scholarly journals Pathophysiology of lumbar disc degeneration: a review of the literature

2002 ◽  
Vol 13 (2) ◽  
pp. 1-6 ◽  
Author(s):  
Michael D. Martin ◽  
Christopher M. Boxell ◽  
David G. Malone
Keyword(s):  
Disc Degeneration ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Review Of The Literature ◽  
Lumbar Disc Degeneration ◽  
Vertebral Endplate ◽  
Discogenic Pain ◽  
Degenerative Process ◽  
Motion Segment ◽  
Disc Nutrition

Lumbar disc degeneration occurs because of a variety of factors and results in a multitude of conditions. Alterations in the vertebral endplate cause loss of disc nutrition and disc degeneration. Aging, apoptosis, abnormalities in collagen, vascular ingrowth, loads placed on the disc, and abnormal proteoglycan all contribute to disc degeneration. Some forms of disc degeneration lead to loss of height of the motion segment with concomitant changes in biomechanics of the segment. Disc herniation with radiculopathy and chronic discogenic pain are the result of this degenerative process.

Association between Measures of Vertebral Endplate Morphology and Lumbar Intervertebral Disc Degeneration

2017 ◽  
Vol 68 (2) ◽  
pp. 210-216 ◽  
Author(s):  
Semra Duran ◽  
Mehtap Cavusoglu ◽  
Hatice Gul Hatipoglu ◽  
Deniz Sozmen Cılız ◽  
Bulent Sakman
Keyword(s):  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Lumbar Disc ◽  
Lumbar Disc Degeneration ◽  
Vertebral Endplate ◽  
Lumbar Intervertebral Disc ◽  
Sagittal Diameter ◽  
Magnetic Resonance Imaging Mri ◽  
Vertebral Endplates

Purpose The aim of this study was to evaluate the association between vertebral endplate morphology and the degree of lumbar intervertebral disc degeneration via magnetic resonance imaging (MRI). Methods In total, 150 patients who met the inclusion criteria and were 20–60 years of age were retrospectively evaluated. Patients were evaluated for the presence of intervertebral disc degeneration or herniation, and the degree of degeneration was assessed at all lumbar levels. Vertebral endplate morphology was evaluated based on the endplate sagittal diameter, endplate sagittal concave angle (ECA), and endplate sagittal concave depth (ECD) on sagittal MRI. The association between intervertebral disc degeneration or herniation and endplate morphological measurements was analysed. Results In MRI, superior endplates ( ie, inferior endplates of the superior vertebra) were concave and inferior endplates ( ie, superior endplates of the inferior vertebra) were flat at all disc levels. A decrease in ECD and an increase in ECA were detected at all lumbar levels as disc degeneration increased ( P < .05). At the L4-L5 and L5-S1 levels, a decrease in ECD and an increase in ECA were detected in the group with herniated lumbar discs ( P < .05). There was no association between lumbar disc degeneration or herniation and endplate sagittal diameter at lumbar intervertebral levels ( P > .05). At all levels, ECD of women was significantly lesser than that of men and ECA of women was significantly greater than that of men ( P < .05). Conclusions There is an association between vertebral endplate morphology and lumbar intervertebral disc degeneration. Vertebral endplates at the degenerated disc level become flat; the severity of this flattening is correlated with the degree of disc degeneration.

scholarly journals Prevalence, Patterns, and Genetic Association Analysis of Modic Vertebral Endplate Changes

2017 ◽  
Vol 11 (4) ◽  
pp. 594-600 ◽  
Author(s):  
Rishi Mugesh Kanna ◽  
Rajasekaran Shanmuganathan ◽  
Veera Ranjani Rajagopalan ◽  
Senthil Natesan ◽  
Raveendran Muthuraja ◽  
...  
Keyword(s):  
Candidate Genes ◽  
Genetic Association ◽  
Association Analysis ◽  
Disc Degeneration ◽  
Lumbar Disc ◽  
Nucleotide Polymorphisms ◽  
Lumbar Disc Degeneration ◽  
Vertebral Endplate ◽  
Genetic Association Analysis ◽  
Study Population

<sec><title>Study Design</title><p>A prospective genetic association study.</p></sec><sec><title>Purpose</title><p>The etiology of Modic changes (MCs) is unclear. Recently, the role of genetic factors in the etiology of MCs has been evaluated. However, studies with a larger patient subset are lacking, and candidate genes involved in other disc degeneration phenotypes have not been evaluated. We studied the prevalence of MCs and genetic association of 41 candidate genes in a large Indian cohort.</p></sec><sec><title>Overview of Literature</title><p>MCs are vertebral endplate signal changes predominantly observed in the lumbar spine. A significant association between MCs and lumbar disc degeneration and nonspecific low back pain has been described, with the etiopathogenesis implicating various mechanical, infective, and biochemical factors.</p></sec><sec><title>Methods</title><p>We studied 809 patients using 1.5-T magnetic resonance imaging to determine the prevalence, patterns, distribution, and type of lumbar MCs. Genetic association analysis of 71 single nucleotide polymorphisms (SNPs) of 41 candidate genes was performed based on the presence or absence of MCs. SNPs were genotyped using the Sequenome platform, and an association test was performed using PLINK software.</p></sec><sec><title>Results</title><p>The mean age of the study population (n=809) was 36.7±10.8 years. Based on the presence of MCs, the cohort was divided into 702 controls and 107 cases (prevalence, 13%). MCs were more commonly present in the lower (149/251, 59.4%) than in the upper (102/251, 40.6%) endplates. L4–5 endplates were the most commonly affected levels (30.7%). Type 2 MCs were the most commonly observed pattern (n=206, 82%). The rs2228570 SNP of VDR (<italic>p</italic>=0.02) and rs17099008 SNP of MMP20 (<italic>p</italic>=0.03) were significantly associated with MCs.</p></sec><sec><title>Conclusions</title><p>Genetic polymorphisms of SNPs of VDR and MMP20 were significantly associated with MCs. Understanding the etiopathogenetic mechanisms of MCs is important for planning preventive and therapeutic strategies.</p></sec>

scholarly journals High Incidence Rate of Lumbar Spinal Disease Among Child and Adolescent Weightlifting Athletes: A Prospective 4-year Cohort Study

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0039
Author(s):  
Kazu Toyooka ◽  
Junsuke Nakase ◽  
Kengo Shimozaki ◽  
Kazuki Asai ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Cohort Study ◽  
Resistance Training ◽  
Disc Degeneration ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Vertebrae ◽  
Child And Adolescent ◽  
Lumbar Disc Degeneration ◽  
Mri Findings ◽  
Lumbar Spondylolysis

Objectives: Resistance training, such as weightlifting, in child and adolescent athletes has been considered unsafe, leading to injuries to the musculoskeletal system and growth plate, and to low back pain (LBP). We focused on the lumbar vertebrae, as these are most frequently injured in weightlifting, and prospectively investigated LBP and abnormal lumbar findings in child and adolescent weightlifters. The purpose of this 4-year cohort study was to assess the incidence and characteristics of LBP and abnormal lumbar findings in child and adolescent weightlifting athletes using medical questionnaires and magnetic resonance imaging (MRI). This study was conducted to evaluate subclinical sports injuries. In the absence of reports on long-term implications of resistance training, the safety and validity of resistance training in children and adolescents, especially weightlifting at the competition level, has remained controversial. The findings may help prevent competition-specific injuries and improve performance levels. Methods: This prospective 4-year cohort study was conducted between 2014 and 2017. Twelve participants (6 boys and 6 girls) were enrolled. The participants were either children or adolescents without history of lumbar disease or surgery who participated in weightlifting for at least 2 years. The mean age of the participants at the start of this study was 11.4±2.0 years. Annual medical questionnaires and lumbar examinations using MRI were performed during the 4-year follow-up. The assessment items included a medical questionnaire, which was used to record the practice frequency and presence of LBP each year, and MRI findings. On MRI, lumbar spondylolysis, disc herniation, and lumbar disc degeneration at all lumbar vertebral levels (L1 to S1) in the sagittal and coronal plane were assessed. Pfirrmann classification was used for the assessment of lumbar disc degeneration. MRI findings were interpreted by two orthopedic surgeons; one was a specialist in spine surgery, and the other was an experienced orthopedic surgeon. Both readers were unaware of the participant’s other findings. Inter-reader and intra-reader agreements were assessed using the κ value. Results: The participants practiced approximately 2 hours per day for about 5 days per week under the guidance of a team coach. At the start of this study, there were no positive findings of LBP, lumbar spondylolysis, or disc herniation on MRI. Lumbar disc degeneration on MRI was observed in only 2 participants. The grade of degeneration was grade 2. During the 4-year study, LBP was confirmed in 5 participants, lumbar spondylolysis in 5, and lumbar disc herniation in 3; 1 of the herniation cases required operative treatment, and lumbar disc degenerations was found in all participants (Table) . In lumbar disc degenerations, 8 participants had lumbar disc degeneration in the second year, with 9 in the third year, and 12 (including 5 with grade 3 degeneration) in the final year. Lumbar disc degeneration changes were irreversible. The κ value of inter-reader agreement was 0.53, with 0.78 for intra-reader agreement. Conclusion: This prospective 4-year cohort study of 12 child and adolescent weightlifters revealed that abnormal lumbar findings occurred in all cases when assessed with MRI, and that the abnormal changes were irreversible. Regardless of the presence or absence of symptoms, resistance training at the competition level is likely to cause irreversible changes in the lumbar vertebrae. [Table: see text]

scholarly journals Does the sagittal spinal profile differ between the elderly Chinese populations with and without lumbar disc herniation?

2021 ◽  
Author(s):  
Jipeng Song ◽  
Fumin Pan ◽  
Chao Kong ◽  
Xiangyao Sun ◽  
Yu Wang ◽  
...  
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Age Groups ◽  
Lumbar Disc Degeneration ◽  
Roussouly Classification ◽  
Asymptomatic Volunteers ◽  
Two Populations

Abstract Background The influence of spinopelvic morphology on the Chinese elderly LDH population was not clear. The purpose of this study is to explore its influence on the characteristics of lumbar disc herniation or degeneration. Methods 212 elderly patients with LDH and 213 asymptomatic volunteers were involved. Spinal parameters were measured on full-length X-ray and compared between two populations. In herniated group, sagittal profiles were determined according to the Roussouly classification, the degenerative grades, the herniated location and the number of intervertebral lumbar disc degeneration were evaluated from the L1 to S1 on MRI scans. The differences on them among Roussouly types were analyzed. Results There were no significant differences in BMI, the mean value of age and sex distribution between two populations. Patients were found to have significantly smaller TK, LL, and SS than those volunteers (p < 0.05), while contradicting observations on PT and TPA were obtained (p < 0.05). Roussouly type 1 and type 2 ( 50.4% and 28.7% respectively) are predominant in the LDH population and the proportion of type 1 in elderly LDH is further increased. Subjects with LDH in type 1 and 2 had lower mean herniated locations and fewer mean herniated numbers than those with type 3 and 4. Conclusions Sagittal spinopelvic parameters were found to be significantly different in elderly LDH patients and asymptomatic volunteers. There were significant differences in the Roussouly distribution among different age groups of LDH. Different Roussouly subtypes have different effects on lumbar disc degeneration and herniation.

scholarly journals Clinical Presentations of Lumbar Disc Degeneration and Lumbosacral Nerve Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Worku Abie Liyew
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc ◽  
Muscular Weakness ◽  
Lumbar Disc Degeneration ◽  
Lower Abdomen ◽  
Sacral Plexus ◽  
Discogenic Pain ◽  
Nerve Lesions ◽  
Clinical Presentations ◽  
Plexus Lesion

Lumbar disc degeneration is defined as the wear and tear of lumbar intervertebral disc, and it is mainly occurring at L3-L4 and L4-S1 vertebrae. Lumbar disc degeneration may lead to disc bulging, osteophytes, loss of disc space, and compression and irritation of the adjacent nerve root. Clinical presentations associated with lumbar disc degeneration and lumbosacral nerve lesion are discogenic pain, radical pain, muscular weakness, and cutaneous. Discogenic pain is usually felt in the lumbar region, or sometimes, it may feel in the buttocks, down to the upper thighs, and it is typically presented with sudden forced flexion and/or rotational moment. Radical pain, muscular weakness, and sensory defects associated with lumbosacral nerve lesions are distributed on lower extremities, the buttock, lower abdomen, and groin region. A lumbosacral plexus lesion presents different symptoms in the territories of the lumbar and sacral nerves. Patients with lumbar plexus lesion clinically present with weakness of hip flexion, knee extension, thigh adduction, and sensory loss in the lower abdomen, inguinal region, and over the entire medial, lateral, and anterior surfaces of the thigh and the medial lower leg, while sacral plexus lesion presents clinical symptoms at nerve fibers destined for the sciatic nerve, common peroneal nerve, and pudendal nerve. Weakness of ankle inversion, plantar flexion, and foot drop are the main clinical manifestations of the sacral plexus lesion area. Numbness and decreased sensation are also present along the anterolateral calf and dorsum of the foot. On examination, foot eversion is usually stronger than foot dorsiflexion. The patients may also present with pain and difficulty of bowel movements, sexual dysfunction assessments, and loss of cutaneous sensation in the areas of the anal canal, anus, labia major, labia minor, clitoris, penis, and scrotum.

scholarly journals Synchronous Lumbar Disc Herniation in Adult Twins. Case Report

2004 ◽  
Vol 31 (4) ◽  
pp. 554-557 ◽  
Author(s):  
Ratan Bhardwaj ◽  
Rajiv Midha
Keyword(s):  
Case Report ◽  
Disc Degeneration ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Genetic Factors ◽  
Lumbar Disc ◽  
Relevant Literature ◽  
Lumbar Disc Degeneration ◽  
Adult Twins

Objective:To report an unusual case of large synchronous lumbar disc herniation in adult twins.Methods:Case report and relevant literature review.Results:The authors report a case of adult female monozygotic twins who synchronously presented with huge lumbar disc herniation. Rather than being a curious coincidence, this case highlights the potential importance of hereditary factors in the causation of lumbar disc degeneration. The relevant literature regarding the role of genetic factors and their relationship to other risk factors in lumbar disc degeneration is reviewed and discussed.Conclusion:Synchronous lumbar disc herniation in adult twins is a rare event. It, however, sheds light on the role of genetic factors in disc degeneration.

scholarly journals Efficacy of percutaneous endoscopic lumbar discectomy for pediatric lumbar disc herniation and degeneration on magnetic resonance imaging: case series and literature review

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098668
Author(s):  
Ruei-Hong Lin ◽  
Hung-Chieh Chen ◽  
Hung-Chuan Pan ◽  
Hsien-Te Chen ◽  
Chien-Chun Chang ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disc Degeneration ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
Resonance Imaging ◽  
Lumbar Disc Degeneration ◽  
Endoscopic Lumbar Discectomy

Objective Pediatric lumbar disc herniation (LDH), although uncommon, causes significant pain, discomfort, and sometimes disability. We examined the efficacy of percutaneous endoscopic lumbar discectomy (PELD) for pediatric LDH and the degree of lumbar disc degeneration at 1 year after PELD. Methods We retrospectively reviewed the data of pediatric patients with LDH who underwent PELD from December 2007 to July 2018. The patients’ symptoms, physical examination findings, clinical images, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and perioperative results (blood loss, length of hospital stay, and complications) were obtained from the medical records. Lumbar disc degeneration was graded using the modified Pfirrmann grading system at the 1-year postoperative magnetic resonance imaging (MRI) examination. Results Six boys and four girls who underwent PELD were evaluated. The patients’ mean age was 15.6 years (range, 13–17 years). The mean VAS score for low back pain, mean VAS score for lower limb pain, and mean ODI preoperatively and 1 year postoperatively were 6.2 and 0.3, 6.9 and 0.5, and 20 and 0.1, respectively. MRI showed significant disc degeneration after PELD. Conclusions Treating pediatric LDH with PELD is safe and effective. It relieves pain and reduces disability. However, lumbar disc degeneration still occurs.

scholarly journals Analysis of Correlation Between Vertebral Endplate Change and Lumbar Disc Degeneration

2017 ◽  
Vol 23 ◽  
pp. 4932-4938 ◽  
Author(s):  
Long Xiao ◽  
Chunlin Ni ◽  
Jiandong Shi ◽  
Zhirong Wang ◽  
Suchun Wang ◽  
...  
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc ◽  
Lumbar Disc Degeneration ◽  
Vertebral Endplate

scholarly journals Correlation between Sagittal Morphology of Lower Lumbar Endplate and Degenerative Changes in Patients with Lumbar Disc Herniation

2020 ◽  
Author(s):  
Chongqing Xu ◽  
Mengchen Yin ◽  
Wen Mo
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Intervertebral Discs ◽  
Modic Changes ◽  
Observer Agreement ◽  
Imaging Data ◽  
Lumbar Disc Degeneration ◽  
Lower Lumbar

Abstract Background: As an important anatomic factor in the process of Lumbar disc herniation (LDH), the correlation between endplate sagittal morphology and intervertebral disc degeneration (IDD) is unclear. and research on imaging data of lumbar endplate in patients with LDH is still insufficient. Our study aimed to observe the morphological change of the lower lumbar endplate (L3-S1) in patients with LDH on magnetic resonance imaging (MRI), and analyze its correlation with the degree of IDD.Methods/Design: All 116 patients were included. Based on their MRI, we divided endplates into three types (concave, flat and irregular), assigned intervertebral discs with Grade I-V given 1-5 points successively according to Pfirrmann system, and determined whether there was Modic change of each endplate. The correlation between the morphology of endplate and the degree of IDD was analyzed.Results: There were excellent inter-observer agreement for each item we analyzed (ICC > 0.75). Concave endplate appeared most frequently (187, 53.7%) and mainly distributed in L3/4 and L4/5, while irregular endplate was the least common type (54, 15.5%) and mainly concentrated in L5/S1. The IDD degree of corresponding disc increased gradually from concave (3.27 ± 0.81) to irregular endplates (4.25 ± 0.79) (P < 0.05). Irregular endplates were more likely to have Modic changes than concave and flat endplates (P < 0.05). Conclusion: The sagittal morphology of lower lumbar endplate is related to Modic changes and degree of IDD (based on Pfirrmann grading system) in patients with LDH, and the concave endplate mostly reflects a lower degree of lumbar disc degeneration, which has substantial clinical significance.

Lumbar Disc Degeneration

1990 ◽  
Vol 31 (6) ◽  
pp. 551-554
Author(s):  
O. Tervonen ◽  
S. Lahde ◽  
J. Rydberg
Keyword(s):  
Disc Degeneration ◽  
Lumbar Disc ◽  
Lumbar Disc Degeneration
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