Correlation between spinous process deviation and lumbar disc herniation in young patients / 中国骨伤

OBJECTIVE@#To explore the relationship between spinous process deviation and lumbar disc herniation in young patients.@*METHODS@#From March 2015 to January 2022, 30 treated young (under the age of 30) patients with lumbar disc herniation were included as the young group. In addition 30 middle-aged patients (quinquagenarian group) with lumbar disc herniation and 30 patients with non-degenerative spinal diseases (young non-degenerative group) were selected as control groups. The angle of the spinous process deviation was measured on CT and statistically analyzed by various groups. All the data were measured twice and the average value was taken and recorded.@*RESULTS@#The average angle of spinous process deviation in the degenerative lumbar vertebra of young patients were (3.89±3.77) degrees, similar to the (3.72±2.98) degrees of quinquagenarian patients(P=0.851). The average angle of s spinous process deviation young non-degenerative group were (2.20±2.28) degrees, significantly less than young group(P=0.040). The spinous process deviation angle of the superior vertebral of the degenerative lumbar in the young group was (4.10±3.44) degrees, which similar to the (3.47±2.87) degrees in the quinquagenarian group (P=0.447). A total of 19 young patients had the opposite deviation direction of the spinous process of the degenerative lumbar vertebra and upper vertebra, while only 7 quinquagenarian patients had this condition(P=0.02). The type of lumbar disc herniation in young patients had no significant relationship with the direction of spinous process deflection of the degenerative or upper lumbar vertebra (P>0.05).@*CONCLUSION@#Spinous process deviation is a risk factor of young lumbar disc herniation patients. If the deviation directions of adjacent lumbar spinous processes are opposite, it will increase the incidence of lumbar disc herniation in young patients. There was no significant correlation between the type of disc herniation and the deviation direction of the spinous process of the degenerative or upper lumbar vertebra. People with such anatomical variation can strengthen the stability of spine and prevent lumbar disc herniation through reasonable exercise.

X-ray dynamic observation of cervical degenerative disease induced by unbalanced dynamic and static forces in rats

Abstract Purpose: To investigate dynamically the X-ray appearance of cervical degenerative disease induced by unbalanced dynamic and static forces in rats. Methods: A total of 60 Sprague Dawley rats were randomized into test (n=45) and control (n=15) groups, which were randomly subdivided into the one-, three- and six-month post-operative groups. The test group included 10, 15 and 20 rats at the respective corresponding post-operative stage and the control group included five rats at each time-point. By excising cervicodorsal muscles, interspinous ligaments and supraspinous ligament of rats in the test group, the balance of dynamic and static forces on cervical vertebrae was disrupted to establish a rat model of cervical degeneration. Spinal X-ray images were acquired, and intervertebral disc space and intervertebral foramen size were measured at one, three and six months post-operation. The results were analyzed and compared among groups. Results: Cervical dynamic and static imbalance accelerated the appearance of cervical degenerative disease on X-ray. Conclusion: Cervical degenerative disease may be induced by unbalanced dynamic and static forces in rats.

Does a small size needle puncture cause intervertebral disc changes?

PURPOSE:Small size needles have been regularly used for intradiscal injection of innocuous/potential therapeutic compounds in experimental conditions, but also in clinic procedures, such as discography. Our aim was to investigate if a 30-gauge needle could trigger observable changes on intact intervertebral discs. We compared these effects to those induced by a large size needle (21-gauge), a well-known intervertebral disc degenerative model based on needle puncture.METHODS:Coccygeal intervertebral discs (Co8-9) of adult male Wistar rats were punctured with a 21-gauge needle, while the coccygeal levels Co7-8 and Co9-10 remained intact. The 30-gauge needle was used to inject a safe volume of saline (2 µl) on both intact (Co9-10) and punctured (Co8-9) discs. MRI and histological score were performed at 2, 15 and 42 days after procedure.RESULTS: MRI analyses revealed significant reduction on signal intensity of 21-gauge punctured discs. Intact discs which received a saline injection through a 30-gauge needle also revealed significant alterations in the MRI signal when compared with control discs. No histological changes were observed in the intact saline injected discs at any time analyzed.CONCLUSION: Since significant intervertebral image changes were observed with a 30-gauge needle, cautious interpretation of the pharmacological inoculation findings is required.

Fatores genéticos e ambientais envolvidos na degeneração do disco intervertebral / Genetic and environmental factors involved on intervertebral disc degeneration

A etiologia da degeneração do disco intervertebral (DDI) ainda não está totalmente esclarecida. O gene do receptor da vitamina D (VDR) tem sido apontado como um dos possíveis envolvidos no surgimento das discopatias. Por outro lado, este estudo relaciona pela primeira vez, a participação dos genes das glutatião transferases M1 e T1 (GSTT1 e GSTM1), responsáveis pela inativação dos componentes do cigarro, na DDI. Foi extraído DNA de leucócitos de 66 pacientes e 88 controles, pareados por gênero e idade. O polimorfismo VDR-FokI foi amplificado por reação em cadeia da polimerase (PCR) seguido de restrição com a enzima FokI. Os polimorfismos das GSTT1/M1 foram determinados por meio da PCR multiplex. A história familial e a gravidade da doença se destacaram nos pacientes portadores do alelo f do gene VDR-FokI (P=0,000 e 0,0012, respectivamente). A idade de surgimento da doença mostrou-se precoce nos indivíduos com genótipo _/f (média de 26 anos). Foi encontrada associação do polimorfismo FokI com a degeneração precoce e gravidade da DDI, sendo que o hábito de fumar também interferiu nesse processo, independente da presença ou não do genótipo favorável para GSTT1/M1.

The etiology of intervertebral disc degeneration (IDD) has not been fully clarified yet. Vitamin D receptorÆs gene (VDR) has been suggested as one of the potential entities involved in disc pathologies onset. On the other hand, this study correlates, for the first time, glutathione transferases M1 and T1 genes (GSTT1 and GSTM1) participation, which are responsible for cigarette componentsÆ inactivation, in IDD. DNA was extracted from leukocytes of 66 patients and 88 controls, paired by gender and age. The VDR-Fokl polymorphism was amplified by polymerase chain reaction (PCR) followed by restriction with Fokl enzyme. GSTT1/M1 polymorphisms were determined by means of PCR multiplex. Family history and disease severity were highlighted in patients carrying the f allele of the VDR-Fokl gene (P=0.000 and 0.0012, respectively). The age at disease onset has shown to be early in individuals with _/f genotype (average 26 years old). A correlation was found between Fokl polymorphism and early degeneration and IDD severity, with smoking habit also interfering in this process, regardless of the presence or absence of a favorable genotype for GSTT1/M1.