scholarly journals Expression of Deiodinase Genes in Intraoperative Samples of Ligamentum FlavumLigamentum Flavum in Patients with Stenotic Processes of the Spinal Canal and Dural Sac on the Lumbar Spine

2019 ◽  
Vol 4 (6) ◽  
pp. 20-25
Author(s):  
L. V. Rodionova ◽  
L. G. Samoilova ◽  
A. V. Nevezhina ◽  
I. A. Shurygina
Keyword(s):  
Lumbar Spine ◽  
Spinal Canal ◽  
Ligamentum Flavum ◽  
Dural Sac

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Nian Chen ◽  
Zhenhua Hong ◽  
Yongyu Zheng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Ventral Side ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions. Methods A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7 ± 8.7 vs 68.4 ± 10.5, P < 0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P < 0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P < 0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

scholarly journals Change of Lumbar Ligamentum Flavum after Indirect Decompression Using Anterior Lumbar Interbody Fusion

2017 ◽  
Vol 11 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Seiji Ohtori ◽  
Sumihisa Orita ◽  
Kazuyo Yamauchi ◽  
Yawara Eguchi ◽  
Yasuchika Aoki ◽  
...  
Keyword(s):  
Pain Relief ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Ligamentum Flavum ◽  
Case Series ◽  
Anterior Fusion ◽  
Dural Sac ◽  
Canal Diameter ◽  
Indirect Decompression

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to examine changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a 10-year follow-up.</p></sec><sec><title>Overview of Literature</title><p>Extreme lateral interbody fusion provides minimally invasive treatment of the lumbar spine; this anterior fusion without direct posterior decompression, so-called indirect decompression, can achieve pain relief. Anterior fusion may restore disc height, stretch the flexure of the ligamentum flavum, and increase the spinal canal diameter. However, changes in the ligamentum flavum thickness and remodeling of the spinal canal after anterior fusion during a long follow-up have not yet been reported.</p></sec><sec><title>Methods</title><p>We evaluated 10 patients with L4 spondylolisthesis who underwent stand-alone anterior interbody fusion using the iliac crest bone. Magnetic resonance imaging was performed 10 years after surgery. The cross-sectional area (CSA) of the dural sac and the ligamentum flavum at L1–2 to L5–S1 was calculated using a Picture Archiving and Communication System.</p></sec><sec><title>Results</title><p>Spinal fusion with correction loss (average, 4.75 mm anterior slip) was achieved in all patients 10 years postsurgery. The average CSAs of the dural sac and the ligamentum flavum at L1–2 to L5–S1 were 150 mm<sup>2</sup> and 78 mm<sup>2</sup>, respectively. The average CSA of the ligamentum flavum at L4–5 (30 mm<sup>2</sup>) (fusion level) was significantly less than that at L1–2 to L3–4 or L5–S1. Although patients had an average anterior slip of 4.75 mm, the average CSA of the dural sac at L4–5 was significantly larger than at the other levels.</p></sec><sec><title>Conclusions</title><p>Spinal stability induced a lumbar ligamentum flavum change and a sustained remodeling of the spinal canal, which may explain the long-term pain relief after indirect decompression fusion surgery.</p></sec>

scholarly journals Activity of genes of matrix metalloproteinases and their inhibitors in the Ligamentum flavum of patients with stenosing processes in spinal canal and dural sac

2021 ◽  
Vol 6 (6-2) ◽  
pp. 58-72
Author(s):  
L. V. Rodionova ◽  
L. G. Samoilova ◽  
V. A. Sorokovikov
Keyword(s):  
Spinal Canal ◽  
Ligamentum Flavum ◽  
Lumbar Stenosis ◽  
Specific Primers ◽  
Tissue Inhibitors ◽  
Metabolic Characteristics ◽  
Dural Sac ◽  
Expression Of Genes ◽  
Insufficient Response ◽  
Increased Activity

New data have been obtained for assessing the expression of genes of metalloproteinases and their tissue inhibitors (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, TIMP-1 and TIMP-2) in the Ligamentum flavum in patients with lumbar stenosis of spinal canal and dural sac. The features of the metabolism of the extracellular matrix (ECM) were revealed, the data obtained were compared with those for previously studied candidate genes. The search for relationships with the features of the ECM metabolic characteristics was carried out.The aim. To study the expression of genes of metalloproteinases and their tissue inhibitors in intraoperative biopsies of the Ligamentum flavum of patients with lumbar stenosis of the spinal canal and dural sac.Materials and methods. A group of 33 people (17 women, 16 men) with lumbar stenosis of the spinal canal and dural sac was studied; the average age is 45.73 ± 1.95 years. RNA was isolated from intraoperative biopsies of the Ligamentum flavum, reverse transcription was performed, and PCR using specific primers was performed.Results. In Ligamentum flavum of patients with stenosing processes of the spinal canal and dural sac, an increased activity of MMP-1 and insufficient response of TIMP-1 and TIMP-2 were found; the expression of MMP-1 increased synchronously with Dio2, and both genes decreased their activity with increasing age of the patient. In patients with Ligamentum flavum ossification, the MMR-8 gene was more actively expressed, and the synthesis of the mRNA of the MMR-9 gene decreased compared to the subgroup without ossification.

scholarly journals Gravity Determines the Direction of Nerve Roots Sedimentation in the Lumbar Spinal Canal

2020 ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Zhenhua Hong ◽  
Jiang Yang ◽  
Tingjie Zhou ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Body Position ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives: To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body position. Methods: A total of 56 patients suffered from back pain and underwent conventional supine lumbar spine MR imaging were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results: The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7±8.7 vs 68.4±10.5, P<0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P<0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P<0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions: The nerve roots sedimentation followed the direction of gravity. Positive SedSign, floating of nerve roots in the canal, may be a MR sign of lumbar pathology involved the spinal canal.

scholarly journals Characteristics of acetylation reactions in patients with stenosing process of the lumbar spinal canal and dural sac depending on severity of Ligamentum flavum ossification

2020 ◽  
pp. 45-52
Author(s):  
Л.В. Родионова ◽  
Л.Г. Самойлова ◽  
И.А. Шурыгина ◽  
О.В. Скляренко ◽  
А.П. Животенко ◽  
...  
Keyword(s):  
Gene Expression ◽  
Connective Tissue ◽  
Spinal Canal ◽  
Ligamentum Flavum ◽  
Genetic Characteristics ◽  
Dural Sac ◽  
Nat2 Gene ◽  
Ossification Of Ligamentum Flavum ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal

Актуальность. В настоящее время совершенно не изучена экспрессия генов ацетилтрансфераз в структурах, участвующих в формировании патологического очага при развитии дегенеративно-дистрофических процессов в позвоночно-двигательном сегменте. Ведущая роль гипертрофии и оссификации жёлтой связки (Ligamentum flavum) в развитии и прогрессировании стенозирующих процессов позвоночного канала и дурального мешка, а также участие ацетилтрансфераз в метаболизме соединительной ткани определило цель исследования: выявить генетические особенности реакций ацетилирования у больных со стенозами позвоночного канала и дурального мешка на поясничном отделе позвоночника в зависимости от выраженности процессов оссификации Ligamentum flavum. Методы. В исследование включен 31 пациент (15 мужчин, 16 женщин, средний возраст 45,7 ± 2,0 лет) со стенозирующими процессами позвоночного канала и дурального мешка на поясничном уровне. У всех пациентов во время оперативного вмешательства были забраны образцы Ligamentum flavum, в которых затем общепринятыми методами патоморфологии определяли признаки наличия или отсутствия гипертрофии и / или оссификации, а также методом количественной ПЦР (кПЦР) определяли экспрессию генов NAT1 и NAT2. Результаты. В биоптатах Ligamentum flavum обнаружена экспрессия генов NAT1 и NAT2, что свидетельствует о ранее неизвестной роли процессов ацетилирования в метаболизме соединительной ткани. Варианты «медленного» ацетилирования достоверно чаще встречались у пациентов с выявленной оссификацией Ligamentum flavum. Обнаружены различные паттерны экспрессии генов NAT1 и NAT2, что свидетельствует о полиморфности клинических вариантов патологии. Часть выявленных вариантов экспрессии изоферментов ацетилтрансфераз характеризуют склонность к развитию оссификации Ligamentum flavum. Женщины чаще страдают от оссификации Ligamentum flavum по сравнению с мужчинами (χ2 = 39,1, р < 0,01), при этом, повторные оперативные вмешательства, как и избыточная масса тела, не увеличивали риск её оссификации. Активность экспрессии гена NAT2 можно отнести к информативным маркёрам, свидетельствующим о повышенном риске развития процессов эктопической оссификации Ligamentum flavum. Заключение. Выявленные особенности реакций ацетилирования у больных со стенозами позвоночного канала и дурального мешка могут помочь клиницистам прогнозировать развитие гипертрофии и оссификации жёлтой связки при оперативном вмешательстве на позвоночнике, а полученные новые фундаментальные знания лягут в основу разработки способов профилактики развития эпидурального фиброза на дооперационном этапе. Background. Expression of acetyltransferase genes in structures participating in formation of a pathological focus in development of degenerative spine conditions is presently unstudied. Hypertrophy and ossification of Ligamentum flavum play a leading role in the development and progression of stenosing processes in the spinal canal and dural sac whereas acetyltransferases are involved in metabolism of connective tissue. The aim of this study was to identify genetic characteristics of acetylation reactions in patients with stenosis of the lumbar spinal canal and dural sac depending on severity of ossification of Ligamentum flavum. Methods. This study included 31 patients (15 men and 16 women aged 45.7 ± 2.0 years) with stenosing processes of the spinal canal and dural sac at the lumbar level. Samples of Ligamentum flavum were taken from all patients at the time of surgical intervention. Signs of hypertrophy and/or ossification were detected in these samples with standard pathomorphological methods. Real time PCR was used to determine the expression of NAT1 and NAT2 genes. Results. Expression of NAT1 and NAT2 genes was found in biopsy samples of Ligamentum flavum. This indicated a previously unknown role of acetylation processes in connective tissue metabolism. Variants of «slow» acetylation were significantly more common in patients with documented ossification of Ligamentum flavum. Different patterns of NAT1 and NAT2 gene expression were identified, which suggested polymorphism of clinical variants of the disease. Some of the identified variants of acetyltransferase isoenzyme expression characterize a tendency towards development of Ligamentum flavum ossification. Women were more likely to have ossification of Ligamentum flavum than men (χ2 = 39.1, p < 0.01). Repeated surgery and overweight did not increase the risk for ossification of Ligamentum flavum. The activity of NAT2 gene expression can be classified as an informative marker for increased risk of ectopic ossification of Ligamentum flavum. Conclusion. The identified patterns of acetylation reactions in patients with spinal canal and dural sac stenosis may help clinicians to predict the development of hypertrophy and ossification of Ligamentum flavum during spine surgery and to find ways for prevention of epidural fibrosis at the preoperative stage.

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2021 ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Nian Chen ◽  
Zhenhua Hong ◽  
Yongyu Zheng ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Ventral Side ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives: To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions. Methods: A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results: The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7±8.7 vs 68.4±10.5, P<0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P<0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P<0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions: The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

scholarly journals Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

2020 ◽  
Author(s):  
Jun Yang ◽  
Zhiyun Feng ◽  
Zhenhua Hong ◽  
Jiang Yang ◽  
Tingjie Zhou ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Mr Imaging ◽  
Spinal Canal ◽  
Body Position ◽  
Lateral Position ◽  
Dorsal Side ◽  
Mr Images ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac

Abstract Objectives: To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body position. Methods: A total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results: The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7±8.7 vs 68.4±10.5, P<0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P<0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P<0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions: The nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

scholarly journals Detection of Degenerative Changes on MR Images of the Lumbar Spine with a Convolutional Neural Network: A Feasibility Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 902
Author(s):  
Nils Christian Lehnen ◽  
Robert Haase ◽  
Jennifer Faber ◽  
Theodor Rüber ◽  
Hartmut Vatter ◽  
...  
Keyword(s):  
Neural Network ◽  
Lumbar Spine ◽  
Diagnostic Accuracy ◽  
Nerve Root ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Degenerative Changes ◽  
High Diagnostic Accuracy ◽  
Canal Stenosis ◽  
Disc Herniations

Our objective was to evaluate the diagnostic performance of a convolutional neural network (CNN) trained on multiple MR imaging features of the lumbar spine, to detect a variety of different degenerative changes of the lumbar spine. One hundred and forty-six consecutive patients underwent routine clinical MRI of the lumbar spine including T2-weighted imaging and were retrospectively analyzed using a CNN for detection and labeling of vertebrae, disc segments, as well as presence of disc herniation, disc bulging, spinal canal stenosis, nerve root compression, and spondylolisthesis. The assessment of a radiologist served as the diagnostic reference standard. We assessed the CNN’s diagnostic accuracy and consistency using confusion matrices and McNemar’s test. In our data, 77 disc herniations (thereof 46 further classified as extrusions), 133 disc bulgings, 35 spinal canal stenoses, 59 nerve root compressions, and 20 segments with spondylolisthesis were present in a total of 888 lumbar spine segments. The CNN yielded a perfect accuracy score for intervertebral disc detection and labeling (100%), and moderate to high diagnostic accuracy for the detection of disc herniations (87%; 95% CI: 0.84, 0.89), extrusions (86%; 95% CI: 0.84, 0.89), bulgings (76%; 95% CI: 0.73, 0.78), spinal canal stenoses (98%; 95% CI: 0.97, 0.99), nerve root compressions (91%; 95% CI: 0.89, 0.92), and spondylolisthesis (87.61%; 95% CI: 85.26, 89.21), respectively. Our data suggest that automatic diagnosis of multiple different degenerative changes of the lumbar spine is feasible using a single comprehensive CNN. The CNN provides high diagnostic accuracy for intervertebral disc labeling and detection of clinically relevant degenerative changes such as spinal canal stenosis and disc extrusion of the lumbar spine.

Hematoma of the ligamentum flavum in the lumbar spine:

2000 ◽  
Vol 53 (6) ◽  
pp. 598-600 ◽  
Author(s):  
Nurullah Yüceer ◽  
Mustafa K Baskaya ◽  
Patricia Smith ◽  
Brian K Willis
Keyword(s):  
Lumbar Spine ◽  
Ligamentum Flavum
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