Progress on propionibacterium acnes and degenerative intervertebral disc / 中国骨伤

The mechanism of degenerative intervertebral disc is very complex, which may be associated with multiple factors such as the mechanical stress force injury of intervertebral disc, nutritional deficiency, inflammatory stimulation, etc. Recently, many studies detected propionibacterium acnes(P. acnes) in degenerative intervertebral disc and supposed P. acnes was associated with degenerative intervertebral disc. Here, the papers related to P. acnes and degenerative intervertebral disc were reviewed. Further, we deduced the approach of P. acnes enterring into the intervertebral disc as well as the mechanism of P. acnes aggravating the disc degeneration. These may provide suggestions for treating degenerative intervertebral disc.

Dose Optimization for Single Intradiscal Administration of the Tumor Necrosis Factor-α Inhibitor, Etanercept, in Rat Disc Injury Models

STUDY DESIGN: Experimental animal study. PURPOSE: We aimed to determine the optimal dose of a single direct injection of the tumor necrosis factor (TNF)-α inhibitor, etanercept, by using the rat model of degenerative intervertebral disc from injury. OVERVIEW OF LITERATURE: The pain-related peptide expression was suppressed in the etanercept (100 µg and 1,000 µg)-administered groups in a dose-dependent manner. METHODS: The neurotracer FluoroGold (FG) was applied to the surfaces of L4/5 discs to label their innervating dorsal root ganglion (DRG) neurons (n=50). Ten rats were included in the nonpunctured disc sham surgery control group, whereas the other 40 were included in the experimental group in which intervertebral discs were punctured with a 23-gauge needle. Saline or etanercept (10 µg, 100 µg, or 1,000 µg) was injected into the punctured discs (n=10 for each treatment). After 14 days of surgery, DRGs from L1 to L6 were harvested, sectioned, and immunostained for calcitonin gene-related peptide (CGRP). The proportion of FG-labeled CGRP-immunoreactive DRG neurons was evaluated in all the groups. RESULTS: There were no significant differences between the puncture+saline group and the puncture+10-µg etanercept group (p >0.05). However, a significant decrease in the percentage of FG and CGRP double-positive cells in FG-positive cells was observed in the etanercept (100 µg and 1,000 µg)-administered groups in a dose-dependent manner (p <0.05). CONCLUSIONS: When a low dose of the TNF-α inhibitor (10 µg of etanercept) was directly administered to the rat intervertebral disc in the rat model of degenerative intervertebral disc from injury, no suppressive effect on the pain-related peptide expression was observed. However, when a higher dose of etanercept (100 µg and 1,000 µg) was administered, the pain-related peptide expression was suppressed in a dose-dependent manner.

Age-related degeneration of each lumbar intervertebral disc in symptomatic patients:MRI analysis / 中国脊柱脊髓杂志

Objective:To determine the most common patterns in symptomatic lumbar intervertibral disc degeneration at various age period.Method:The lumbar MRI imaging data of 529 patients treated for low back pain with or without skelagia in Santa Monica hospital in USA from 2004 to 2006 were reviewed retrospectively in this study .There were 191 females, 338 males.Degenerative grading was made for all disc levels in the lumbar spine for each patient. The patients were also classified into five age different groups starting from below age 30,with the intervals of a single decade,until over age 60 (≤29 years,30-39 years,40-49 years, 50-59 years and≥60 years).The degenerative grade of all disc levels (L1/2 to L5/S1) in each patient was classified based on Pfirrmann's gading system,and locations and the progressive manner of the degeneration were determined for age groups.SPSS software version 13.0 (SPSS Inc.,Chicago,IL) on a personal computer was used for statistical analyses.Result:The most common pattern in all ages is normal in all the discs and it is described as 1-1-1-1-1 and this normal pattern was found in 71 patients (13.4%).There was rare change to develop severe degeneration (grade 4) for low age groups.The upper levels of the lumbar spine had more commonly lower degenerative grades,and the lower levels had relatively higher grades of advanced disc de-generation.In the age groups of below 29 years and 30-39 years,the most common pattern was normal in all the discs of 5 levels as 1-1-1-1-1.And this pattern was more prominent in the age group below 29 years.In the age group of 40-49 years.it was changed to single level L5-S1 degeneration with 1-1-1-1-3(7.6%) butthe normal discs in all levels had also a similar portion(6.8%).In the age groups of 50-59 years and over 60 years,it was changed to the pattern with all discs abnormal as 3-3-3-3-3.Single level involvement was negatively correlated with age (P<0.01 ).On the contrary,whole symmetrical degenerative involvement of all levels was positively correlated with age (P<0.01).Single L5/S1 involvement was most common in the age group of below 29 years,but in the age group of 30-39 years,the most common pattern was changed to L4/5 and L5/ S1 double involvement(P< 0.05).A relative small portion appeared as the most common pattern with less than two-level involvement in the age groups over 50 years.Conclusion:The rate of unilevel degenerative pattern of lumbar spine in overall population decreases with the progression of age, while that of all-level degenerative pattern increases with the progression of age.