeneration.

ADAM Proteins↗
PubMed1992

Is tomography of intervertebral disc calcification useful in children?

In the past ten years, we have found cervical intervertebral disc calcifications in three children on plain films of the cervical spine made because of cervical pain. In each case, we required further radiological investigations, antero-posterior and lateral linear tomography for two children and an axial computed tomography for one child. In each case, tomography revealed no supplementary useful information. On retrospect, we think that these examinations caused unnecessary irradiation and that they should only be carried out in the rare circumstances when disc calcification is associated with neurological symptoms.

Adolescent↗
PubMed2000

Intervertebral disc structure: observation by a novel use of ultrasound imaging.

The internal structure of intervertebral discs is clinically important in the management of back pain. No current routine imaging modality is able to image disc structure satisfactorily. The aim of this work was to investigate and validate ultrasound imaging so that it might be applied to assessment of structural integrity and degree of degeneration. The optimum imaging technique was determined using a 3.5 MHz probe in one female subject. The applicability of this technique to investigate disc structure in the entire thoracolumbar spine was further investigated in 13 subjects. The optimum disc imaging technique was found to be a posterolateral approach, 1 to 2 cm lateral of the dorsal midline, that revealed structure within the disc not apparent using other approaches. It was demonstrated that posterolateral imaging introduces a smaller reproducibility error in measurements of linear dimensions close to the disc. It is possible to observe internal structure within the disc between T11 and L3 in at least 54% of individuals.

Adolescent↗
PubMed2001

Application of short-time magnetic resonance examination for intervertebral disc diseases in dogs.

The usefulness of magnetic resonance (MR) is already established, but it has a disadvantage of requiring a long scanning time. A short-time examination is more or less needed so as to be more practical in veterinary clinics. A protocol of the short-time MR examination was devised based on parameters determined, and validity of the protocol was assessed through the diagnosis of clinical cases with intervertebral disc diseases. With this protocol, it was possible to complete an MR examination for the spine within 15 min. The MR images and myelographic findings were correlated well in this study, suggesting the short-time protocol of MR examination can be used in the clinical diagnosis of spinal diseases.

Animals↗
PubMed1988

Swelling pressure of the lumbar intervertebral discs: influence of age, spinal level, composition, and degeneration.

The fluid content of the intervertebral disc is important in determining its mechanical response and also its transport and biologic properties. Fluid content depends on the proteoglycan content of the tissue and on the relationship of the external load to the disc's swelling pressure. The influence of proteoglycan content and external load on the hydration of nuclei from 32 human lumbar discs was measured. Swelling pressure of the same specimens was measured by equilibrium dialysis. The influence of age (14-91 years) and spinal level was noted. Proteoglycan content of the discs fell with age, and for all spines tested, proteoglycan content was lowest in the L5-S1 disc; no systematic change in collagen content was found. The hydration of the discs, as received, also fell with increase in age; in each complete lumbar spine tested, the L1-L2 and the L5-S1 discs had the lowest hydration at postmortem examination. As the stress applied to the discs was increased, hydration decreased. Although a stress of 0.10-0.23 MPa maintained the disc slices at their postmortem hydration, under a stress of about 0.6-0.8 MPa, most discs lost 40-60% of their initial fluid. The relationship between change in hydration and swelling pressure was found to depend on the composition of the disc rather than on age or degree of degeneration; the relationship between equilibrium hydration and swelling pressure could be predicted satisfactorily for a disc of known collagen and proteoglycan content.

Adolescent↗
PubMed1975

Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc.

In a case-control study of the epidemiology of acute herniated lumbar intervertebral disc in the New Haven, Connecticut, area, it was found that driving of motor vehicles was associated with an increased risk for developing this disease. It was estimated that men who spend half or more of their time on their job driving a motor vehicle are about three times as likely to develop an acute herniated lumbar disc as those who do not hold such jobs. Persons of either sex who said that they drove a car (either away from work or at work) were more likely to develop an acute herniated lumbar disc than those who did not drive at all. These associations between driving and acute herniated lumbar disc could not be attributed to any confounding variables considered in this study.

Acute Disease↗
PubMed1984

Excision of prolapse of thoracic intervertebral disc. A transthoracic technique.

A new technique for the transthoracic removal of a prolapsed intervertebral disc in the mid or lower thoracic spine is described. Investigations before operation include thoracic myelography, selective spinal angiography and CT scanning. Image intensification is used at operation to check the level of the prolapse. A tunnel in the coronal plane (vertebrotomy) is made through the posterolateral part of the disc and the adjacent vertebral bodies, to reach the spinal canal at the site of the prolapse. This gives good exposure and enables gentle removal of the disc prolapse and any associated osteophytes, under direct vision without need for retraction or pressure on the dura or spinal cord. Spinal stability is not compromised, and the blood supply of the cord is not disturbed. Five consecutive patients are reported, including one in whom the disc prolapse was calcified and had herniated into the spinal cord. All were treated successfully.

Adult↗
PubMed2000

Anti-apoptotic effects of IGF-1 and PDGF on human intervertebral disc cells in vitro.

STUDY DESIGN: Human cells from the anulus were grown in tissue culture in an experimental design to study the anti-apoptotic effect of two selected cytokines. OBJECTIVES: To determine whether two selected cytokines, insulin-like growth factor-1 and platelet-derived growth factor, were effective in decreasing apoptosis in human cells from the anulus grown in culture for 10 days. SUMMARY OF THE BACKGROUND DATA: Previous studies have shown that there is a small cell population in the aging human intervertebral disc. Earlier work from the authors' laboratory suggested that apoptosis (programmed cell death) may be a major contributing factor to the decrease in cell number. A wide variety of inhibitors of apoptosis have now been identified; the present report presents findings on the actions of insulin-like growth factor-1 and platelet-derived growth factor in retarding or preventing apoptosis. METHODS: Using previously published culture methods, cells from the anulus of 25 subjects (mean age, 41.7 years) were grown in monolayer culture for 10 days and tested under the following conditions: 1) control growth in the presence of 20% fetal bovine serum; 2) positive control conditions promoting the development of apoptosis in the absence of serum; or 3) in dose-response regimes where insulin-like growth factor-1 or platelet-derived growth factor were added in the presence of only 1% fetal bovine serum (necessary for basal cell maintenance). Specimens were derived from 18 lumbar, 9 cervical, and 1 thoracic sites; the average Thompson score was III. Cells were grown on chambered slides and evaluated in situ using the TdT in situ apoptosis detection reaction to identify apoptotic cells. An average of 300 cells were counted in replicate cultures at each dose to determine the incidence of apoptosis; results were analyzed with standard statistical techniques. Cultured cells also were examined with transmission electron microscopy. RESULTS: Serum withdrawal to a 1% level was used as a positive apoptosis control in vitro and resulted in a significantly greater percentage of apoptosis compared with the 20% serum negative control (1.02% +/- 0.34 (28) versus 0.14% +/- 0. 04 (27; mean +/- SEM (n)), P < 0.0001). Exposure to 50 ng/mL insulin-like growth factor-1 significantly reduced the percentage of apoptosis (vs.- 1% serum) to 0.49% +/- 0.26 (P = 0.005); 500 ng/mL was also significantly effective (% apoptosis = 0.09% +/- 0.04 (P = 0.0001). Platelet-derived growth factor at a dose of 100 ng/mL also significantly reduced apoptosis (0.18 +/- 0.11, P = 0.0001). CONCLUSIONS: Data demonstrate a significant reduction in the percentage of apoptotic disc cells after exposure to 50-500 ng/mL insulin-like growth factor-1 or exposure to 100 ng/mL platelet-derived growth factor. These findings expand the understanding of the cell biology of the disc cell and show that selected cytokines can retard or prevent programmed cell death in vitro. The administration of these cytokines may have future therapeutic potential in the treatment of disc degeneration.

Adolescent↗
PubMed1987

Prolapsed intervertebral disc at the upper lumbar level. Diagnostic difficulties. A report on 12 cases.

Prolapsed intervertebral disc at the upper lumbar level causes problems in diagnosis. Compressive root syndromes at L1-L2-L3 present clinical features which are not very specific. They are frequently pluriradicular and may be referred to areas of atypical distribution. The anatomical features and the relationship between discs and nerve roots and any variations are illustrated. Based on our personal experience with 12 cases of herniation of the first two lumbar discs, we would emphasize the importance of extending myelography and CT scanning to the high lumbar metameres whenever the symptomatology is equivocal. If such a policy were adopted, the incidence of prolapsed disc at the higher lumbar levels would probably be found to be higher than is at present supposed.

Adult↗
PubMed2002

Elastic tissues of the intervertebral disc.

Elastic fibres have been generally considered to play no significant role in the mechanical functioning of the intervertebral disc since earlier studies reported that the elastic fibre network was sparse and irregular. However, a recent study has reported that the network is highly organized and that the distribution and orientation of elastic fibres varies from region to region. In the annulus, elastic fibres appear densely distributed in the region between the lamellae and also in 'bridges' across the lamellae. They are also organized in the nucleus where long straight fibres are radially oriented and anchor perpendicularly or obliquely into the cartilaginous endplate. Immunohistochemistry using specific antibodies indicates that elastin is present in the network, as is fibrillin. Biochemical studies show, however, that the amino acid composition of the residue remaining after alkaline (NaOH) extraction or CNBr digestion contains a higher concentration of polar amino acids than ligamentum nuchal elastin. The composition of the residue suggests that disc elastin may cross-link strongly with some other matrix components. With such coupling, it is thought that elastic fibres could play a significant mechanical role even though overall elastin is less than 5% of the total dry weight of the disc.

Animals↗
PubMed2003

Cervical spine degenerative changes (narrowed intervertebral disc spaces and osteophytes) in coal miners.

A series of 685 x-ray films of the cervical spine obtained in coal miners was analyzed to explore the occurrence of narrowed disc spaces and osteophytes in this occupational group, and to examine the association of x-ray changes with age, duration of employment, and duration of occupational exposure to hand-arm vibration. All data were extracted from individual medical files of coal miners examined for suspected hand-arm vibration-related disorders in 1989-1999 at the Occupational Medicine Center in Katowice. The narrowed intervertebral disc spaces were found in 188 coal miners (26.9%) and osteophytes in 332 coal miners (47.5%). The occurrence of degenerative changes in coal miners was similar to that observed in a small group of 68 blue-collar workers (no exposure to hand-arm vibration) employed in the coal industry. Univariate comparisons showed that narrowed intervertebral disc spaces and osteophytes were more frequent among older subjects and among subjects with longer duration of employment. The prevalence of changes also showed some relationship with the number of years of exposure to hand-arm vibration. The results of logistic regression analysis confirmed statistically significant effect of age, but not of other factors included in the model. When both x-ray changes were grouped together (a combined dependent variable) age remained the only statistically significant explanatory variable. The findings do not support the view that the examined degenerative changes in the cervical spine are more prevalent in coal miners and depend on duration of physical work or local exposure to hand-arm vibration in this occupational group.

Adult↗
PubMed1992

Management of cervical spinal cord injury in ankylosing spondylitis: the intervertebral disc as a cause of cord compression.

Twenty-one patients with universal syndesmophytosis due to ankylosing spondylitis were identified in a consecutive series of 1578 patients with acute spine and spinal cord injuries. They were predominantly male, older than spinal cord-injured patients in general, and most were injured by falls. Approximately one-half were managed by halo-vest immobilization alone with good clinical and radiological outcomes. The remainder required surgery either for recurrent dislocation or for spinal cord compression associated with neurological deterioration. Extradural hematoma, a recognized cause of spinal cord compression in ankylosing spondylitis patients with spinal fractures, was encountered in two patients. Herniated intervertebral disc as a cause of spinal cord compression in ankylosing spondylitis does not appear to have been previously reported and was recognized three times in the present series, once in association with extradural hematoma. The pathology of ankylosing spondylitis is such that the nucleus pulposus tends to be spared, allowing disc herniation to occur in the heavily ossified spine. In virtually all patients, satisfactory correction of the flexion deformity could be safely accomplished following spinal fracture. It is concluded that fracture/dislocations of the cervical spine should be managed initially by halo-vest immobilization, without prior traction and with careful incremental correction of flexion deformity. Decompression is performed as required for extradural hematoma or intervertebral disc herniation, and internal fixation is carried out for recurrent dislocation.

Adult↗
PubMed2002

Ultrastructure of the human intervertebral disc during aging and degeneration: comparison of surgical and control specimens.

STUDY DESIGN: Human intervertebral disc tissue from the annulus was obtained in a prospective study investigating the ultrastructural features of disc cells and extracellular matrix. Experimental studies were approved by the authors' Human Subjects Institutional Review Board. Discs were obtained from surgical specimens and control donors. OBJECTIVE: To compare the cellular and extracellular matrix characteristics of the annulus from control and surgical disc specimens using electron microscopy and specialized fixation that visualizes proteoglycans. SUMMARY OF THE BACKGROUND DATA: The ultrastructural features of disc cells and the disc matrix have received little attention, as compared with the literature on age- and disease-related changes in bone and cartilage. METHODS: Ultrastructural studies investigated disc tissue obtained from control and surgical disc specimens using transmission electron microscopy. Specialized fixation with ruthenium red was used to highlight matrix proteoglycans. RESULTS: Cellular and extracellular matrix fine structure was assessed in disc specimens from 29 control donors (newborns to 79-year-olds) and surgical disc specimens from 49 patients (16- to 77-year-olds). Control and surgical tissue showed similar ultrastructural features. Unusual matrix surrounding and encircling single cells or clusters of cells was common (48% of control and 63% of surgical specimens) and often contained fibrous long-spacing collagen (41.3% of control and 36.7% of surgical specimens). Ruthenium red greatly aided visualization of proteoglycans pooled in lacunar spaces. Variable cross-sectional diameters of collagen fibrils was present in 34% of control and 59% of surgical specimens. Regions with sparse interterritorial matrix were common. Cell morphology showed both cells with apoptotic nuclei and synthetically active cells that appeared healthy. CONCLUSIONS: Control and surgical specimens of the annulus showed similar ultrastructural features. Heterogeneity of collagen fibril diameter is an important observation because it is believed that fibril size relates to biomechanical disc function. Fibrous long-spacing collagen may reflect extracellular matrix remodeling or the presence of previous fibril depolymerization followed by repolymerization and reassociation with proteoglycans. Synthetic activity of disc cells is reflected in active rough endoplasmic reticulum, Golgi, and pools of proteoglycans in lacunar spaces and unusual extracellular matrix components that encircle cells and cell clusters. Such components may influence biomechanical quality. Departures from normal extracellular matrix organization of the aging or degenerating disc undoubtedly contribute to decreased biomechanical function of the annulus because they disrupt the normal annulus architecture. This study underscores the need for a fuller understanding of the dynamic relation between disc cells and the surrounding extracellular matrix, which they continually produce and remodel.

Adolescent↗