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Adult Stem Cells for Intervertebral Disc Repair
Published in Raquel M. Gonçalves, Mário Adolfo Barbosa, Gene and Cell Delivery for Intervertebral Disc Degeneration, 2018
Esther Potier, Delphine Logeart-Avramoglou
The first signs of degeneration appear in the NP, where type II collagen and proteoglycans are replaced by type I collagen, causing a drop in water content (Antoniou et al. 1996; Le Maitre et al. 2007b) and, subsequently, a decline in the height and the load-bearing capacity of the IVD. The ensuing stress redistribution spreads to adjacent AF, end-plates, and vertebral bodies, which may ultimately lead to crack formation, rupture, and/or structural deterioration in the IVD. These tissue modifications can, in turn, result in painful symptoms and neurological deficits due to nerve root compression, facet joint arthrosis, etc. Changes in the NP composition are the result of increased production of both proinflammatory cytokines, and enzymes degrading the collagens and proteoglycans (Kepler et al. 2013; Le Maitre, Freemont, and Hoyland 2004), combined with the inability of the NP cell population to maintain and/or produce the NP-specific matrix due to their declining number and altered phenotype (Freemont 2009; Raj 2008). Contrary to most of the other musculoskeletal tissues, the IVD starts to degenerate spontaneously as early as in the second decade of life (Boos et al. 2002). This process is the natural aging of the IVD, as shown by the high incidence of IVD degenerative changes in asymptomatic patients, but it could be accelerated and become pathological because of genetic, environmental, or biomechanical factors (Battié and Videman 2006).
Acute low back pain
Published in Pamela E Macintyre, Suellen M Walker, David J Rowbotham, Clinical Pain Management, 2008
In the absence of factors suggesting a red flag condition, laboratory tests and imaging can be deferred for four weeks because of the favorable natural history during this time and the need to avoid unnecessary radiation and expense. In addition, radiological interobserver error in some conditions, such as degenerative spondylolisthesis, facet joint arthrosis, and sacroiliac joint arthrosis, needs to be considered.74
The biomechanical effects of Ti versus PEEK used in the PLIF surgery on lumbar spine: a finite element analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Hongwei Wang, Yi Wan, Xinyu Liu, Bing Ren, Yan Xia, Zhanqiang Liu
Excessive facet joint contact force might result in facet joint arthrosis (Park et al. 2013). In the present study, facet joint forces of instrumented models were compared with the intact model under the torsion load condition. No contact occurred in the instrumented segments of all configurations. The increased facet joint forces in the non-instrumented segments compensated for no contact in the instrumented segment. In addition, the contact force in PCTR and TCTR configurations increased higher than PCPR and TCPR, which might contribute to a higher risk of facet joint arthrosis. Facet joint force value is sensitive to loading conditions and facet joint geometry. In Chen–Sheng’s study, the contact force value was higher, however, a similar trend was observed (Chen et al. 2001). The difference might be due to the differences in facet joint geometry and the gap of facet joints (Woldtvedt et al. 2011).
Risk factors related to adjacent segment degeneration: retrospective observational cohort study and survivorship analysis of adjacent unfused segments
Published in British Journal of Neurosurgery, 2019
Jose Ramirez-Villaescusa, Jesús López-Torres Hidalgo, Antonio Martin-Benlloch, David Ruiz-Picazo, Francisco Gomar-Sancho
By analysing changes in all adjacent unfused lumbar discs, this study made it possible to evaluate the most frequent biomechanical consequences of fusion on adjacent discs, as well as changes in non-contiguous segments due to secondary compensatory mechanisms. Although the lumbosacral spine in upright position could be evaluated and the variables associated with the appearance of radiographic changes could be measured in all patients, the lack of a radiographic study of the complete spine in the upright position in all patients ruled out pre- and post-operative evaluation of the sagittal axis, as a possible determining factor of the appearance of changes linked to the repositioning of spinal and pelvic parameters. Furthermore, the lack of a computed tomography study on all patients at end of follow-up made it impossible to evaluate degenerative facet joint changes responsible for pain during follow-up and identify facet joint arthrosis as a cause of adjacent segment degeneration.
When to consider “mixed pain”? The right questions can make a difference!
Published in Current Medical Research and Opinion, 2020
Rainer Freynhagen, Roberto Rey, Charles Argoff
Imaging findings. (A) Multisegmental osteochondrosis with anterior spondylosis of the thoracic 11/12 and lumbar 1/2/3. Caudally emphasized facet joint arthrosis. (B) Spondylarthrosis L3/4/5 and S1 (hypertrophic, destructive and activated as L4/5). (C) Synovial cyst L5/S1 left with relocation and compression of the nerve route S1 left.