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PubMed1977

Calcified cervical intervertebral discs in children. Report of three cases.

Calcified cervical intervertebral discs in children are manifestations of an uncommon, distinct disease of unknown cause. Acute symptoms are usually followed by a benign course of spontaneous recovery, frequently culminating in resorption of the calcium. Rarely herniation of the disc may cause neurological complications. Two cases are presented as examples of the typical syndrome. A third case was operated on because of herniation with radiculopathy; the clinical, radiographic, and pathological findings are reported in detail.

Calcinosis↗
PubMed2003

Anterior decompression and instrumentation with cervical butterfly-like locking plate system for herniated cervical intervertebral discs.

OBJECTIVE: To evaluate the clinical efficacy of anterior decompression and internal fixation with cervical butterfly-like locking plate system (CBLP, made in China) in the treatment of cervical intervertebral disc herniation. METHODS: This study included 16 patients with cervical intervertebral disc herniation, aged from 26 to 46 years (36.2 years on average), with the disc hernia occurring in single segment in 12 and 2 segments in 4 cases. The patients received anterior decompression, autogenous iliac bone grafting and internal fixation with CBLP, and follow-up studies lasting for 12 to 24 months (mean 18 months) were conducted in all the cases. RESULTS: All the patients had significant improvements in terms of symptom alleviation without any complications during the follow-up period. Solid bone fusion was achieved within an average period of 3 months, and no screw loosening or plate failure occurred. CONCLUSION: Anterior decompression and internal fixation with CBLP proves to be effective for managing cervical intervertebral disc herniation.

Adult↗
PubMed2001

Intervertebral disc cells exhibit differences in gene expression in alginate and monolayer culture.

STUDY DESIGN: The mRNA levels of aggrecan and collagen were quantified in intervertebral disc cells cultured under three conditions: primary alginate culture, monolayer culture, and re-encapsulation in alginate after monolayer culture. OBJECTIVES: To compare the phenotype of intervertebral disc cells under different culture conditions and to investigate the reversibility of cell phenotype after re-encapsulation in alginate after monolayer culture. SUMMARY OF BACKGROUND DATA: The intervertebral disc contains heterogeneous populations of cells that vary with anatomic region. These cells possess significant differences in phenotype that can be preserved in vitro, although the effect of culture conditions on the phenotype of these cells is poorly understood. METHODS: The intervertebral disc cells of 4-5-month-old pigs were isolated enzymatically from three anatomic zones: anulus fibrosus (AF), transition zone (TZ), and nucleus pulposus (NP). Gene expression levels of aggrecan and collagen Types I and II were measured using a quantitative reverse transcriptase--polymerase chain reaction. RESULTS: Gene expression levels of anulus fibrosus and transition zone cells were shifted in monolayer compared with alginate, although the shift was partially reversed when re-encapsulated in alginate. However, NP cells appeared to be insensitive to culture conditions. Furthermore, characteristic patterns of gene expression among AF, TZ, and NP cells in primary alginate culture did not exist in monolayer culture, but they were also observed after re-encapsulation in alginate. CONCLUSION: The findings of this study suggest that anulus fibrosus and transition zone cells undergo a reversible shift in phenotype when cultured in monolayer compared with alginate. These differences suggest that the culture system exerts a strong influence on cell phenotype and may play a role in the response of these cells to biophysical and biochemical stimuli in vitro.

Aggrecans↗
PubMed2005

Expression and distribution of tumor necrosis factor alpha in human lumbar intervertebral discs: a study in surgical specimen and autopsy controls.

STUDY DESIGN: Immunohistochemical study of tumor necrosis factor alpha expression in autopsy and surgical specimens of human lumbar intervertebral discs. OBJECTIVES: To investigate the occurrence and localization of tumor necrosis factor alpha in intervertebral disc tissue and to correlate its expression with age and the degree of disc degeneration. SUMMARY OF BACKGROUND DATA: The source and origin of discogenic pain are as yet unknown. Recently identified changes of the cellular phenotype during senescence and disc pathology with partly phagocytic properties suggest an 'inflammatory' phenotype. Tumor necrosis factor alpha is one of the most potent proinflammatory cytokines possibly modulating cellular phenotypes. It may also promote pain induction. Very little is known about the occurrence and localization of tumor necrosis factor alpha in intervertebral disc tissue of defined age and degree of histologic tissue degeneration. METHODS: The study population comprised 20 cross-sections of the complete motion segment of human lumbar vertebrae (age range 0-86 years) obtained at autopsy and 28 surgical disc specimens of individuals undergoing lumbar surgical interventions for various reasons. The temporospatial distribution of tumor necrosis factor alpha-positive cells using a polyclonal antibody was correlated with a histologic degeneration score. RESULTS: Tumor necrosis factor alpha is expressed substantially in (nonsymptomatic) autopsy material in fetal/infantile and older adult nucleus pulposus, whereas it is sparsely expressed in adolescent and young adult nucleus pulposus. In the anulus fibrosus, tumor necrosis factor alpha is not found in young adults (<25 years), but then significantly increases in extent. In contrast, symptomatic nucleus pulposus and anulus fibrosus (surgical material) contain substantially more tumor necrosis factor alpha-positive cells. A significant positive correlation of tumor necrosis factor alpha expression and disc degeneration (histologic degeneration score) was found for the anulus fibrosus in both sample groups. In the surgical material, an additional significant positive correlation was identified for nuclear tumor necrosis factor alpha, disc degeneration, and age. CONCLUSIONS: Tumor necrosis factor alpha is substantially expressed in disc material of symptomatic patients (surgical specimens) in comparison to samples taken at autopsy. The expression of tumor necrosis factor alpha in early fetal/infantile nucleus pulposus may indicate 'physiologic' tissue disarrangement with closure of the blood vessel canals. The expression of tumor necrosis factor alpha in adult discs, in contrast, is statistically associated with disc degeneration. Its occurrence in adults of more advanced age suggests that tumor necrosis factor alpha is not involved in the initiation of disc degeneration, but may be associated with further promotion of degenerative disarrangement and pain induction.

Adolescent↗
PubMed2005

Surgical pinealectomy accelerates intervertebral disc degeneration process in chicken.

Despite the importance of intervertebral disc (IVD) degeneration both in research and clinical practice, the underlying biological mechanism of this phenomenon remains obscure. The current study investigated the effects of neonatal pinealectomy on the development of IVD degeneration process in chicken. Thirty chicks (3 days of age) were divided into two equal groups: unoperated controls (Group X) and pinealectomized chicks (Group Y). Pinealectomies were performed at the age of 3 days. At the age of 8 weeks, magnetic resonance imaging examination of one animal in each experimental group was taken. At the end of the study, serum melatonin level was determined by using ELISA method and histopathological or biochemical examination of specimens from all subjects was done. The results of biochemical analyses were compared using Mann-Whitney U test, whereas The Chi-square test was adopted for the histological findings. In this study, the serum melatonin levels in Group Y were significantly lower than those in Group X (P < 0.001). Similarly, scoliosis was developed in 14 out of 15 (93%) in Group Y. Hydroxyproline content of IVD tissue was high in Group Y compared with the values in Group X, although there was no significant difference. Histologically, an appearance of normal IVD was observed in Group X, while the presence of a degenerated IVD was observed in Group Y. From the results of the current study, it is evident that surgical pinealectomy in new-hatched Hybro Broiler chicks has a significant effect on serum melatonin level as well as on the development of IVD degeneration and spinal malformation. In the light of these results from present animal study, melatonin may play a role in the development of IVD degeneration in human beings, but this suggestion need to be validated in the human setting.

Animals↗
PubMed1981

Swelling of the intervertebral disc in vitro.

Slices of the intervertebral disc swell rapidly in aqueous solutions. Following swelling, a large proportion of the proteoglycans leach out. These changes can introduce artifacts into in vitro experimental work. Swelling results from the large Gibbs-Donnan osmotic pressure of the proteoglycans which the collagen network of the disc is unable to oppose alone. Swelling can be prevented by applying pressure to disc slices either mechanically or with iso-osmotic solutions.

False Negative Reactions↗
PubMed1998

The effect of compressive force applied to the intervertebral disc in vivo. A study of proteoglycans and collagen.

STUDY DESIGN: Coil springs were stretched and attached to produce a compressive force across the lumbar intervertebral discs of dogs for up to 27 weeks. OBJECTIVE: To test the hypothesis that a high compressive force applied over a period of time affects the production of proteoglycans and collagen by the intervertebral disc cells. SUMMARY OF BACKGROUND DATA: It is a commonly held belief that high forces applied to the intervertebral disc, and to joints in general, play a role in causing degeneration. METHODS: Pairs of stainless steel coil springs were stretched and attached to produce a compressive force across the lumbar intervertebral discs (L1-L2 and L3-L4) of 16 dogs. Dogs were killed between 13 and 27 weeks after the springs were attached. The discs (L1-L2 and L3-L4) were excised and assessed using immunohistochemical analyses and enzyme-linked immunosorbent assay; T13-L1 and L4-L5 were used as controls. RESULTS: The main result relates to a group effect in the six dogs, assessed using enzyme-linked immunosorbent assay, that were generally at the highest values of force for the greatest number of weeks. For the nucleus, but not the anulus, Spearman rank correlations revealed a strong correlation between increases in force and force-weeks (force multiplied by number of weeks) and increases in collagen type I accompanied by decreases in proteoglycans, chondroitin sulfate, and collagen type II for both experimental discs (L1-L2 and L3-L4), as compared with corresponding values in the controls (T13-L1 and L4-L5). In other words, as either the force or the force-weeks increased, the effect on the nucleus became greater. CONCLUSION: A high compressive force applied to the disc over a period of time initiates changes in proteoglycans and collagen.

Aggrecans↗
PubMed2006

Anisotropic ion diffusivity in intervertebral disc: an electrical conductivity approach.

STUDY DESIGN: Investigation of the transport behavior of ions in intervertebral disc using an electrical conductivity method. OBJECTIVES: To determine the electrical conductivity and ion diffusivity of nucleus pulposus and anulus fibrosus in 3 major directions (axial, circumferential, and radial). SUMMARY OF BACKGROUND DATA: Knowledge of diffusivity of small molecules is important for understanding nutrition supply in intervertebral disc and disc degeneration. However, little is known on the anisotropic behaviors of ion diffusivity and of electrical conductivity in intervertebral disc. METHODS: Electrical conductivity measurement was performed on 24 axial, circumferential, and radial anulus fibrosus specimens and 24 axial nucleus pulposus specimens from bovine coccygeal discs. The diffusivity of Na and Cl were estimated by the analysis of conductivity data. RESULTS: The electrical conductivity (mean +/- standard deviation; n = 24) of the bovine anulus fibrosus was 4.70 +/- 1.08 mS/cm in the axial, 2.86 +/- 0.83 mS/cm in the radial, and 4.38 +/- 1.25 mS/cm in the circumferential direction. For nucleus pulposus, the electrical conductivity (mean +/- standard deviation; n = 24) was 8.95 +/- 0.89 mS/cm. The mean value for nucleus pulposus was significantly higher than that of anulus fibrosus (t test, P < 0.05). For anulus fibrosus, the conductivity in the radial direction was significantly lower than in axial or circumferential directions. Similar trends were found for both Na and Cl diffusivities. Both electrical conductivity and ion diffusivity were highly sensitive to water content. CONCLUSIONS: Electrical conductivity and ion diffusivity of anulus fibrosus are anisotropic.

Animals↗
PubMed1992

Holmium:YAG laser ablation of human intervertebral disc: preliminary evaluation.

Percutaneous discetomy has become a viable alternative in the treatment of herniated intervertebral disc. This study determined the effectiveness of holmium: YAG laser for ablation of human disc tissue. Human cadaveric intervertebral disc was harvested and stored in cold saline-soaked gauze for evaluation within 24 hr of removal. Using a specially designed apparatus, a 600 microns diameter fiber was advanced perpendicular through the annulus fibrosis at a controlled force of 0.098 Newtons (10 g). Samples were lased in air (n = 17) and in room temperature saline (n = 32). The laser energy was delivered at 5 Hz, 250 microseconds pulsewidth, and from 50 mJ/mm2 to 1,100 mJ/mm2 fluence. Three to six holes were lased using identical parameters in each tissue specimen and were evaluated histologically and by morphometric analysis. The maximum zone of thermal necrosis and thermal denaturation occurred at 700-1,100 mJ/mm2; 140 microns and 590 microns in air and 80 microns and 730 microns in saline, respectively. At fluences between 200 and 700 mJ/mm2, the thermal necrosis ranged from 20 to 60 microns in air and from 10 to 50 microns in saline, the zone of denaturation also being less. The holes created with the 600 microns fiber were circular in shape, with a mean diameter of 500 microns (n = 3). The etch rates (penetration/pulse) appeared to increase with increasing fluences. In saline, the etch rate ranged from 7 to 53 microns/pulse (r = 0.57, P less than or equal to 0.10), and, in air, the values ranged from 7 to 65 microns/pulse (r = 0.79, P less than or equal to 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Acoustics↗
PubMed1976

A comparative chemical and histochemical study of the chondrodystrophoid and nonchondrodystrophoid canine intervertebral disc.

The chemical composition of the intervertebral disc of 9-month-old chondrodystrophoid and nonchondrodystrophoid dogs was studied for collagen, noncollagenous protein and glycosaminoglycan. Content of these substances differed significantly between breeds. The differences were most marked in the nucleus pulposus; the noncollagenous protein content of the nonchondrodystrophoid breed was higher than in that of the chondrodystrophoid dogs. The total nitrogen value of the nonchondrodystrophoid nuclei pulposi was less than that of the corresponding chondrodystrophoid discs mainly because of the high collagen content of the latter discs. Histochemically, it was found that the nuclei pulposi of the nonchondrodystrophoid breed contains larger amounts of glycosaminoglycan than in the discs of the chondrodystrophoid breeds.

Animals↗
PubMed2006

Intervertebral disc biomechanics in the pathogenesis of idiopathic scoliosis.

The aim of the present study is to investigate whether the deformation of the intervertebral disc contributes to the progression of idiopathic scoliotic curves. In the standing posteroanterior x-rays of 92 scoliotic curves the following readings were obtained: Cobb angle (CA), apical vertebral rotation (AVR), apical vertebral wedging (AVW) and the adjacent to the apical vertebra Upper (UIVDW) and Lower (LIVDW) InterVertebral Discs Wedging. The statistical analyses included inter - intraobserver reliability test, descriptives, monofactorial linear regression and Pearson correlation coefficient, with p<0.05 considered statistical significant (SS). The mean thoracic CA was 13.4 degrees, lumbar CA 13.8 degrees, thoracic AVR 5.3 degrees, lumbar AVR 4.7 degrees, thoracic AVW 1.4 degrees, lumbar AVW 1.5 degrees, thoracic UIVDW 1.6 degrees, thoracic LIVDW 1 degrees, lumbar UIVDW 1.3 degrees and lumbar LIVDW 2 degrees. Both thoracic and lumbar CA regressed SS with lumbar LIVDW, lumbar UIVDW, thoracic LIVDW and thoracic AVW. Lumbar LIVDW correlates SS with thoracic CA, lumbar CA and thoracic LIVDW. An inter and intra-observer error was below 1 degrees . The eccentric intervertebral disc in the scoliotic spine, through variation in its water concentration produces asymmetrically cyclical load during the 24-hour period and an asymmetrical growth of the vertebral body (Hueter-Volkman's law). The statistical analysis revealed that AVW appears later when already CA increases, the IVDW is more important than AVW and the LIVDW, which is greater than UIVDW, is the most frequent correlated radiographic parameter. The deformation of the apical intervertebral disc seems to be an important contributory factor in the progression of a scoliotic curve.

Adolescent↗
PubMedDate not supplied

Asymptomatic radiographic disappearance of calcified intervertebral disc material in the Dachshund.

The occurrence of asymptomatic disappearance of intervertebral disc calcification was evaluated in a radiographic prospective longitudinal study of 40 Dachshunds followed from 6 or 12 months of age to 2 years of age. Radiographic follow-up was performed at 3 to 4 years of age in 12 dogs. Disappearance of calcified disc material was observed in 9 thoracic and 1 lumbar intervertebral discs. The crude incidence rate tended to increase with age from 1 year of age. The features of the disappearing calcifications involved indicate that the phenomenon is part of the progressive degenerative process. A possible pathogenesis includes tearing of the annulus fibrosus due to the severe degeneration of the disc, followed by an inflammatory response to nuclear material and phagocytic resorption of calcified material.

Animals↗
PubMedDate not supplied

1980 Volvo award winner in basic science. Nutritional pathways of the intervertebral disc. An experimental study using hydrogen washout technique.

The pathways of material transfer to the intervertebral disc were studied in adult dogs by measuring diffusion of hydrogen molecules in the nucleus pulposus before and after disruption of the route through the annulus fibrosus and before and after disruption of the end-plate route. The interfaces was only in the central two-thirds of one side, caused significantly greater decrease in the rate of hydrogen washout than the disruption of the annulus route. Histologically, the bone-cartilage interface was frequently perforated by marrow cavity and vascular buds. These findings suggest that the end-plate route is a major pathway for material transfer to the intervertebral disc.

Animals↗
PubMed1982

X-ray diffraction demonstrates reorientation of collagen fibres in the annulus fibrosus during compression of the intervertebral disc.

The annulus fibrosus of the intervertebral disc is reinforced by tilted collagen fibres. It has been predicted that the tilt angle should increase as the disc was compressed. This prediction has now been confirmed using X-ray diffraction. Diffraction patterns were recorded from the ventral annulus of intact L1/2 rabbit discs during various stages of compression. At each stage the ventral height was measured. Fibre tilts were measured from the diffraction patterns and found to increase as the disc was compressed. For five out of six discs the quantitative dependence of tilt on compressed height was in good agreement with theoretical predictions; the sixth did not compress evenly but an increase in tilt was still observed.

Animals↗
PubMed2003

Tissue engineering of the intervertebral disc with cultured annulus fibrosus cells using atelocollagen honeycomb-shaped scaffold with a membrane seal (ACHMS scaffold).

The objective of the study was to investigate the regeneration of intervertebral discs after laser discectomy using tissue engineering procedures. Annulus fibrosus (AF) cells from the intervertebral discs of Japanese white rabbits were cultured in an atelocollagen honeycomb-shaped scaffold with a membrane seal (ACHMS scaffold), to produce a high-density, three-dimensional culture for up to 3 weeks. Although the DNA content in the scaffold increased at a lower rate than that in the monolayer culture, expression of type II collagen and glycosaminoglycan accumulation in the scaffold were at higher levels than in the monolayer. The AF cells that had been cultured in the scaffold for 7 days were allografted into the lacunae of intervertebral discs of recipients (40 rabbits, 14-16 weeks old; average weight, 3.2 kg), whose nucleus pulposus (NP) had been vaporised with an ICG dye-enhanced laser. The allografted cultured AF cells survived and produced hyaline-like cartilage. Furthermore, the narrowing of the intervertebral disc space of the cell-containing scaffold insertion groups was significantly inhibited after 12 post-operative weeks.

Animals↗
PubMed2000

Lumbar intervertebral disc herniation following experimental intradiscal pressure increase.

An experimental biomechanical model of overload and rupture of the annulus fibrosus (AF) and lumbar disc herniation was achieved by increasing intradiscal pressure while keeping disc height constant in 69 motion segments at the L4-L5 level excised from cadaveric spines. The experiments were made on 53 specimens in neutral posture and on 16 specimens in flexion posture. The values found for the rupture intradiscal pressure (RIP) ranged from 750 to 1300 kPa for neutral posture and the maximum RIP in anterior flexion was 1177 kPa. The degree of disc degeneration was assessed by vertebral transcorporeal discography (previous to experiment) and by sectioning the intervertebral disc after the experiment. The herniated lumbar intervertebral disc model by intradiscal pressure increase makes possible these assertions: * The correlation between the degree of AF degeneration and the RIP is significant: the maximum RIP corresponds to a non-degenerated AF and the less RIP can tear only a degenerated AF; so disc herniation only occurs to discs with torn AF. * AF breaking is more often paramedian, left or right. The place of AF breaking was paramedian in 70.3% cases, median in 9.45% cases and posterolateral in 20.25% cases.

Adult↗
PubMed1993

Identification and characterization of glycanated and non-glycanated forms of biglycan and decorin in the human intervertebral disc.

Immunological studies revealed the presence of several different forms of biglycan and decorin in human intervertebral-disc tissues (annulus fibrosus, nucleus pulposus and cartilage end-plate). In the young intervertebral disc, glycosaminoglycan-containing (glycanated) forms of both biglycan and decorin represented a greater proportion of the total proteoglycan population present in extracts of annulus fibrosus and cartilage end-plate compared with extracts of nucleus pulposus, in which they were barely detectable. In older discs the glycanated forms of biglycan and decorin represented only a small proportion of the total proteoglycan present. Immunochemical analyses with an antibody to chondroitin/dermatan sulphate isomers indicated differences in the glycosaminoglycans substituted on glycanated forms of small proteoglycans found in different disc tissues. Dermatan sulphate was the predominant glycosaminoglycan present on biglycan and decorin in annulus fibrosus extracts, whereas chondroitin 4-sulphate was present in both small proteoglycans isolated from cartilage end-plate. In addition, immunochemical analyses with antibodies against core protein epitopes identified two non-glycanated forms of both biglycan and decorin. These non-glycanated forms of the small proteoglycans were found in all three regions of the disc. The two nonglycanated forms of biglycan had estimated molecular masses of 37 and 41 kDa and those of decorin were 43 and 45 kDa, respectively. These non-glycanated forms of biglycan and decorin increased in proportion with aging. N-terminal sequence analysis indicated that the larger non-glycanated form of decorin was a degradation product of its glycanated precursor. However, no N-terminal sequence information was obtainable from the other non-glycanated form of decorin or the two non-glycanated forms of biglycan. These data are consistent with the hypothesis that some of the non-glycanated forms of decorin and biglycan are degradation products of native precursors. However, the possibility remains that several different post-translationally modified forms of decorin and biglycan are synthesized by intervertebral-disc tissues.

Adolescent↗
PubMed2006

[Correlativity of the therapeutic effect of acupuncture on prolapse of lumbar intervertebral disc with the area location of image].

OBJECTIVE: To probe into the correlativity of the therapeutic effect of acupuncture combined with traction on prolapse of lumbar intervertebral disc with the three-dimensional location. METHODS: According to the three-dimensional location developed by HU You-gu, the position of the prolapse of lumbar intervertebral disc in the spinal canal was located from the sagittal plain, frontal plain and horizontal plain. One hundred and thirty patients with prolapse of lumbar intervertebral disc and completion of clinical data were treated with acupuncture, and the therapeutic effects were analyzed with three-dimensional location. RESULTS: Among 98 cases in the effective group, 73 cases had the prolapse at the I plane in sagittal location, accounting for 74.49%, 82 cases had the prolapse at the 1, 2 zone in horizontal location, accounting for 83.68%, 52 cases had the prolapse at the a area in frontal location, accounting for 53.06%; among the 32 cases in the ineffective group, 10 cases had the prolapse at the I plane, accounting for 31.25%, 12 cases in the 1, 2 zone, accounting for 37.50%, 3 cases in the a area, accounting for 9.38%. There was a statistically significant difference between the two groups in the location. CONCLUSION: The three-dimensional location can objectively show the size, direction, position, and the characteristics of the protruded discs, and correctly infer the pathological changes of the affected nerve root. Acupuncture combined with tract has a better effect on I plane, 1-2 zone, and a area.

Acupuncture Therapy↗