scholarly journals The Expression of P16 and S100 Associated with Elastin Degradation and Fibrosis of the Ligamentum Flavum Hypertrophy

2019 ◽  
Author(s):  
Wei hu ◽  
Shunli Kan ◽  
Guang Liu ◽  
Zegang Cao ◽  
Rusen Zhu
Keyword(s):  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Positive Staining ◽  
Elastic Tissue ◽  
Elastin Degradation ◽  
Weighted Magnetic Resonance Imaging ◽  
Correlation Tests ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Abstract Background: One of the characteristics of lumbar spinal stenosis (LSS) is elastin degradation and fibrosis in the ligamentum flavum (LF). P16 and S100 participate in scar formation and collagen development in wound healing and fibrosis diseases. In this study, we investigate the association between P16 and S100 expression and the fibrosis of the hypertrophic LF in LSS. Methods: The LF specimens were surgically obtained from thirty patients with single-segment LSS (SLSS) and 30 patients with double-segment LSS (DLSS). 30 patients with L4/5 lumbar disc herniation were included as control. The LF thickness was measured by axial T1-weighted Magnetic Resonance Imaging(MRI). The extent of LF elastin degradation and fibrosis were graded based on hematoxylin-eosin (H&E) and Verhoff’s Van Gieson’s (VVG) stain, respectively. The localization of P16 and S100 within the LF tissue was determined by immunohistochemistry. Linear correlation tests between LF thickness, fibrosis, P16 and S100 expression was analyzed. Results: The Absolute and relative LF thickness were greater in the DLSS group compared with the SLSS and LDH groups (p < 0.05). The mean thickness in the DLSS group was 5.658mm (RT = 43.107), compared with 4.924 mm (RT=36.520) and 2.886 mm (RT=21.330), respectively in the SLSS and LDH groups. The amount of collagen deposition is significantly higher in the DLSS group compared with the SLSS and LDH groups (p < 0.05) as shown by the H&E staining. A higher level of elastic tissue was also seen in the DLSS group compared with the SLSS and LDH groups (p < 0.05) though VVG staining. There was a significant correlation between H&E mean rating and relative LF thickness in the DLSS group (r = 0.562; p = 0.010). The specimens in the DLSS group showed positive staining of P16. All the three groups were stained with S100 in the dorsal layer of the LF. Conclusions: Elastin degradation and fibrosis of the LF in the DLSS patients is more severe compared with the SLSS and LDH patients. The expression of P16 may related to LF hypertrophy in the patients who suffer with LSS. LF hypertrophy process may not be associated with S100.

scholarly journals The expression of P16 and S100 associated with elastin degradation and fibrosis of the Ligamentum Flavum hypertrophy

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Wei Hu ◽  
Shunli Kan ◽  
Guang Liu ◽  
Zegang Cao ◽  
Rusen Zhu
Keyword(s):  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Positive Staining ◽  
Elastic Tissue ◽  
Dorsal Aspect ◽  
Elastin Degradation ◽  
Almost All ◽  
Lumbar Spinal ◽  
Histologic Changes ◽  
Hematoxylin Eosin

Abstract Background One of the characteristics of lumbar spinal stenosis (LSS) is elastin degradation and fibrosis in the ligamentum flavum (LF). However, the biochemical factors that cause these histologic changes is unclear. P16 and S100 participate in scar formation and collagen development in wound healing and fibrosis diseases. In this study, we investigate the association between P16 and S100 expression and the fibrosis of the hypertrophic LF in LSS. Methods The LF specimens were surgically obtained from 30 patients with single-segment LSS (SLSS), 30 patients with double-segment LSS (DLSS) and 30 patients with L4/5 lumbar disc herniation (LDH). The LF thickness was measured by axial T1-weighted MRI. The extent of LF elastin degradation and fibrosis were graded based on hematoxylin-eosin (HE) and Verhoff’s Van Gieson’s (VVG) stain, respectively. The localization of P16 and S100 was determined by immunohistochemistry. Results The Absolute and relative LF thickness were greater in the DLSS group compared with the SLSS and LDH groups (p <  0.05). The elastic tissue from the dorsal aspect to the dural aspect in SLSS and DLSS groups was significantly increased. The amount of collagen deposition and elastic tissue is significantly higher in the DLSS group compared with the SLSS and LDH groups (p <  0.05). The specimens in the DLSS group showed positive staining of P16, especially in the dorsal layer. Almost all samples in the SLSS group were partially positive for P16. The LDH group showed negative staining of P16 in both the dural and dorsal layers. All the three groups were stained with S100 in the dorsal layer of the LF. On the contrary, S100 staining was absent in the dural layer of the LF in the three groups. Conclusions Elastin degradation and fibrosis of the LF in the DLSS patients is more severe compared with the SLSS and LDH patients. Increased expression of P16 associated with LF fibrosis and thickness, suggested that the expression of P16 may related to LF hypertrophy in the patients who suffer with LSS. LF hypertrophy process may not be associated with high expression of S100.

scholarly journals The Expression of P16 and S100 Associated with Elastin Degradation and Fibrosis of the Ligamentum Flavum Hypertrophy

2019 ◽  
Author(s):  
Wei hu(Former Corresponding Author) ◽  
Shunli Kan ◽  
Guang Liu ◽  
Zegang Cao ◽  
Rusen Zhu(New Corresponding Author)
Keyword(s):  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Positive Staining ◽  
Elastic Tissue ◽  
Dorsal Aspect ◽  
Elastin Degradation ◽  
Almost All ◽  
Lumbar Spinal ◽  
Histologic Changes ◽  
Hematoxylin Eosin

Abstract Background: One of the characteristics of lumbar spinal stenosis (LSS) is elastin degradation and fibrosis in the ligamentum flavum (LF). However, the biochemical factors that cause these histologic changes is unclear. P16 and S100 participate in scar formation and collagen development in wound healing and fibrosis diseases. In this study, we investigate the association between P16 and S100 expression and the fibrosis of the hypertrophic LF in LSS. Methods: The LF specimens were surgically obtained from thirty patients with single-segment LSS (SLSS), 30 patients with double-segment LSS (DLSS) and 30 patients with L4/5 lumbar disc herniation (LDH). The LF thickness was measured by axial T1-weighted MRI. The extent of LF elastin degradation and fibrosis were graded based on hematoxylin-eosin (HE) and Verhoff’s Van Gieson’s (VVG) stain, respectively. The localization of P16 and S100 was determined by immunohistochemistry. Results: The Absolute and relative LF thickness were greater in the DLSS group compared with the SLSS and LDH groups (p < 0.05). The elastic tissue from the dorsal aspect to the dural aspect in SLSS and DLSS groups was significantly increased. The amount of collagen deposition and elastic tissue is significantly higher in the DLSS group compared with the SLSS and LDH groups (p < 0.05). The specimens in the DLSS group showed positive staining of P16, especially in the dorsal layer. Almost all samples in the SLSS group were partially positive for P16. The LDH group showed negative staining of P16 in both the dural and dorsal layers. All the three groups were stained with S100 in the dorsal layer of the LF. On the contrary, S100 staining was absent in the dural layer of the LF in the three groups. Conclusions : Elastin degradation and fibrosis of the LF in the DLSS patients is more severe compared with the SLSS and LDH patients. Increased expression of P16 associated with LF fibrosis and thickness, suggested that the expression of P16 may related to LF hypertrophy in the patients who suffer with LSS. LF hypertrophy process may not be associated with high expression of S100.

scholarly journals The correlation between imaging expression of P16 and S100 in hypertrophic ligamentum flavum

2020 ◽  
Author(s):  
Wei Hu ◽  
Yidong Liu ◽  
Shunli Kan ◽  
Tengfei Zhang ◽  
Zehua Jiang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Quantitative Polymerase Chain Reaction ◽  
S100 Protein ◽  
Pathological Process ◽  
Neurological Dysfunction ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Abstract Background: Lumbar spinal stenosis (LSS) is a common degenerative disease, which can lead to neurological dysfunction and requires surgical treatment. In the previous study, we used H&E staining and immunohistochemistry to qualitatively analyze the expression of S100 and P16 in the pathological process of ligamentum flavum (LF) hypertrophy in patients with LSS. To further explore the relationship between P16, S100 and LF hypertrophy in patients with LSS, we quantitatively detected S100 and P16 and their expressed products based on molecular biology techniques, and analyzed their imaging correlation.Methods: Before posterior lumbar surgery, LF thickness was measured by Magnetic Resonance Imaging (MRI). Through the operation, we obtained the specimens of LF from 120 patients, all of whom were L4/5 LF. They were designated: simple lumbar disc herniation (LDH), single-segment spinal stenosis (SLSS), and double-segment LSS (DLSS). The detection of each side of LF was assessed. S100 and P16 and their expression products were detected by western blot and quantitative polymerase chain reaction (qPCR).Results: The dorsal mRNA expression of P16 in DLSS group was significantly higher than that in SLSS group. On the dorsal and dural side of LF, the expression of P16 mRNA and proteins in the LDH group was significantly lower than that in SLSS and DLSS groups. We found a correlation between the thickness of LF and the expression of P16. However, there was no significant difference in the expression of S100 mRNA and S100 protein on both sides of the ligament and among the three groups, and no significant correlation between the expression of S100 and the thickness of LF.Conclusions: P16 is involved in the process of LF hypertrophy in patients with LSS, and the imaging thickness of LF is related to the expression of P16. No obvious evidence proves that S100 may be related to the hypertrophy of LF in patients with LSS.

scholarly journals The correlation between imaging expression of P16 and S100 in hypertrophic ligamentum flavum

2020 ◽  
Author(s):  
Wei Hu ◽  
Yidong Liu ◽  
Shunli Kan ◽  
Tengfei Zhang ◽  
Zehua Jiang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Quantitative Polymerase Chain Reaction ◽  
S100 Protein ◽  
Pathological Process ◽  
Neurological Dysfunction ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Abstract Background: Lumbar spinal stenosis (LSS) is a common degenerative disease, which can lead to neurological dysfunction and requires surgical treatment. In the previous study, we used H&E staining and immunohistochemistry to qualitatively analyze the expression of S100 and P16 in the pathological process of ligamentum flavum (LF) hypertrophy in patients with LSS. To further explore the relationship between P16, S100 and LF hypertrophy in patients with LSS, we quantitatively detected S100 and P16 and their expressed products based on molecular biology techniques, and analyzed their imaging correlation.Methods: Before posterior lumbar surgery, LF thickness was measured by Magnetic Resonance Imaging (MRI). Through the operation, we obtained the specimens of LF from 120 patients, all of whom were L4/5 LF. They were designated: simple lumbar disc herniation (LDH), single-segment spinal stenosis (SLSS), and double-segment LSS (DLSS). The detection of each side of LF was assessed. S100 and P16 and their expression products were detected by western blot and quantitative polymerase chain reaction (qPCR).Results: The dorsal mRNA expression of P16 in DLSS group was significantly higher than that in SLSS group. On the dorsal and dural side of LF, the expression of P16 mRNA and proteins in the LDH group was significantly lower than that in SLSS and DLSS groups. We found a correlation between the thickness of LF and the expression of P16. However, there was no significant difference in the expression of S100 mRNA and S100 protein on both sides of the ligament and among the three groups, and no significant correlation between the expression of S100 and the thickness of LF.Conclusions: P16 is involved in the process of LF hypertrophy in patients with LSS, and the imaging thickness of LF is related to the expression of P16. No obvious evidence proves that S100 may be related to the hypertrophy of LF in patients with LSS.

scholarly journals The correlation between imaging expression of P16 and S100 in hypertrophic ligamentum flavum

2020 ◽  
Author(s):  
Wei Hu ◽  
Yidong Liu ◽  
Shunli Kan ◽  
Tengfei Zhang ◽  
Zehua Jiang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Quantitative Polymerase Chain Reaction ◽  
S100 Protein ◽  
Pathological Process ◽  
Neurological Dysfunction ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Abstract Background Lumbar spinal stenosis (LSS) is a common degenerative disease, which can lead to neurological dysfunction and requires surgical treatment. In the previous study, we used H&E staining and immunohistochemistry to qualitatively analyze the expression of S100 and P16 in the pathological process of ligamentum flavum (LF) hypertrophy in patients with LSS. To further explore the relationship between P16, S100 and LF hypertrophy in patients with LSS, we quantitatively detected S100 and P16 and their expressed products based on molecular biology techniques, and analyzed their imaging correlation. Methods Before posterior lumbar surgery, LF thickness was measured by Magnetic Resonance Imaging (MRI). Through the operation, we obtained the specimens of LF from 120 patients, all of whom were L4/5 LF. They were designated: simple lumbar disc herniation (LDH), single-segment spinal stenosis (SLSS), and double-segment LSS (DLSS). The detection of each side of LF was assessed. S100 and P16 and their expression products were detected by western blot and quantitative polymerase chain reaction (qPCR). Results The dorsal mRNA expression of P16 in DLSS group was significantly higher than that in SLSS group. On the dorsal and dural side of LF, the expression of P16 mRNA and proteins in the LDH group was significantly lower than that in SLSS and DLSS groups. We found a correlation between the thickness of LF and the expression of P16. However, there was no significant difference in the expression of S100 mRNA and S100 protein on both sides of the ligament and among the three groups, and no significant correlation between the expression of S100 and the thickness of LF. Conclusions P16 is involved in the process of LF hypertrophy in patients with LSS, and the imaging thickness of LF is related to the expression of P16. S100 may not be related to the hypertrophy of LF in patients with LSS, and there is no correlation between the imaging thickness of LF and the expression of S100.

scholarly journals The correlation between imaging expression of P16 and S100 in hypertrophic ligamentum flavum

2020 ◽  
Author(s):  
Wei Hu ◽  
Yidong Liu ◽  
Shunli Kan ◽  
Tengfei Zhang ◽  
Zehua Jiang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Quantitative Polymerase Chain Reaction ◽  
S100 Protein ◽  
Pathological Process ◽  
Neurological Dysfunction ◽  
Significant Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Abstract Background: Lumbar spinal stenosis (LSS) is a common degenerative disease, which can lead to neurological dysfunction and requires surgical treatment. In the previous study, we used H&E staining and immunohistochemistry to qualitatively analyze the expression of S100 and P16 in the pathological process of ligamentum flavum (LF) hypertrophy in patients with LSS. To further explore the relationship between P16, S100 and LF hypertrophy in patients with LSS, we quantitatively detected S100 and P16 and their expressed products based on molecular biology techniques, and analyzed their imaging correlation.Methods: Before posterior lumbar surgery, LF thickness was measured by Magnetic Resonance Imaging (MRI). Through the operation, we obtained the specimens of LF from 120 patients, all of whom were L4/5 LF. They were designated: simple lumbar disc herniation (LDH), single-segment spinal stenosis (SLSS), and double-segment LSS (DLSS). The detection of each side of LF was assessed. S100 and P16 and their expression products were detected by western blot and quantitative polymerase chain reaction (qPCR).Results: The dorsal mRNA expression of P16 in DLSS group was significantly higher than that in SLSS group. On the dorsal and dural side of LF, the expression of P16 mRNA and proteins in the LDH group was significantly lower than that in SLSS and DLSS groups. We found a correlation between the thickness of LF and the expression of P16. However, there was no significant difference in the expression of S100 mRNA and S100 protein on both sides of the ligament and among the three groups, and no significant correlation between the expression of S100 and the thickness of LF.Conclusions: P16 is involved in the process of LF hypertrophy in patients with LSS, and the imaging thickness of LF is related to the expression of P16. No obvious evidence proves that S100 may be related to the hypertrophy of LF in patients with LSS.

scholarly journals Ligamentum Flavum Haematoma: A Report of Two Cases

2009 ◽  
Vol 17 (2) ◽  
pp. 212-215 ◽  
Author(s):  
Hiroshi Takahashi ◽  
Akihito Wada ◽  
Yuichirou Yokoyama ◽  
Shinichirou Fukushi ◽  
Tatsuro Sakurai ◽  
...  
Keyword(s):  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Epidural Haematoma ◽  
Spinal Canal Stenosis ◽  
Definitive Diagnosis ◽  
Surgical Removal ◽  
Lumbar Spinal Canal Stenosis ◽  
Resonance Imaging ◽  
Canal Stenosis ◽  
Lumbar Spinal

We present 2 cases of ligamentum flavum haematoma causing root compression. Magnetic resonance imaging showed an epidural mass linked to the ligamentum flavum. The mass was isointense in T1-weighted images, and was centrally hyperintense and peripherally hypointense in T2-weighted images. Surgical removal of the ligamentum flavum achieved resolution of the symptoms. The definitive diagnosis could only be confirmed by histopathological examinations. The differential diagnoses include lumbar disc herniation and lumbar spinal canal stenosis caused by neoplasm, infection, epidural haematoma, or facet cyst.

scholarly journals Radiological Analysis of Sagittal and Cross-sectional Morphology of Congenital Lumbar Spinal Stenosis

2021 ◽  
Author(s):  
Qihui Cheng ◽  
Ganghui Yin ◽  
Minjun Huang ◽  
Haojie Mi ◽  
Junwei Guan ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Disc Degeneration ◽  
Lumbar Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Lumbar Disc ◽  
Leg Pain ◽  
Control Group ◽  
Lumbar Disc Degeneration ◽  
Lumbar Spinal ◽  
And Control

Abstract Background Purpose This retrospective study was applied to investigate the morphology characteristics of the spine and pelvis in patients with congenital spinal stenosis, to explore the effect of morphological parameters in the pathogenesis and development of the disease.Methods The analysis is based on data of a case-control study, including 40 patients (19 females/21 males) with congenital lumbar spinal stenosis, 40 patients (17females/23males) with age-、Sex- and the waist and leg pain score-matched acquired lumbar spinal stenosis and 40 age-、Sex-matched normal volunteers(controls). Lumbar MRI, lumbar computerized tomography（CT）and full-length radiographs were used to obtain sagittal and cross-sectional parameters. Parameters including pelvic incidence（PI）, sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), sagittal vertical axis（SVA）, and thoracic kyphosis（TK）on the sagittal plane were measured on full-length radiographs and analyzed. The anteroposterior (AP) bone canal diameter and spinal canal area of L4 were collected and analyzed on Lumbar CT. Lumbar MRI was taken to evaluate the angle of the ligamentum flavum at the level of L4/5 intervertebral space，and the Lumbar disc degeneration degree was calculated.Results Total scores for lumbar disc degeneration and the angle of the ligamentum flavum were significantly lower in the congenital group than in the acquired group（P= 0.02 and P= 0.012，respectively ； P＜0.05）. The differences of LL, PT, SVA and TK values were statistically significant ， while the differences of SS and PI were not significant among the acquired, congenital, and control groups. TK values were significantly lower in the congenital group than in the acquired and control groups（P=0.024 and P=0.006，respectively； P＜0.05）. Patients in the congenital and acquired groups had significantly lower LL values than patients in the control group (p = 0.000 and 0.041, respectively； P＜0.05). The mean value of LL was 30.31°±13.42° in the congenital group, while 41.10°±12.51° in the acquired group. And the difference of LL between these two groups was statistically significant（p=0.000＜0.05）. The SVA values of the congenital group, acquired group, and control group increased respectively(all P＜0.05). The PT in the congenital group showed significantly lower values than the acquired group (p = 0.041＜0.05). There is no statistically significant difference in other parameters.The correlations between LL and PI are well in the congenital group（r=0.336；P=0.034）, acquired group（r=0.464；P=0.003） and control group（r=0.584；P=0.000）. However, the trend line of LL/PI in the acquired group was drawn below the control population. Also, the trend line of LL/PI in the congenital group was below the waist and leg pain score-matched acquired group with lower lumbar degeneration.Conclusion In addition to bony structural stenosis, the smaller angle of the ligamentum flavum may be an anatomical factor that causes the smaller effective area of the spinal canal in patients with congenital lumbar spinal stenosis. Patients with congenital lumbar spinal stenosis show a significant reduction in the physiological curvature of the thoracic and lumbar spine, and the trunk leans forward. In addition to intervertebral disc degeneration and pain factors, bony spinal stenosis is also a possible factor leading to smaller LL in patients with congenital lumbar spinal stenosis. LL less than 41° can be used as the initial screening standard for congenital lumbar spinal stenosis among patients with lumbar spinal stenosis.

scholarly journals Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis

2017 ◽  
Vol 11 (2) ◽  
pp. 278-284 ◽  
Author(s):  
Shardul Madhav Soman ◽  
Jimmy Chokshi ◽  
Naitik Chhatrala ◽  
Gulam Haider Tharadara ◽  
Mukund Prabhakar
Keyword(s):  
Decision Making ◽  
Grading System ◽  
Gender Ratio ◽  
Radiological Findings ◽  
Single Centre ◽  
Dural Sac ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal ◽  
A Prospective Study

<sec><title>Study Design</title><p>This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS).</p></sec><sec><title>Purpose</title><p>The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS.</p></sec><sec><title>Overview of Literature</title><p>LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features. We used a qualitative grading system to help in the decision-making process of the management of patients with multilevel LSS.</p></sec><sec><title>Methods</title><p>80 patients with LSS were treated with decompression and prospectively followed-up for a minimum of 12 months. All had failed conservative treatment. Qualitative grading of LSS severity was based on the dural sac in T2 weighted axial MRI images at all disc levels and was done from L1–2 to L5–S1 (n=400). Functional outcome was assessed using the Oswestry disability index (ODI).</p></sec><sec><title>Results</title><p>The mean patient age was 56.6 years, with a gender ratio of 0.6:1. Forty patients had degenerative LSS and 40 had degenerative spondylolysthesis. A total of 178 levels were decompressed, the majority of which were L4–L5 (43.82%), followed by L5–S1 (41.57%). According to our qualitative grading system, grade D stenosis (53.93%) was decompressed most frequently, followed by grade C stenosis (41.57%). The average preoperative ODI score was 58.55%, which later reduced to 19.15%. Seventy percent of patients achieved excellent results, whereas 30% achieved good results.</p></sec><sec><title>Conclusions</title><p>Morphological grading is a useful tool in decision making in surgery for multilevel LSS. Grade C and D stenosis should be decompressed, whereas A and B should not be, unless clinically justified.</p></sec>

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