'Clinical triad' findings in pediatric Klippel-Feil patients

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Scoliosis and Spinal Disorders journal: a new, cutting-edge frontier in spine publishing

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Clarifying the nomenclature of intervertebral disc degeneration and displacement: from bench to bedside

As a significant determinant of low back pain, intervertebral disc degeneration (IDD) has attracted more and more attention of both investigators and physicians. Disc herniation, termed as intervertebral disc displacement, is amongst the most prevalent spinal diseases closely linked with IDD. Due to the same origins and similar pathophysiology, the ambiguity regarding the similarity and difference of IDD and intervertebral disc displacement thus remains. The aim of this study was to clarify the nomenclature of IDD and disc herniation in terms of molecular etiology, pathophysiology, nature history and clinical outcomes. Collectively, IDD is a type of multifaceted, progressive spinal disease with or without clinical symptoms as back pain, characterized by extracellular matrix and the integrity of NP and AF lost, fissures formation. Disc herniation (termed as intervertebral disc displacement) is a type of spinal disease based on IDD or not, with local pain and/or sciatica due to mechanical compression and autoimmune cascades upon the corresponding nerve roots. Clarifying the nomenclature of intervertebral disc degeneration and displacement has important implications both for investigators and for physicians.published_or_final_versio

Cervical spine disease in Asian populations

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Are patterns of lumbar disc degeneration associated with low back pain? New insights based on skipped level disc pathology

Free Papers: Spine ‐ Lumbar: abstract no. 29648INTRODUCTION: The clinical relevance of 'patterns' of disc degeneration of the lumbar spine is unknown. In the setting of multilevel disc degeneration (2 or more levels), this study addressed the clinical implications of skipped level disc degeneration (SLDD) to that of consecutive, multilevel disc degeneration (CMDD) of the lumbar ...poatprin

Body mass index and its association with lumbar disc herniation and sciatica: a large-scale, population-based study

Electronic Poster Presentations: P33INTRODUCTION: This large-scale study addressed the association of body mass index (BMI), especially overweight / obesity with lumbar disc herniation, its global lumbar involvement and implications with sciatica that little of which is ...postprin

Defining clinically relevant values for developmental spinal stenosis: a large-scale magnetic resonance imaging study

STUDY DESIGN: Case-control study. OBJECTIVE: The aim of this study was to define clinically relevant relative and critical (absolute) magnetic resonance imaging values of lumbar spinal stenosis in a cohort of 100 surgical cases and 100 asymptomatic controls. SUMMARY OF BACKGROUND DATA: Developmental spinal stenosis is a precipitating factor in patients presenting with lumbar canal stenosis. Yet, due to a lack of agreement on definitions and methods of assessment, as well as ethnic-specific normative values, its prevalence and significance is not known. METHODS: This was a case-control study comparing 100 age and sex-matched asymptomatic, volunteers with that of 100 patients who underwent surgery for spinal stenosis. All patients were of Chinese ethnicity and their details were blinded to 2 observers. Spinal stenosis parameters were measured on the basis of axial (pedicle level) and sagittal (midsagittal) magnetic resonance images. RESULTS: Anteroposterior spinal canal diameters change with levels. At each level, patients were found to have significantly narrower anteroposterior canal diameters than controls. By use of receiver operating characteristic curve, we defined developmental spinal stenosis if the anteroposterior canal diameter was at L1 <20 mm, L2 <19 mm, L3 <19 mm, L4 <17 mm, L5 <16 mm, and at S1 <16 mm on the basis of a value including 50% of controls and demonstrated best sensitivity and specificity. Furthermore, for L4, L5, and S1, critical stenosis values could be defined, below which almost all subjects needed surgery, these were L4 <14 mm, L5 <14 mm, and S1 <12 mm. CONCLUSION: This is the largest magnetic resonance imaging-based study with standardized measurements and comparable groups to determine clinically relevant magnetic resonance imaging criteria for lumbar spinal stenosis. The findings strongly suggest that developmental stenosis plays an important role in the pathogenesis of symptomatic spinal stenosis. Critical values of stenosis below which symptoms were highly likely were defined. These will need to be validated by longitudinal studies in future. However, they may possess clinical utility in determining the appropriate levels requiring canal-widening surgery.Level of Evidence: 3.postprin

The safety and efficacy of mesenchymal stem cells for prevention or regeneration of intervertebral disc degeneration: a systematic review

General Posters: abstract no. GP86INTRODUCTION: Mesenchymal stem cells (MSCs) have been used to halt the progression or regenerate the disc with hopes to prevent or treat discogenic back pain. However, the safety and efficacy of the use of MSCs for such treatment in animal and human models at short and long term assessment (i.e. greater than 48 weeks) have not been systematically addressed. This study addressed a systematic review of comparative controlled studies addressing the use of MSCs to that of no treatment/saline for the treatment of disc degeneration. METHODS: Online databases were extensively searched. Controlled trials in animal models and humans were eligible for inclusion. Trial design, MSC characteristics, injection method, disc assessment, outcome intervals, and complication events were assessed. Validity of each study was assessed addressing trial design. Two individuals independently addressed the aforementioned. RESULTS: Twenty-two animal studies were included. No human comparative controlled trials were reported. All three types of MSCs (i.e. derived from bone marrow, synovial and adipose tissue) showed successful inhibition of disc degeneration progression. From three included studies, bone marrow derived MSC showed superior quality of disc repair when compared to other treatments, including TGF-β1, NP bilaminar co-culture and axial distraction regimen. However, osteophyte development was reported in two studies as potential complication of MSC transplantation. CONCLUSIONS: Based on animal models, the current evidence suggests that in the short-term MSC transplantation is safe and effective in halting disc degeneration; however, additional and larger studies are needed to assess the long-term regenerative effects and potential complications. Inconsistency in methodological design and outcome parameters prevent any robust conclusions. In addition, randomized controlled trials in humans are needed to assess the safety and efficacy of such therapy.published_or_final_versio

Genetics of Lumbar Disk Degeneration: Technology, Study Designs, and Risk Factors

Lumbar disk degeneration (LDD) is a common musculoskeletal condition. Genetic risk factors have been suggested to play a major role in its cause. This article reviews the main research strategies that have been used to study the genetics of LDD, and the genes that thus far have been identified to influence susceptibility to LDD. With the rapid progress in genomic technologies, further advances in the genetics of LDD are expected in the next few years. © 2011 Elsevier Inc.postprin