Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patie...Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.展开更多
Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resecti...Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from the cervical vertebrae Mechanical instability in the cervical spine elicited by this surgical intervention accelerated the process of intervertebral disc degeneration The extent of intervertebral disc degeneration was graded in morphologically, and the thicknesses of the calcified layer and the uncalcified layer of the cartilage end plate were measured in each degenerated cervical disc Results In less severely degenerative cervical discs, the morphology of the cartilage end plate showed nearly normal construction, and the tidemark was clear In severely degenerative discs, the matrix and cells showed fibrosis, the tidemark advanced, and the calcified cartilage thickened There exists a positive correlation between the thickness of the calcified layer of the cartilage end plate and the degree of cervical disc degeneration Conclusion The calcification of the cartilage end plate is the key factor that initiates and promotes cervical disc degeneration展开更多
Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis an...Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.展开更多
Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying...Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the retative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study. Methods From January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2Wl sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray. Results In scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side （P 〈0.001）. The vertebral body height on the convex side was greater than the height on the concave side （P=0.016） There was a significant difference between the scoliosis group and the control group （P=0.003）, and between T-value and the rate of osteoporosis between the two groups （both P 〈0.001）. Results were verified using multiple linear regression analysis. Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis and the disc index, the degre展开更多
文摘Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.
文摘Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from the cervical vertebrae Mechanical instability in the cervical spine elicited by this surgical intervention accelerated the process of intervertebral disc degeneration The extent of intervertebral disc degeneration was graded in morphologically, and the thicknesses of the calcified layer and the uncalcified layer of the cartilage end plate were measured in each degenerated cervical disc Results In less severely degenerative cervical discs, the morphology of the cartilage end plate showed nearly normal construction, and the tidemark was clear In severely degenerative discs, the matrix and cells showed fibrosis, the tidemark advanced, and the calcified cartilage thickened There exists a positive correlation between the thickness of the calcified layer of the cartilage end plate and the degree of cervical disc degeneration Conclusion The calcification of the cartilage end plate is the key factor that initiates and promotes cervical disc degeneration
文摘Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.
文摘Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the retative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study. Methods From January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2Wl sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray. Results In scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side （P 〈0.001）. The vertebral body height on the convex side was greater than the height on the concave side （P=0.016） There was a significant difference between the scoliosis group and the control group （P=0.003）, and between T-value and the rate of osteoporosis between the two groups （both P 〈0.001）. Results were verified using multiple linear regression analysis. Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis and the disc index, the degre
