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Lumbar herniation of the spleen.

Hernias of the lumbar region are rare but have been reported to occur after trauma, flank surgery, iliac bone grafting, spontaneously, or as a result of congenital abnormality of musculoskeletal development. The acquired type is more common than the congenital type. The contents of the hernia most commonly are retroperitoneal fat, kidney, and bowel. We report a case of an asymptomatic postincisional lumbar herniation of a spleen that was diagnosed by computed tomography.

Aged↗

PubMed2006

Effects of muscle fatigue induced by low-level clenching on experimental muscle pain and resting jaw muscle activity: gender differences.

The purpose of this study was to investigate the effects of jaw-muscle fatigue evoked by low-level tooth-clenching followed by the induction of experimental muscle pain by injection of glutamate on the perception of fatigue and pain and on the resting electromyographic (EMG) activity. In addition, the role of gender on these interactions was studied. The EMG activities of bilateral masseter (MAL, MAR) and temporalis (TAL, TAR) muscles in 11 healthy young women and 12 men were measured before (Baseline) and after tooth-clenching for 30 min at 10% of maximal force (Post1), after subsequent glutamate (Glu) or isotonic saline (Iso) injection into the MAL following the tooth-clenching (Post2) and 60 min after tooth-clenching (Post3). The intensities of fatigue, fatigue-related muscle pain and headache-like symptoms were scored on 0-10 cm visual analog scales (VAS). The glutamate-evoked pain was continuously scored on an electronic VAS. Sustained low-level tooth-clenching consistently produced fatigue sensation, fatigue-related muscle pain and headache-like symptoms in both genders with significantly higher fatigue VAS scores in men than in women, while the accompanying increase in the resting EMG activity appears higher in women than in men in the masseter muscles. In this study no gender differences were found for the perceived amount of experimental pain induced by glutamate injection. Additional increases of the resting EMG activity after injections occurred only in men in the injected masseter muscle and non-injected temporalis muscles. The present findings provide new information on the complex influence of gender on sensory-motor integration in the trigeminal system which may contribute to differences in susceptibility to develop musculoskeletal pain problems.

Adult↗

PubMed1996

Quasi-static analysis of muscle forces in the shoulder mechanism during wheelchair propulsion.

During wheelchair propulsion the largest net joint moments and net joint powers are generated around the shoulder. The analysis of the contribution of arm- and shoulder muscles to the joint moments could explain the low efficiency of wheelchair propulsion. Basically, it is assumed that a large magnitude of muscle activity will be needed to stabilize the shoulder. In addition, the muscular requirements for the minimization of negative power are assumed to be of importance. For such an analysis an inverse dynamic model is required. To utilize an inverse dynamic model of the shoulder mechanism, the trajectories of the upper extremity bones are needed. Since at this stage, dynamic non-invasive measurement techniques of scapular motion are not available, the aim of this study was to record the three-dimensional position of the scapula in static situations with the help of a palpation technique. Positions of the trunk, shoulder girdle and upper extremity, and the surface EMG of ten muscles were recorded simultaneously with forces on the rim on a stationary wheelchair ergometer. Four healthy male subjects participated in the experiment. Five hand positions on the rim and five different load levels per hand position were measured for each subject. A previously developed musculoskeletal model of the shoulder mechanism (Van der Helm, 1994a, J. Biomechanics 27(5) 551-569) was used to calculate muscle forces in an inverse static simulation. The measured EMG and the calculated muscle forces compared well except for three muscles. The moment balance between external sources and muscles around each joint axis of the shoulder mechanism is discussed. Results of the experiment indicate that large muscle contributions are needed for joint stabilization. The experimental results on the scapular motions will, in combination with experimental data collected under dynamic conditions, be used for application of the model to dynamic situations. It is concluded that the musculoskeletal model of the shoulder mechanism can be very useful in studies to determine the contribution of muscles and the mechanical load on morphological structures.

Adult↗

PubMed2004

Effects of hypophysectomy and recombinant human growth hormone on material and geometric properties and the pre- and post-yield behavior of femurs in young rats.

To study the musculoskeletal effects of hypophysectomy (Hx) and a partial replacement treatment with recombinant human growth hormone (rhGH) in rats, we determined the stiffness (elastic modulus, E) and volumetric BMD (vBMD) of cortical bone; the periosteal and endosteal perimeters, area and bending moment of inertia (xCSMI) of the cross sections, and the structural stiffness and pre- and post-yield strength of the femur diaphyses by pQCT and mechanical tests, and the gastrocnemius weight of rats that were either intact (n = 9) or Hx at 15 days of age (20). The latter were otherwise untreated (Hx controls, 4) or given 0.4 (8) or 2.0 (8) IU kg(-1) day(-1), s.c., of rhGH for 45 days starting 15 days after surgery. Hx delayed musculoskeletal development (gastrocnemius weight, bone geometric properties), thus affecting the diaphyseal stiffness and strength. It also reduced the cortical vBMD through an undefined mechanism, and increased the elastic modulus of cortical bone. The Hx also affected the correlation between bone geometric and material properties (xCSMI vs. E), suggesting an antianabolic interaction with the biomechanical control of bone modeling in response to strains caused by mechanical usage. As a result, Hx reduced the stiffness, post-yield, and ultimate strength of the diaphyses. These effects should reflect changes in bone tissue microstructure, perhaps associated with crack generation and progress, but unrelated to bone mineral mass. They are compatible with the induction of a delay in collagen turnover with associated increases in fibers' diameter and crystals' size that may have resulted from the suppression of some other hormones, such as thyroid, prolactin, or other hormones regulated by ACTH. The above doses of rhGH significantly but incompletely prevented the negative Hx effects on bone and muscle development (bone geometric properties, muscle mass). However, rhGH treatment failed to prevent the demineralizing and stiffening effect of Hx on bone tissue and the unusual effects on the post-yield strength (less clearly related to muscle development than the former). Consequently, rhGH treatment tended to preserve the natural relationship between muscle function and bone geometry but not bone strength. The effects of larger rhGH doses and the interaction of other hormones with the described effects remain to be investigated. Nevertheless, these findings would deserve special attention because they challenge the prevailing view that in endocrine-metabolic bone-weakening diseases the bone matrix always has a normal composition.

Aging↗

PubMed2006

Identification and characterization of the Mustang promoter: regulation by AP-1 during myogenic differentiation.

We previously identified Mustang (musculoskeletal temporally activated novel gene) with expression exclusively in the musculoskeletal system. Although its expression is almost undetectable in intact bone, it is robustly upregulated during bone regeneration. It is also abundantly expressed in adult skeletal muscle and tendon. As such, Mustang represents a marker for these cells and thus identifying its promoter would enable us to characterize its transcriptional regulation. To this end, we have isolated and characterized a 1512-bp mouse genomic clone representing the Mustang 5'-flanking region and identified a transcription start site, a TATA box, and multiple putative transcription factor binding sites (including AP-1 and AP-2). The activity of this promoter was detected in musculoskeletal cells and embryonic fibroblasts, even exceeding levels (145%) of the control SV40 promoter (in C2C12 cells). Further, the contribution of specific AP-1 and AP-2 sites was determined with serially deleted and mutated promoter constructs. Results indicate that one of the four AP-1 sites is required for substantial transcriptional activation, as its specific deletion or mutation decreases promoter activity by 32% and 40%, respectively. In contrast, deletion of both identified AP-2 sites results in only a 12% decrease in promoter activity. We further characterized the key AP-1 site by EMSA and determined that in both proliferating and differentiating C2C12 cells, only c-Fos, Fra-2 and JunD were required for transcriptional activation. Mustang's restricted tissue specificity and strong promoter makes this gene an ideal candidate for utilization in cell lineage studies that could unveil cellular/molecular mechanisms responsible for musculoskeletal development and regeneration.

Animals↗

PubMed2006

Paediatric spinal trauma and associated injuries.

Paediatric spinal injuries, although rare (1-2% of all paediatric fractures) are associated with the highest mortality rate of all orthopaedic injuries in children. The low incidence is due, not only to the plasticity of the paediatric spine, but also the difficulty of diagnosis and the usually severe if not fatal associated injuries. A 10-year (1995-2004) retrospective study was undertaken of all patients treated for a spinal injury at our institute, which functions as both an acute care centre and a tertiary referral centre for seriously injured children. The study was performed in order to highlight the unique features of spinal injuries in children, and to assess the incidence and pattern of associated injuries. A total of 40 patients had a documented diagnosis of spinal injury. The charts and radiographs of all patients were retrieved and reviewed. The median age was 10 years (range 2-15) and 25 were male. The causative factors were motor vehicle accidents in 16, falls in 14, sport injuries in 7 and assaults in 3. Over 65% of the children sustained one or more associated injuries, the mean injury severity score was 18.95. There were two deaths, both in patients with severe multiple trauma and associated spinal fracture. Treatment included closed reduction in two patients and posterior open reduction and stabilisation in two patients, with one of these also requiring decompression. Spinal injuries in children differ from adults due primarily to the biomechanical and anatomical features of the developing musculoskeletal system. When a spinal injury is identified on initial radiographic or clinical evaluation of an injured child, one should have a high index of suspicion that concurrent, potentially life-threatening injuries may be present.

Accidental Falls↗

PubMed1997

Cumulative trauma disorders in the upper extremities: reliability of the postural and repetitive risk-factors index.

OBJECTIVE: This study addresses test-retest reliability of the Postural and Repetitive Risk-Factors Index (PRRI) for work-related upper body injuries. This assessment was developed by the present authors. DESIGN: A repeated measures design was used to assess the test-retest reliability of a videotaped work-site assessment of subjects' movements. SUBJECTS: Ten heavy users of video display terminals (VDTs) from a local banking industry participated in the study. SETTING: The 10 subjects' movements were videotaped for 2 hours on each of 2 separate days, while working on-site at their VDTs. MAIN OUTCOME MEASURE: The videotaped assessment, which utilized known postural risk factors for developing musculoskeletal disorder, pain, and discomfort in heavy VDT users (ie, repetitiveness, awkward and static postures, and contraction time), was called the PRRI. The videotaped movement assessments were subsequently analyzed in 15-minute sessions (five sessions per 2-hour videotape, which produced a total of 10 sessions over the 2 testing days), and each session was chosen randomly from the videotape. The subjects' movements were given a postural risk score according to the criteria in the PRRI. Each subject was therefore tested a total of 10 times (ie, 10 sessions), over two days. The maximum PRRI score for both sides of the body was 216 points. RESULTS: Reliability coefficients (RCs) for the PRRI scores were calculated, and the reliability of any one session met the minimum criterion for excellent reliability, which was .75. A two-way analysis of variance (ANOVA) confirmed that there was no statistically significant difference between sessions (p < .05). Calculations using the standard error of measurement (SEM) indicated that an individual tested once, on one day and with a PRRI score of 25, required a change of at least 8 points in order to be confident that a true change in score had occurred. The significant results from the reliability tests indicated that the PRRI was a reliable measurement tool that could be used by occupational health practitioners on the job site.

Adult↗

PubMed1994

CT appearances of desmoid tumours in familial adenomatous polyposis: further observations.

Intra-abdominal desmoid tumours represent a major cause of morbidity and mortality in patients with familial adenomatous polyposis (FAP), and such patients are also liable to develop musculoskeletal desmoids. We have reviewed the CT appearances of 44 desmoid lesions (28 intra-abdominal and 16 musculoskeletal) in 20 patients with FAP. We found a considerable heterogeneity in the CT appearance of musculoskeletal and intraabdominal desmoids, with respect to their density, definition and change in size or density on follow-up, not only between different patients but also in patients with multiple lesions, who rarely showed identical appearances of all lesions. In some cases, mesenteric tumours may initially present as ill-defined soft tissue infiltration of mesenteric fat, becoming larger and more mass-like with time. On medical treatment, shrinkage was seen infrequently in musculoskeletal desmoids, and not at all with mesenteric lesions. CT evidence of bowel involvement by intra-abdominal lesions was frequent, most commonly appearing as 'tethering' or encasement of bowel loops. The presence of a large mesenteric mass (> 10 cm diam.), multiple mesenteric masses, extensive small bowel involvement and/or bilateral hydronephrosis were associated with ultimate death.

Adenomatous Polyposis Coli↗

PubMed2002

NFAT signaling: choreographing the social lives of cells.

Calcium signaling activates the phosphatase calcineurin and induces movement of NFATc proteins into the nucleus, where they cooperate with other proteins to form complexes on DNA. Nuclear import is opposed by kinases such as GSK3, thereby rendering transcription continuously responsive to receptor occupancy. Disruptions of the genes involved in NFAT signaling are implicating this pathway as a regulator of developmental cell-cell interactions.

Active Transport, Cell Nucleus↗

PubMed2004

Enhancing enhancers: new complexities in the retinoid regulation of gene expression.

Retinoic acid is a signalling molecule central to morphogenesis and musculoskeletal development. It can exist in several isomeric forms, of which all-trans- and 9-cis-retinoic acid are thought to be the most relevant as signalling molecules. Retinoic acid regulates gene expression via RARs (retinoic acid receptors) working as heterodimers with RXRs (retinoid X receptors). RXRs also heterodimerize with other nuclear receptors. In this issue of the Biochemical Journal, Harris et al. have shown that an enhancer responsible for chondrocyte-specific expression of the col11a2 gene is itself regulated by a retinoic-acid-dependent interaction with RXRbeta bound to a downstream response element. Thus, RXRs bound to hormone-response elements can regulate gene expression indirectly via interactions with tissue-specific enhancers. This study raises interesting questions about the nature of the response element, the RXRbeta partner and the ligands able to influence col11a2 expression, and will provide a model system with which to understand tissue and ligand specificity of retinoid responses.

Animals↗

PubMed2002

An ergonomic evaluation comparing desktop, notebook, and subnotebook computers.

OBJECTIVE: To evaluate and compare the postures and movements of the cervical and upper thoracic spine, the typing performance, and workstation ergonomic factors when using a desktop, notebook, and subnotebook computers. DESIGN: Repeated-measures design. SETTING: A motion analysis laboratory with an electromagnetic tracking device. PARTICIPANTS: A convenience sample of 21 university students between ages 20 and 24 years with no history of neck or shoulder discomfort. INTERVENTION: Each subject performed a standardized typing task by using each of the 3 computers. MAIN OUTCOME MEASURES: Measurements during the typing task were taken at set intervals. RESULTS: Cervical and thoracic spines adopted a more flexed posture in using the smaller-sized computers. There were significantly greater neck movements in using desktop computers when compared with the notebook and subnotebook computers. The viewing distances adopted by the subjects decreased as the computer size decreased. Typing performance and subjective rating of difficulty in using the keyboards were also significantly different among the 3 types of computers. CONCLUSIONS: Computer users need to consider the posture of the spine and potential risk of developing musculoskeletal discomfort in choosing computers.

Adult↗

PubMed2002

Low bone mass in glycogen storage disease type 1 is associated with reduced muscle force and poor metabolic control.

OBJECTIVE: To study the relation between muscle force, bone mass, and metabolic control in patients with glycogen storage disease type (GSD 1). STUDY DESIGN: Distal radius bone mass and density were evaluated in 19 patients with GSD 1 (15 GSD 1a, 4 GSD 1b) by means of peripheral quantitative computed tomography. Grip force was quantified with a dynamometer. RESULTS: Height, weight, bone mass, and grip force were significantly decreased in the patients with GSD 1a, mainly as the result of low values in the poorly controlled subgroup. Boys had lower bone mass than girls. Patients with GSD 1b had higher values for bone mineral density in the trabecular compartment. In most of the study participants bone mass appeared to be adequately adapted to the mechanical requirements imposed by muscle contraction. However, 3 patients with GSD 1a had evidence for a low bone mass. CONCLUSIONS: In GSD 1, both reduced muscle strength and a direct disease effect can contribute to low bone mass. The quality of treatment is crucial to prevent disturbances in musculoskeletal development.

Adolescent↗

PubMed2000

Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters.

Workers in physically demanding occupations require rest breaks to recover from physiological stress and biomechanical loading. Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain. The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters. An existing 4-h activity-rest schedule was obtained from observations on eight male porters. This schedule formed the normal trial, which included two 5- and one 15-min breaks. An alternative 4-h schedule was proposed (experimental condition) that had two breaks each of 12.5 min. It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial, due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid. Ten males performed both test conditions and oxygen uptake VO2, heart rate, minute ventilation VE, perceived exertion and spinal shrinkage were recorded. There were no significant differences in any of the measured variables between the two trials (p > 0.05). Median heart rates were 78 (range 71-93) and 82 (71-90) beats.min(-1) for the normal trial and the experimental trial respectively, indicating that the activity was of low intensity. The light intensity was corroborated by the oxygen uptakes (0.75, range 0.65-0.94 1.min(-1)). Spinal shrinkage occurred to the same extent in the two trials (2.12 +/- 3.16 mm and 2.88 +/- 2.92 mm in the normal trial and the experimental trial respectively). Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials. More physically demanding work than the porters' schedule should induce greater physiological fatigue and spinal shrinkage. The ratio between activity and rest breaks would then become more important.

Adult↗

PubMed2003

Duration of employment is not a predictor of disability of cleaners: a longitudinal study.

AIMS: Cleaning is a high-risk occupation for developing musculoskeletal disorders. Sickness absence is twice as high as in other occupations. Disability pensions for musculoskeletal disorders are twice as high in cleaners as in other employed women. However, a result from Norwegian and Danish studies shows that female cleaners do not report higher morbidity of musculoskeletal disorders than other women. The objective was to analyse whether female cleaners have a higher risk of obtaining a disability pension than women in other unskilled occupations and whether the length of employment influences the risk. METHODS: The material is from the National Census in 1980 and 1990 and supplemented with disability pensioning data from the National Insurance Administration and the Population registry. Women aged 20-49, working as cleaners, seamstresses, nursing, kitchen, or shop assistants in 1980 were followed until 1990 or until receiving disability pension. Female cleaners aged 30-59 years in 1990 were categorized into two cohorts by occupation in 1980. They were followed from 1991 to 1994, to the date they died, or received disability pension. Incidence rates and incidence rate ratio for disability pension and mortality was calculated by Poisson regression. Cox regression calculated the relative risk of obtaining disability pension. RESULTS: Disability pension rates were higher among cleaners than among other women in unskilled occupations (1.4 per 1,000 person years (CI 95% 1.35-1.46)), but the risk of obtaining disability pension did not increase with increasing exposure to cleaning (HR 0.8 (CI 95% 0.6-1.2)). CONCLUSIONS: The cleaning occupation has high disability rates compared with other unskilled occupations. A contribution factor to these high rates is a selection of women with poor health into the occupation.

Adult↗

PubMed1991

Joint mobilization for children with central nervous system disorders: indications and precautions.

Because clinicians are introducing joint mobilization into treatment programs for children with cerebral palsy, we felt that a review of the procedure and its scientific basis would be timely. The goals of the introductory section of this article are to define joint mobilization as it has been used for adults with musculoskeletal disabilities, to discuss various rationales for its effects, to describe contraindications and precautions for its use, and to discuss its efficacy as reported in the research literature. The latter part of the article deals with the use of joint mobilization for children with central nervous system (CNS) disorders. In an effort to understand precautions for the use of joint mobilization in children, musculoskeletal development will be described both for typically developing children and for children with spastic cerebral palsy. Indications for using joint mobilization techniques in children with spasticity will be outlined. Specific neurodevelopmental disabilities for which joint mobilization would be strongly contraindicated will be listed. Finally, future research directions in evaluating reliability of assessment of joint dysfunction and efficacy of joint mobilization in children will be discussed.

Biomechanical Phenomena↗

PubMed2003

Sports injuries in the young athlete.

Children and adolescents increasingly are participating in competitive sports, and there has been a corresponding rise in the incidence of sports-related injuries in this group. Many sports injuries follow the same patterns as are seen in adults, but the developing musculoskeletal system is uniquely susceptible to other types of injury. This review describes anatomic and developmental aspects that result in increased susceptibility to injury and the magnetic resonance imaging characteristics of immature cartilage, marrow, and menisci. Injuries that are usually or exclusively encountered in children and adolescents are emphasized.

Adolescent↗

PubMed1996

Paracoccidioidomycosis of bones and joints. A clinical, radiologic, and pathologic study of 9 cases.

Paracoccidioidomycosis is a systemic fungal infection endemic to Central and South America. It is associated with a broad spectrum of clinical manifestations and has been classified into acute and chronic forms. The latter is the most common type and usually affects male agricultural workers in rural communities. The disease typically begins in the lungs producing varying degrees of parenchymal damage, and in a significant number of cases the organism spreads through bronchogenic, lymphatic, or hematogenous routes to involve 1 or more organs. Bone and joint infection is relatively uncommon and has not been well described in the English literature. Much of the information on this form of the disease has been derived from radiographic and autopsy studies on patients with severe or fatal infections in whom skeletal involvement was a minor or incidental finding. We describe our experience with 9 cases in which osteoarticular manifestations were the sole or 1 of the few major complications of the disease. All 9 patients were male, from 9 to 49 years of age (mean, 36.6 yr). Six were farmers. Evidence of visceral infection was present in 6 patients, in all of whom the lungs were considered the primary site of disease. The osteoarticular lesions were symptomatic in all cases, with the duration of symptoms ranging from 1 week to 2 years. The lesions were centered in bone in 2 cases: they manifested radiographically as circumscribed areas of lysis with or without a rim of sclerosis. The disease was centered in joints in 7 cases; the associated radiographic changes included evidence of joint effusion, periarticular bony erosions, and narrowing of the joint space. Biopsy of the involved skeletal site revealed compact or loose granulomas containing variable numbers of fungi. Although follow-up information was not available for all patients, those treated with TMP-SMX (and 1 patient who also received amphotericin B) and who were followed had prompt resolution of their signs and symptoms. Our findings substantiate some of what is known about the epidemiology of bone and joint involvement in chronic paracoccidioidomycosis. Our patients exhibited features of skeletal infection that have not been emphasized previously, however, including 1) frequent involvement of large joints or long bones of the extremities, 2) presentation with relatively rapidly developing musculoskeletal symptoms, and 3) manifestation as a solitary joint or bone lesion with or without concurrent clinically detectable pulmonary disease. Bone and joint paracoccidioidomycosis should be considered in the differential diagnosis in patients who have skeletal lesions with or without pulmonary involvement and have either lived in or traveled through endemic areas. Early diagnosis and treatment with antifungal medications can achieve an excellent outcome with limited local sequelae.

Adult↗

PubMed2006

Effects of growth differentiation factor-5 on the intervertebral disc--in vitro bovine study and in vivo rabbit disc degeneration model study.

STUDY DESIGN: In vitro studies on the effects of recombinant human growth and differentiation factor-5 (rhGDF-5) on matrix metabolism of bovine intervertebral disc cells and an in vivo study on the effect of rhGDF-5 in the rabbit anular puncture model. OBJECTIVE: To determine the reparative capacity of rhGDF-5 on the intervertebral disc. SUMMARY OF BACKGROUND DATA: The in vitro and in vivo effects of rhGDF-5, a crucial protein in the developing musculoskeletal system, on repair of the degenerated intervertebral disc remain unidentified. METHODS: In vitro, bovine nucleus pulposus and anulus fibrosus cells were cultured with or without rhGDF-5 (100 or 200 ng/mL). On days 7, 14, and 21, the contents of deoxyribonucleic acid and proteoglycan, and the synthesis of proteoglycan and collagen were assessed. In vivo, 16 adolescent New Zealand white rabbits received anular punctures in 2 lumbar discs. Four weeks later, phosphate buffered saline or rhGDF-5 (10 ng, 1 and 100 mug) was injected into the nucleus pulposus. The rabbits were followed up for 16 weeks for disc height, magnetic resonance imaging, and histologic grading. RESULTS: In vitro, rhGDF-5 increased the deoxyribonucleic acid and proteoglycan contents of both cell types significantly after day 14. rhGDF-5 at 200 ng/mL significantly stimulated proteoglycan synthesis (nucleus pulposus: +138%, anulus fibrosus: +24%) and collagen synthesis (nucleus pulposus: +95%, anulus fibrosus: +23%) at day 21. In vivo, the injection of rhGDF-5 resulted in a restoration of disc height, improvement of magnetic resonance imaging scores, and histologic grading scores with statistical significance (P < 0.05-0.001). CONCLUSION: A single injection of rhGDF-5 has a reparative capacity on intervertebral discs, presumably based on its effects to enhance extracellular matrix production in vitro.

Animals↗