scholarly journals Inflammatory, Structural, and Pain Biochemical Biomarkers May Reflect Radiographic Disc Space Narrowing: The Johnston County Osteoarthritis Project

2019 ◽  
Vol 38 (5) ◽  
pp. 1027-1037 ◽  
Author(s):  
Adam P. Goode ◽  
Todd A. Schwartz ◽  
Virginia B. Kraus ◽  
Janet L. Huebner ◽  
Steven Z. George ◽  
...  
2011 ◽  
Vol 16 (2) ◽  
pp. 8-9
Author(s):  
Marjorie Eskay-Auerbach

Abstract The incidence of cervical and lumbar fusion surgery has increased in the past twenty years, and during follow-up some of these patients develop changes at the adjacent segment. Recognizing that adjacent segment degeneration and disease may occur in the future does not alter the rating for a cervical or lumbar fusion at the time the patient's condition is determined to be at maximum medical improvement (MMI). The term adjacent segment degeneration refers to the presence of radiographic findings of degenerative disc disease, including disc space narrowing, instability, and so on at the motion segment above or below a cervical or lumbar fusion. Adjacent segment disease refers to the development of new clinical symptoms that correspond to these changes on imaging. The biomechanics of adjacent segment degeneration have been studied, and, although the exact mechanism is uncertain, genetics may play a role. Findings associated with adjacent segment degeneration include degeneration of the facet joints with hypertrophy and thickening of the ligamentum flavum, disc space collapse, and translation—but the clinical significance of these radiographic degenerative changes remains unclear, particularly in light of the known presence of abnormal findings in asymptomatic patients. Evaluators should not rate an individual in anticipation of the development of changes at the level above a fusion, although such a development is a recognized possibility.


Rheumatology ◽  
2020 ◽  
Author(s):  
Anaïs Guiot ◽  
Charline Estublier ◽  
Marine Gaude ◽  
Pawel Szulc ◽  
Roland Chapurlat

Abstract Objective To analyse the risk of incident vertebral and non-vertebral fracture in men with DISH. Methods In 782 men ages 50–85 years, DISH was diagnosed using Resnick’s criteria. In men followed prospectively for 7.5 years, a radiographic incident vertebral fracture was defined by a decrease of ≥20% or ≥4mm in any vertebral height vs baseline. Self-reported incident non-vertebral fractures were confirmed by medical records. Results Men with DISH had higher BMD at the lumbar spine (P < 0.05), but not at other skeletal sites. After adjustment for confounders including disc space narrowing (DSN) and endplate irregularity, the risk of vertebral fracture was higher in men with DISH vs men without DISH [10/164 (6.1%) vs 16/597 (2.7%), P < 0.05; odds ratio (OR) 2.89 (95% CI 1.15, 7.28), P < 0.05]. DISH and low spine BMD were each associated with a higher vertebral fracture risk. The vertebral fracture risk was higher in men who had both DISH and severe DSN. DISH and endplate irregularities (EIs) were each associated with higher vertebral fracture risk. DISH, DSN and EIs define the intervertebral space dysfunction, which was associated with higher vertebral fracture risk [OR 3.99 (95% CI 1.45, 10.98), P < 0.01]. Intervertebral space dysfunction improved the vertebral fracture prediction (ΔAUC = +0.111, P < 0.05), mainly in men with higher spine BMD (>0.9 g/cm2; ΔAUC = +0.189, P < 0.001). DISH was not associated with the risk of non-vertebral fracture. Conclusion DISH is associated with higher vertebral fracture risk, independently of other risk factors. Assessment of the intervertebral space dysfunction components may improve the vertebral fracture prediction in older men.


2004 ◽  
Vol 28 (1-2) ◽  
pp. 39-50 ◽  
Author(s):  
Pavan Chamarthy ◽  
R.Joe Stanley ◽  
Gregory Cizek ◽  
Rodney Long ◽  
Sameer Antani ◽  
...  

2012 ◽  
Vol 72 (7) ◽  
pp. 1141-1148 ◽  
Author(s):  
Frances M K Williams ◽  
Aruna T Bansal ◽  
Joyce B van Meurs ◽  
Jordana T Bell ◽  
Ingrid Meulenbelt ◽  
...  

ObjectiveLumbar disc degeneration (LDD) is an important cause of low back pain, which is a common and costly problem. LDD is characterised by disc space narrowing and osteophyte growth at the circumference of the disc. To date, the agnostic search of the genome by genome-wide association (GWA) to identify common variants associated with LDD has not been fruitful. This study is the first GWA meta-analysis of LDD.MethodsWe have developed a continuous trait based on disc space narrowing and osteophytes growth which is measurable on all forms of imaging (plain radiograph, CT scan and MRI) and performed a meta-analysis of five cohorts of Northern European extraction each having GWA data imputed to HapMap V.2.ResultsThis study of 4600 individuals identified four single nucleotide polymorphisms with p<5×10−8, the threshold set for genome-wide significance. We identified a variant in the PARK2 gene (p=2.8×10−8) associated with LDD. Differential methylation at one CpG island of the PARK2 promoter was observed in a small subset of subjects (β=8.74×10−4, p=0.006).ConclusionsLDD accounts for a considerable proportion of low back pain and the pathogenesis of LDD is poorly understood. This work provides evidence of association of the PARK2 gene and suggests that methylation of the PARK2 promoter may influence degeneration of the intervertebral disc. This gene has not previously been considered a candidate in LDD and further functional work is needed on this hitherto unsuspected pathway.


2008 ◽  
Vol 67 (10) ◽  
pp. 1427-1430 ◽  
Author(s):  
T Neogi ◽  
M C Nevitt ◽  
K E Ensrud ◽  
D Bauer ◽  
D T Felson

2005 ◽  
Vol 5 (4) ◽  
pp. S12-S13
Author(s):  
Jiayong Liu ◽  
Nabil Ebraheim ◽  
Haitham Elsamaloty ◽  
Nakul Karkare ◽  
Richard Yeasting ◽  
...  

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 674-678 ◽  
Author(s):  
M. Fazl ◽  
J. LaFebvre ◽  
R. A. Willinsky ◽  
S. Gertzbein

Abstract Three patients with hyperflexion sprain of the cervical spine secondary to motor vehicle accidents are discussed. One patient exhibited tetraplegia and the other two only had paresthesia of the upper and/or lower extremities at the scene of the accident. All patients were young with no evidence of degenerative disc disease or osteoarthritis. Diagnosis of hyperflexion sprain is suggested by transient or persistent neurological deficits, local tenderness, or plain film findings, which include interspinous fanning, localized kyphotic angulation, subluxation, or disc space narrowing. Review of our patients' records revealed that some of these findings were evident at their initial presentation. In patients who have no neurological deficits, controlled flexion and extension views after routine plain films may be diagnostic of an unstable cervical spine. If there is a persistent neurological deficit, a magnetic resonance imaging scan is the examination of choice. If there is no compression of the thecal sac or spinal cord, supervised flexion and extension views of cervical spine should be done. Definitive management of the unstable spine is operative fixation.


Sign in / Sign up

Export Citation Format

Share Document