scholarly journals Vertebral Endplate Changes Correlate with Presence of Cartilaginous Endplate in the Herniated Disc Tissue: Factor Predicting Failure of Conservative Treatment

2021 ◽  
Author(s):  
Rabia Latif ◽  
Sumera Imran ◽  
Ijaz Ahmad ◽  
Muhammad Saad Ilyas ◽  
Amer Aziz ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Tissue Factor ◽  
Herniated Disc ◽  
Vertebral Endplate ◽  
Disc Tissue ◽  
Endplate Changes ◽  
Cartilaginous Endplate

Differential Diagnosis of Degenerative Vertebral Endplate Changes and Diskitis in MRI

1994 ◽  
Vol 30 (6) ◽  
pp. 1013
Author(s):  
Seoung Oh Yang ◽  
Ki Nam Lee ◽  
Jong Cheul ◽  
Sun Seob Choi ◽  
Yung Il Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Vertebral Endplate ◽  
Endplate Changes

Influence of Macrophage Infiltration of Herniated Disc Tissue on the Production of Matrix Metalloproteinases Leading to Disc Resorption

Spine ◽  
2001 ◽  
Vol 26 (14) ◽  
pp. 1522-1527 ◽  
Author(s):  
Minoru Doita ◽  
Takako Kanatani ◽  
Takuma Ozaki ◽  
Nobuzo Matsui ◽  
Masahiro Kurosaka ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Macrophage Infiltration ◽  
Herniated Disc ◽  
Disc Tissue

Adequacy of herniated disc tissue as a cell source for nucleus pulposus regeneration

2011 ◽  
Vol 14 (2) ◽  
pp. 273-280 ◽  
Author(s):  
Aldemar A. Hegewald ◽  
Michaela Endres ◽  
Alexander Abbushi ◽  
Mario Cabraja ◽  
Christian Woiciechowsky ◽  
...  
Keyword(s):  
Nucleus Pulposus ◽  
Cell Expansion ◽  
Cell Biology ◽  
3D Culture ◽  
Polyglycolic Acid ◽  
Herniated Disc ◽  
Marker Genes ◽  
Disc Tissue ◽  
Study Results

Object The object of this study was to characterize the regenerative potential of cells isolated from herniated disc tissue obtained during microdiscectomy. The acquired data could help to evaluate the feasibility of these cells for autologous disc cell transplantation. Methods From each of 5 patients (mean age 45 years), tissue from the nucleus pulposus compartment as well as from herniated disc was obtained separately during microdiscectomy of symptomatic herniated lumbar discs. Cells were isolated, and in vitro cell expansion for cells from herniated disc tissue was accomplished using human serum and fibroblast growth factor-2. For 3D culture, expanded cells were loaded in a fibrin-hyaluronan solution on polyglycolic acid scaffolds for 2 weeks. The formation of disc tissue was documented by histological staining of the extracellular matrix as well as by gene expression analysis of typical disc marker genes. Results Cells isolated from herniated disc tissue showed significant signs of dedifferentiation and degeneration in comparison with cells from tissue of the nucleus compartment. With in vitro cell expansion, further dedifferentiation with distinct suppression of major matrix molecules, such as aggrecan and Type II collagen, was observed. Unlike in previous reports of cells from the nucleus compartment, the cells from herniated disc tissue showed only a weak redifferentiation process in 3D culture. However, propidium iodide/fluorescein diacetate staining documented that 3D assembly of these cells in polyglycolic acid scaffolds allows prolonged culture and high viability. Conclusions Study results suggested a very limited regenerative potential for cells harvested from herniated disc tissue. Further research on 2 major aspects in patient selection is suggested before conducting reasonable clinical trials in this matter: 1) diagnostic strategies to predict the regenerative potential of harvested cells at a radiological or cell biology level, and 2) clinical assessment strategies to elucidate the metabolic state of the targeted disc.

Modic Type 1 Vertebral Endplate Changes: Injury, Inflammation, or Infection?

2017 ◽  
Vol 209 (1) ◽  
pp. 167-170 ◽  
Author(s):  
Matthew Thomas Crockett ◽  
Brendan Sean Kelly ◽  
Susie van Baarsel ◽  
Eoin Carl Kavanagh
Keyword(s):  
Vertebral Endplate ◽  
Endplate Changes ◽  
Modic Type

scholarly journals Spontaneous regression of lumbar herniated disc Case presentation

2015 ◽  
Vol 29 (4) ◽  
pp. 381-384 ◽  
Author(s):  
A. Chiriac ◽  
Giorgiana Ion ◽  
Z. Faiyad ◽  
I. Poeata
Keyword(s):  
Conservative Treatment ◽  
Intervertebral Disc ◽  
Clinical Improvement ◽  
Spontaneous Regression ◽  
Surgical Intervention ◽  
Herniated Disc ◽  
Common Disease ◽  
Intervertebral Disc Herniation ◽  
Case Presentation

Abstract Intervertebral disc herniation is a common disease that usually requires surgical intervention. However, in some cases, neurological symptoms may improve with conservative treatment. In this article, we present a case with spontaneous regression of extruded lumbar herniated disc correlated with clinical improvement and documented with follow up MRI studies.

scholarly journals Incidence and clinical impact of vertebral endplate changes after limited lumbar microdiscectomy and implantation of a bone-anchored annular closure device

2020 ◽  
Author(s):  
Jenny Christine Kienzler ◽  
Sofia Rey ◽  
Oliver Wetzel ◽  
Hermien Atassi ◽  
Sabrina Bäbler ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Clinical Findings ◽  
Closure Device ◽  
Vertebral Endplate ◽  
Endplate Changes ◽  
High Incidence ◽  
Recurrent Herniation ◽  
Annular Closure Device

Abstract Background: An annular closure device (ACD) could potentially prevent recurrent herniation by blocking larger annular defects after limited microdiscectomy (LMD). The purpose of this study was to analyze the incidence of endplate changes (EPC) and outcome after LMD with additional implantation of an ACD to prevent reherniation. Methods: This analysis includes data from a) RCT study-arm of patients undergoing LMD with ACD implantation and b) additional patients undergoing ACD implantation at our institution. Clinical findings (VAS,ODI), radiological outcome (reherniation, implant integrity, volume of (EPC) and risk factors for EPC were assessed. Results: Seventy-two patients (37men, 47±11.63yo) underwent LMD and ACD implantation between 2013-2016. A total of 71 (99%) patients presented with some degree of EPC during the follow-up period (14.67±4.77months). In the multivariate regression analysis, localization of the anchor was the only significant predictor of EPC (p=0.038). The largest EPC measured 4.2 cm3. Reherniation was documented in 17 (24%) patients (symptomatic: n=10; asymptomatic: n=7). Six (8.3%) patients with symptomatic reherniation underwent rediscectomy. Implant failure was documented in 19 (26.4%) patients including anchor head breakage (n=1, 1.3%), dislocation of the whole device (n=5, 6.9%), and mesh dislocation into the spinal canal (n=13, 18%). Mesh subsidence within the EPC was documented in 15 (20.8%) patients. Seven (9.7%) patients underwent explantation of the entire, or parts of the device.Conclusion: Clinical improvement after LMD and ACD implantation was proven in our study. High incidence and volume of EPC did not correlate with clinical outcome. Mechanical friction of the polymer mesh with the endplate is most likely the cause of EPC after ACD.

scholarly journals Proton Density Fat Fraction Spine MRI for Differentiation of Erosive Vertebral Endplate Degeneration and Infectious Spondylitis

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 78
Author(s):  
Frederic Carsten Schmeel ◽  
Asadeh Lakghomi ◽  
Nils Christian Lehnen ◽  
Robert Haase ◽  
Mohammed Banat ◽  
...  
Keyword(s):  
Proton Density ◽  
Vertebral Endplate ◽  
Proton Density Fat Fraction ◽  
Endplate Changes ◽  
Modic Type ◽  
Fat Fraction ◽  
Magnetic Resonance Imaging Mri ◽  
Spine Mri ◽  
Infectious Spondylitis

Vertebral Modic type 1 (MT1) degeneration may mimic infectious disease on conventional spine magnetic resonance imaging (MRI), potentially leading to additional costly and invasive investigations. This study evaluated the diagnostic performance of the proton density fat fraction (PDFF) for distinguishing MT1 degenerative endplate changes from infectious spondylitis. A total of 31 and 22 patients with equivocal diagnosis of MT1 degeneration and infectious spondylitis, respectively, were retrospectively enrolled in this IRB-approved retrospective study and examined with a chemical-shift encoding (CSE)-based water-fat 3D six-echo modified Dixon sequence in addition to routine clinical spine MRI. Diagnostic reference standard was established according to histopathology or clinical and imaging follow-up. Intravertebral PDFF [%] and PDFFratio (i.e., vertebral endplate PDFF/normal vertebrae PDFF) were calculated voxel-wise within the single most prominent edematous bone marrow lesion per patient and examined for differences between MT1 degeneration and infectious spondylitis. Mean PDFF and PDFFratio of infectious spondylitis were significantly lower compared to MT1 degenerative changes (mean PDFF, 4.28 ± 3.12% vs. 35.29 ± 17.15% [p < 0.001]; PDFFratio, 0.09 ± 0.06 vs. 0.67 ± 0.37 [p < 0.001]). The areas under the curve (AUC) and diagnostic accuracies were 0.977 (p < 0.001) and 98.1% (cut-off at 12.9%) for PDFF and 0.971 (p < 0.001) and 98.1% (cut-off at 0.27) for PDFFratio. Our data suggest that quantitative evaluation of vertebral PDFF can provide a high diagnostic accuracy for differentiating erosive MT1 endplate changes from infectious spondylitis.

scholarly journals Incidence and Clinical Impact of Vertebral Endplate Changes after Limited Lumbar Microdiscectomy and Implantation of a Bone-anchored Annular Closure Device 

2020 ◽  
Author(s):  
Jenny Christine Kienzler ◽  
Sofia Rey ◽  
Oliver Wetzel ◽  
Hermien Atassi ◽  
Sabrina Bäbler ◽  
...  
Keyword(s):  
Multivariate Regression Analysis ◽  
Clinical Findings ◽  
Implant Failure ◽  
Closure Device ◽  
Vertebral Endplate ◽  
Endplate Changes ◽  
High Incidence ◽  
Recurrent Herniation ◽  
Annular Closure Device

Abstract Background: An annular closure device (ACD) could potentially prevent recurrent herniation by blocking larger annular defects after limited microdiscectomy (LMD). The purpose of this study was to analyze the incidence of endplate changes (EPC) and outcome after LMD with additional implantation of an ACD to prevent reherniation. Methods: This analysis includes data from a) RCT study-arm of patients undergoing LMD with ACD implantation and b) additional patients undergoing ACD implantation at our institution. Clinical findings (VAS,ODI), radiological outcome (reherniation, implant integrity, volume of (EPC) and risk factors for EPC were assessed. Results: Seventy-two patients (37men, 47±11.63yo) underwent LMD and ACD implantation between 2013-2016. A total of 71 (99%) patients presented with some degree of EPC during the follow-up period (14.67±4.77months). In the multivariate regression analysis, localization of the anchor was the only significant predictor of EPC (p=0.038). The largest EPC measured 4.2 cm3. Reherniation was documented in 17 (24%) patients (symptomatic: n=10; asymptomatic: n=7). Six (8.3%) patients with symptomatic reherniation underwent rediscectomy. Implant failure was documented in 19 (26.4%) patients including anchor head breakage (n=1, 1.3%), dislocation of the whole device (n=5, 6.9%), and mesh dislocation into the spinal canal (n=13, 18%). Mesh subsidence within the EPC was documented in 15 (20.8%) patients. Seven (9.7%) patients underwent explantation of the entire, or parts of the device.Conclusion: Clinical improvement after LMD and ACD implantation was proven in our study. High incidence and volume of EPC did not correlate with clinical outcome. The ACD might prevent disc reherniation despite implant failure rates. Mechanical friction of the polymer mesh with the endplate is most likely the cause of EPC after ACD.

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