The Dietary Intake of Polyphenols Is Associated with a Lower Risk of Severe Lumbar Spinal Stenosis: A Case-Control Analysis from the PREFACE Study

Polyphenols are naturally occurring compounds endowed with antioxidant and anti-inflammatory properties. We sought to examine the association of dietary polyphenols with the risk of severe lumbar spinal stenosis (LSS), a condition possibly characterized by a high inflammatory component. A case-control study included 156 patients with LSS and indication to surgery and 312 controls, matched (1:2) for sex, age (±6 months), and physical activity. The polyphenol intake was calculated by matching food consumption data from a 188-item food frequency questionnaire with the Phenol-Explorer database regarding the polyphenol content of each reported food. In a multivariable-adjusted logistic regression analysis including lifestyles, sociodemographic factors, and the Mediterranean Diet Score, a 1-standard deviation (SD) increase in dietary polyphenols intake was associated with lower odds of LSS (Odds ratio [OR] = 0.65; 95% CI: 0.47–0.89). Analyses of different polyphenol classes showed that a per 1-SD in the consumption of flavonoids and stilbenes was related to lower LSS risk (OR = 0.57; 95% CI: 0.42–0.78; OR = 0.40; 95% CI: 0.27–0.61, respectively). Further adjustment for the total dietary antioxidant capacity did not modify the strength of these associations. A diet rich in polyphenols is independently associated with a lower risk of severe LSS, possibly through mechanisms that include the anti-inflammatory potential of these bioactive compounds

Classification of three-dimensional thoracic deformities in adolescent idiopathic scoliosis from a multivariate analysis

PURPOSE: Understanding how to classify and quantify three-dimensional (3D) spinal deformities remains an open question in adolescent idiopathic scoliosis. The objective of this study was to perform a 3D manifold characterization of scoliotic spines demonstrating thoracic deformations using a novel geometric and intuitive statistical tool to determine patterns in pathological cases. METHODS: Personalized 3D reconstructions of thoracic (T)/lumbar (L) spines from a cohort of 170 Lenke Type-1 patients were analyzed with a non-linear manifold embedding algorithm in order to reduce the high-dimensionality of the data, using statistical properties of neighbouring spine models. We extracted sub-groups of the data from the underlying manifold structure using an unsupervised clustering algorithm to understand the inherent distribution and determine classes of pathologies which appear from the low-dimensional space. RESULTS: For Lenke Type-1 patients, four clusters were detected from the low-dimensional manifold of 3D models: (1) normal kyphosis (T) with hyper-lordosis (L) and high Cobb angles (37 cases), (2) low kyphosis (T) and normal lordosis (L), with high rotation of plane of maximum curvature (55 cases), (3) hypo-kyphotic (T) and hyper-lordosis (L) (21 cases) and (4) hyper-kyphotic (T) with strong vertebral rotation (57 cases). Results show the manifold representation can potentially be useful for classification of 3D spinal pathologies such as idiopathic scoliosis and serve as a tool for understanding the progression of deformities in longitudinal studies. CONCLUSIONS: Quantitative evaluation illustrates that the complex space of spine variability can be modeled by a low-dimensional manifold and shows the existence of an additional hyper-kyphotic subgroup from the cohort of 3D spine reconstructions of Lenke Type-1 patients when compared with previous findings on the 3D classification of spinal deformities

L1CAM variants cause two distinct imaging phenotypes on fetal MRI

Data on fetal MRI in L1 syndrome are scarce with relevant implications for parental counseling and surgical planning. We identified two fetal MR imaging patterns in 10 fetuses harboring L1CAM mutations: the first, observed in 9 fetuses was characterized by callosal anomalies, diencephalosynapsis, and a distinct brainstem malformation with diencephalic-mesencephalic junction dysplasia and brainstem kinking. Cerebellar vermis hypoplasia, aqueductal stenosis, obstructive hydrocephalus, and pontine hypoplasia were variably associated. The second pattern observed in one fetus was characterized by callosal dysgenesis, reduced white matter, and pontine hypoplasia. The identification of these features should alert clinicians to offer a prenatal L1CAM testing.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.Published version, accepted version, submitted versio

Dietary factors and the risk of lumbar spinal stenosis: A case\u2013control analysis from the PREFACE study

Background and aims: There is a lack of knowledge on the association of dietary factors and Lumbar Spinal Stenosis (LSS). We evaluated the association of a Mediterranean diet (MD), its major food components and ultra-processed food (UPF) with the risk of LSS. Methods and results: Participants were recruited from the Neurosurgery Department of the IRCCS Neuromed, Italy. The study sample consisted of 156 cases of LSS, and 312 controls matched 1:2 for sex, age (\ub16 months) and physical activity, without a history or clinical evidence of LSS who were identified from the general population. Adherence to MD was assessed by the Mediterranean Diet Score based on 9 food groups. UPF was defined according to NOVA classification and calculated as the ratio (%) of UPF (g/d) on total food consumed (g/d). In multivariable-adjusted analysis, a 2-point increase in the MD score was not associated with LSS risk (OR: 1.02, 95% CI: 0.72\u20131.46). An increment of 10 g/d of fruits and nuts, cereals or fish led to lower odds of LSS (OR: 0.97, 95% CI: 0.95\u20130.99; OR: 0.88, 95% CI: 0.82\u20130.94; OR: 0.87, 95% CI: 0.76\u20130.99, respectively). Additionally, 1% increment in the consumption of UPF in the diet was independently associated with higher LSS risk (OR: 1.09, 95% CI: 1.04\u20131.14). Conclusion: A diet rich in fruits, cereals, fish is associated with lower risk of LSS while a large dietary share of UPF increases the risk of this disease. Further studies with a prospective design and larger sample sizes are warranted