Intervertebral Disc Residual and Equilibrium Viscoelastic Parameters Specific to Location and Degeneration Severity

2010 ◽  
Author(s):  
A. M. Ellingson ◽  
D. J. Nuckley
Keyword(s):  
Residual Stress ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Low Back ◽  
Viscoelastic Parameters ◽  
Viscoelastic Modeling ◽  
Insight Into

Chronic low back pain affects an estimated 15–65% of the U.S. population. Disc degeneration is often accredited as the origin of low back pain. With degeneration comes the breakdown of proteoglycans, loss of water content, and a decrease in the height of the intervertebral disc (IVD). These changes likely affect the disc’s viscoelastic response, making modeling and subsequent prediction of degeneration mechanics difficult. Unfortunately, much of the previous mechanical testing of IVD tissues has involved excision of the tissue and disruption of annular fibers. To gain insight into the in situ viscoelastic material properties, we have developed a new methodology of hybrid confined / in situ compression. This technique also allows for the quantification of the residual stress and strain that the IVD experiences in vivo and improved viscoelastic modeling parameters. Residual measurements, to the knowledge of the authors, have yet to be reported in previous studies. Therefore, the purpose of this study was to define the viscoelastic properties of the intact intervertebral disc as well as the residual stress/strain specific to degeneration grade and location.

Quantification of In Vivo Deformation of Healthy Lumbar Intervertebral Discs in Flexion

2012 ◽  
Author(s):  
Tina M. Nagel ◽  
Victor H. Barocas ◽  
David J. Nuckley
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Annulus Fibrosus ◽  
Intervertebral Discs ◽  
Low Back ◽  
Ivd Degeneration ◽  
Level 2 ◽  
Walled Cylinder

Intervertebral disc (IVD) degeneration is hypothesized to be the precursor to non-specific low back pain, which is a widespread problem [1]. However, before disc degeneration can be understood, a better understanding of healthy discs must be gained. The disc is a short thick-walled cylinder with a gelatinous center, the nucleus pulposus, and a largely concentric, layered collagenous ring, the annulus fibrosus, Figure 1. The layers are referred to as lamella. The IVD is integral to the strength and flexibility of the spine. Whole disc mechanics have been widely studied, but degeneration occurs at the fiber level [2]. To understand the mechanics of degeneration, testing needs to be performed at a finer level where degenerative / injury effects occur. These effects such as tears occur in the annular lamella.

scholarly journals Cognitive–Evaluative Dimension of Pain in Neuropathic Pain Relapse in Sciatica: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 658
Author(s):  
Tsubasa Kawasaki ◽  
Takuya Yada ◽  
Masahiro Ohira
Keyword(s):  
Neuropathic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Acute Phase ◽  
Low Back ◽  
Evaluative Dimension ◽  
Long Duration ◽  
Improvement Process ◽  
Insight Into

The cognitive–evaluative (C–E) dimension of pain is commonly observed in patients with a relatively long duration of pain. However, little is known about the effects of pain relapse on the C–E dimension of pain. Moreover, the improvement process of the C–E dimension of pain following treatment is unknown. The objective of this case report was to (a) demonstrate that the C–E dimension was affected in the acute phase of neuropathic pain in cases of pain relapse, and (b) demonstrate the improvement process of the C–E dimension of pain. A woman was diagnosed with low back pain (LBP) and sciatica. The patient had previously experienced symptoms of LBP and sciatica; thus, this episode was a case of pain relapse. At the beginning of rehabilitation, the C–E dimension of pain was present in addition to the sensory–discriminative (S–D) dimension of pain. It was observed that improvement of the C–E dimension of pain was delayed in comparison with that of the S–D dimension of pain. The C–E dimension of pain was observed with pain relapse even though it was in the acute phase of pain. This case provides a novel insight into the C–E dimension of pain. Moreover, the delay in improving the C–E dimension of pain indicates a difference in the improvement process for each pain dimension.

scholarly journals Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis

2021 ◽  
Vol 13 ◽  
pp. 1759720X2110280
Author(s):  
Camille Daste ◽  
Stéphanie Laclau ◽  
Margaux Boisson ◽  
François Segretin ◽  
Antoine Feydy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Activity Limitations ◽  
Low Back ◽  
Short Term

Objectives: We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP). Methods: We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months). Results: Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91). Conclusion: GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies. Registration PROSPERO: CRD42019106336.

scholarly journals Author response: Senotherapeutic drugs for human intervertebral disc degeneration and low back pain

2020 ◽  
Author(s):  
Hosni Cherif ◽  
Daniel G Bisson ◽  
Matthew Mannarino ◽  
Oded Rabau ◽  
Jean A Ouellet ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Author Response ◽  
Low Back

scholarly journals Reactive Oxygen Species Mediate Low Back Pain by Upregulating Substance P in Intervertebral Disc Degeneration

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Jiancheng Zheng ◽  
Jian Zhang ◽  
Xingkai Zhang ◽  
Zhiping Guo ◽  
Wenjian Wu ◽  
...  
Keyword(s):  
Reactive Oxygen Species ◽  
Low Back Pain ◽  
Back Pain ◽  
Substance P ◽  
Intervertebral Disc ◽  
Reactive Oxygen ◽  
Alternative Methods ◽  
Low Back ◽  
Oxygen Species ◽  
Ivd Degeneration

Reactive oxygen species (ROS) are thought to have a strong correlation with a number of intervertebral disc (IVD) diseases. Here, we aimed to determine whether ROS represent an etiology of low back pain (LBP) during IVD degeneration. Thirty degenerated intervertebral disc samples were obtained from patients, and ROS levels were quantified using dihydroethidium (DHE) staining. The results suggested a significant correlation between the ROS level and the severity of LBP. Subsequently, a puncture-induced LBP model was established in rats, and ROS levels significantly increased compared with those in the sham surgery group, accompanied with severe puncture-induced IVD degeneration. In addition, when ROS levels were increased by H2O2 administration or decreased by NAC treatment, the rats showed increased or decreased LBP, respectively. Based on this evidence, we further determined that stimulation with H2O2 in nucleus pulposus cells (NPCs) in vivo or in vitro resulted in upregulation of substance P (SP), a peptide thought to be involved in the synaptic transmission of pain, and that the severity of LBP decreased when SP levels were increased by exogenous SP administration or neutralized via aprepitant treatment in the IVDs of rats. In conclusion, ROS are primary inducers of LBP based on clinical and animal data, and the mechanism involves ROS stimulation of NPCs to secrete SP, which is a critical neurotransmitter peptide, to promote LBP in IVDs. Therefore, reducing the level of ROS with specific drugs and inhibiting SP may be alternative methods to treat LBP in the clinic.

scholarly journals Ectopic expression of Smurf2 and acceleration of age-related intervertebral disc degeneration in a mouse model

2017 ◽  
Vol 27 (1) ◽  
pp. 116-126 ◽  
Author(s):  
Qiuqian Wu ◽  
Jason H. Huang
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Transgenic Mice ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Ectopic Expression ◽  
Cell Phenotype ◽  
Low Back ◽  
Age Related

OBJECTIVELumbar intervertebral disc degeneration, an age-related process, is a major cause of low-back pain. Although low-back pain is a very common clinical problem in the aging population, no effective treatment is available, largely owing to lack of understanding of the molecular mechanisms underlying disc degeneration. The goal of this study was to characterize how ectopic expression of Smurf2 driven by the collagen Type II alpha 1 (Col2a1) promoter alters disc cell phenotype and associated cellular events, matrix synthesis, and gene expression during disc degeneration in mice.METHODSTo characterize how ectopic expression of Smurf2 in Col2a1-promoter working cells affects the disc degeneration process, the authors performed histological and immunohistochemical analysis of lumbar spine specimens harvested from wild-type (WT) and Col2a1-Smurf2 transgenic mice at various ages (n ≥ 6 in each age group). To elucidate the molecular mechanism underlying Smurf2-mediated disc degeneration, the authors isolated cells from WT and Col2a1-Smurf2 transgenic lumbar intervertebral discs and performed Western blot and real-time RT-PCR (reverse transcription polymerase chain reaction) to examine the protein and mRNA levels of interesting targets.RESULTSThe authors demonstrated that approximately 30% of WT mice at 10–12 months of age had started to show disc degeneration and that the disc degeneration process was accelerated by 3–6 months in Col2a1-Smurf2 transgenic mice. Chondrocyte-like cell proliferation, maturation, and fibrotic tissue formation in the inner annulus were often accompanied by fibroblast-to-chondrocyte differentiation in the outer annulus in transgenic discs. The chondrocyte-like cells in transgenic discs expressed higher levels of connective tissue growth factor (CTGF) than were expressed in WT counterparts.CONCLUSIONSThe findings that ectopic expression of Smurf2 driven by the Col2a1 promoter accelerated disc degeneration in Col2a1-Smurf2 transgenic mice, and that higher levels of CTGF protein and mRNA were present in Col2a1-Smurf2 transgenic discs, indicate that Smurf2 accelerates disc degeneration via upregulation of CTGF.

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