Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SPONDYLOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 919 records · Page 51Linked to original sources
PubMed2026

GFPT1 as a cross-ancestry validated target for degenerative spinal disease: genetic association in a Chinese cohort and functional characterization in zebrafish.

Degenerative spinal disease (DSD), including spinal stenosis and spondylosis, lacks effective pharmacological treatment. To identify druggable targets and assess cross-ancestry applicability, we integrate multi-omics analyses using Summary-data-based Mendelian Randomization (SMR), colocalization, and two-sample Mendelian randomization with European whole-blood, peripheral-blood, and CSF eQTL/pQTL datasets, followed by whole-genome sequencing (WGS) validation in a Chinese cohort. We identify 7 genes/proteins associated with spinal stenosis and 5 with spondylosis, with GFPT1, GPX1, and SERPINA1 shared by both. Two-sample MR further supports the causal associations of these targets with DSD. Phenome-wide MR prioritization selects GFPT1 and GPX1 as favorable candidates with no predicted adverse effects and potential beneficial effects on hypertension. In the Chinese cohort (67 lumbar spinal stenosis patients and 100 controls), WGS identifies 4 GFPT1 cis-eQTL loci (rs13016371, rs35392088, rs12997521, and rs13019789) associated with lumbar spinal stenosis risk; all risk alleles are linked to increased GFPT1 expression, and all 24 variant carriers show L4/L5 stenosis on imaging. Druggability analysis identifies IOX1 as the sole preclinical-stage compound targeting GFPT1, and molecular docking supports robust binding to GFPT1 (- 6.39 kcal/mol). Functional assays show that IOX1 directly inhibits GFPT1 enzymatic activity and induces fructose-6-phosphate accumulation. In zebrafish, IOX1 significantly rescues GFPT1-induced degenerative phenotypes. These findings establish GFPT1 as a cross-ancestry validated therapeutic target for DSD and nominate IOX1 as a promising disease-modifying candidate.

Animals↗
PubMed1998

Cervical myeloradiculopathy with entrapment neuropathy: a study based on the double-crush concept.

In an attempt to formulate a standardised approach to the diagnosis and management of patients with the double-crush syndrome, we reviewed 65 surgical cases (39 men and 26 women) with cervical myeloradiculopathy associated with entrapment neuropathy in the arm by examining the clinical features, results of nerve conduction velocity studies and distribution of the vertebral levels of compression. Fifty-three patients (average age, 43 years) presented with a carpal tunnel syndrome at the wrist and cervical lesions (41 with spondylosis and 12 with ossified posterior longitudinal ligament), while 12 had a cubital tunnel syndrome at the elbow with cervical lesions (eight with spondylosis and four with ossification of the posterior longitudinal ligament). In the former group, the lesions were found mostly at C5-6 and C6-7 levels, while in the latter group involvement of C6-7 was frequently observed. Two patients in each group required additional cervical decompression after carpal or cubital tunnel release. A retrospective review of our patients suggested that it is reasonable to pursue an accurate diagnosis followed by treatment based on individual neurological and electrophysiological findings, but taking into consideration the significant level of physical impairment associated with cord compromise, we believe that it may be reasonable to perform a cervical decompression rather than peripheral nerve release in such cases. Our findings suggest that one should be aware of a double-crush during examination of patients complaining of neck and hand problems.

Adult↗
PubMed1998

Clinical outcomes of cervical spinal cord injuries without radiographic evidence of trauma.

We investigated 33 cervical spinal cord injury patients (25 males and eight females) without bony injury. Patients whose neurologic recovery had reached a plateau and who had evidence on imaging of persistent spinal cord compression were considered candidates for surgical decompression. When imaging did not show spinal cord compression or patients were maintaining a good neurologic recovery from the early days after injury, we pursued conservative treatment. Age at injury varied from 20 to 76 years (mean, 55.6). Average follow-up was 31 months. Twelve patients were treated conservatively (Group 1). Groups 2 and 3 had surgery. Group 2 (14 cases) had multi-level compression of spinal cord due to pre-existing cervical spine conditions such as ossification of posterior longitudinal ligament, cervical canal stenosis, and cervical spondylosis. Group 3 (7 cases) patients existed single-level compression of spinal cord by cervical disc herniations or spondylosis. We evaluated clinical results according to the Frankel classification, the American Spinal Injury Association (ASIA) scales and Japanese Orthopaedic Association (JOA) scores. Overall improvement of JOA and ASIA scores after treatment was 56.3 +/- 35.5% and 67.1 +/- 38.0%, respectively. Patients in Group 1 showed very good recovery after conservative treatment, with improvement of JOA and ASIA scores being 70.4 +/- 40.2% and 77.4 +/- 34.2%, respectively. The average interval between injury and operation was 4.3 +/- 4.4 months. The improvement of the surgically treated patients (Groups 2 and 3) in JOA and ASIA score was 48.2 +/- 30.7% and 61.2 +/- 39.6% respectively. We obtained good neurological recovery after operation, with significantly more improvement in Group 3 than in Group 2. No significant neurologic recovery had occurred preoperatively in these groups. In such patients operative intervention is essential for neurologic recovery.

Adult↗
PubMed1995

Cervicogenic headache: a personal view.

Cervicogenic headache describes pain referred along the upper three cervical roots and is a common source of headache in the over fifties. A review of clinical features, anatomy, and investigations using neural blockade shows several clinical pictures. Diseases of the cranio-vertebral junction, e.g. syringomyelia, and tonsilar descent, can produce mechanical or hydrodynamic head and neck pain. Pre-existent migraine and tension headache may be precipitated or aggravated by cervical spondylosis, but the anatomical mechanism is unclear. Headaches which arise from and are primarily caused by disorders in the cervical spine are exemplified by spondylosis and acute whiplash injury, but are usually transient. Evidence for a cervicogenic mechanism of chronic whiplash headache is, however, lacking.

Cervical Vertebrae↗
PubMed2002

Sudden onset of cervical spondylotic myelopathy during sleep: a case report.

Cervical spondylotic myelopathy is a common cause of compressive spinal cord dysfunction. The typical course involves either a gradual or an episodic increase in symptoms and neurologic deficits, with impairment evolving over a period of months to years. Acute neurologic deterioration in conjunction with cervical spondylosis has been described almost exclusively in traumatic situations such as disk herniation. We report a case of an acute, nontraumatic onset of tetraplegia in association with cervical spondylosis. A 56-year-old man developed tetraplegia during a 1-hour nap, with loss of volitional control of his extremities, impaired sensation below the C3 dermatome, and increased muscle tone. Magnetic resonance imaging of the cervical spine revealed canal stenosis and increased T2 signal within the cord. This case report describes the rehabilitation course for this patient and reviews the clinical spectrum of onset and progression of cervical spondylotic myelopathy.

Humans↗
PubMed1992

Transfer of multiple sclerosis into severe combined immunodeficiency mice by mononuclear cells from cerebrospinal fluid of the patients.

To investigate the mode of the pathogenesis of multiple sclerosis (MS), we transferred cerebrospinal fluid (CSF) cells, predominantly mononuclear cells, from MS patients at both exacerbation and remission stages of the disease into severe combined immunodeficiency mice by intracisternal injection. As controls, (i) CSF cells from patients with cervical spondylosis and (ii) peripheral blood mononuclear cells from normal individuals were transferred. Four to 6 weeks after transfer, most mice transferred with CSF cells from MS patients at the exacerbation stage of the disease developed paralysis and ataxia. The histopathological examination on the sacrificed mice revealed multiple scattered, discrete lesions localized in the white matter of the brainstems and spinal cords. These lesions were characterized by various degrees of tissue necrosis, involving inflammatory-cell infiltration. Most infiltrating cells were macrophages, although a smaller number of granulocytes appeared in several foci. Reactive astrocytic gliosis was also seen around the necrotic foci. Furthermore, these lesions exhibited demyelination. These histopathological changes are similar to those seen in MS. In contrast, none of the severe combined immunodeficiency mice transferred with CSF cells from MS patients at the remission stage of the disease, or with CSF cells from the patients with cervical spondylosis, or with peripheral blood mononuclear cells from normal individuals showed any such histopathological changes. These observations provide convincing direct evidence of encephalitogenicity of mononuclear cells in CSF from MS patients at the exacerbation stage of the disease.

Animals↗
PubMed1995

Neurologic features of chronic minamata disease (organic mercury poisoning) and incidence of complications with aging.

To elucidate the neurologic features of chronic Minamata disease, and the incidence of complications with aging, we studied 80 patients with documented Minamata disease (organic mercury poisoning) from 1986 to 1994 (mean age: 63 years). Of the cardinal neurologic findings, sensory impairment was seen with highest frequency in 98.8% of patients limited to the extremities in 86.3%. Impairment of lower extremity coordination was observed in 60%, constriction of the visual field in 51.9%, and retrocochlear hearing loss in 41%. To assess age-related complications, patients were separated into three groups by age: Group I (10 to 39 years); Group II (40 to 69 years); Group III (> or = 70 years). The incidences of hypertension and cerebrovascular diseases, organic ophthalmologic disorders (including cataracts), presbyacusis, and cervical spondylosis deformans increased significantly with age. Compared with a preceding survey (1981 to 1985, 171 patients, mean age: 63.5 years), the incidences of complicated hypertension and cataracts had decreased, whereas those of cerebrovascular disease and retinitis pigmentosa remained unchanged. The incidences of abnormal brain computed tomography (CT), presbyacusis, cervical spondylosis deformans, and positive tests for urine sugar also increased. The incidences of these complications other than retinitis pigmentosa were similar to those in the general population. These results accurately reflect the recent epidemiological disease tendencies in Japan toward a decreased incidence of hypertension and an increased incidence of diabetes.

Adolescent↗
PubMed2003

Magnetic resonance assessment of the double-crush phenomenon in patients with carpal tunnel syndrome: a bilateral quantitative study.

Our main goal was to assess the coexistence of narrowed cervical foramens and cervical canal stenosis in patients with carpal tunnel syndrome (CTS). We took magnetic resonance (MR) images of 120 wrists and 480 foramens in 60 age and sex matched subjects (30 patients with CTS and 30 controls). All patients had nerve conduction velocity tests before MR examination. We measured the volume of the carpal canal in all participants bilaterally. We also quantified the cross-sectional areas of the cervical foramens on both sides from C4 to T1 and measured the diameter of the cervical canal in all participants. We searched for the prevalence and location of cervical spondylosis and disc prolapse on the side of the symptomatic wrist(s). All patients had CTS-related neurophysiological findings. There was no correlation between the symptoms and the reduced carpal canal volume. The mean (SD) area of the foramens was 109.5 (12.8) mm2 in the patients compared with the controls 126.4 (28.7) mm2 (p = 0.007). Cervical spondylosis and disc prolapse were more common in the patients than the controls at the C5-C6 and C6-C7 levels, and their locations were on the same side as the symptoms in the wrist(s) in 50% of cases. There was no difference in the size of the cervical canal between the two groups. The higher incidence of narrowed cervical foramens in the patients and its concordance with affected nerve roots on the same side as the CTS symptoms support the hypothesis of a double-crush phenomenon.

Adult↗
PubMed1986

Are cervical spine radiographs of value in elderly patients with vertebrobasilar insufficiency?

Radiographs of the cervical spine of 32 elderly patients clinically diagnosed as having vertebrobasilar insufficiency secondary to cervical spondylosis were compared with 32 age- and sex-matched controls. The mean age was 77.6 years. There was no significant difference in the severity of the radiological changes between the two groups as judged by the narrowing of disc space and marginal osteophyte formation. It is concluded that there is no place for routine examination of the cervical spine in patients thought to have vertebrobasilar insufficiency secondary to cervical spondylosis.

Aged↗
PubMed1988

Cervical myelopathy due to ossification of the posterior longitudinal ligament. A clinical, radiological and evoked potentials study in six Chinese patients.

Six consecutive Chinese patients with cervical myelopathy due to ossification of the posterior longitudinal ligament (OPLL) who presented in a 4 yr period were studied. There were 5 males and 1 female whose mean age at presentation was 67 yrs. The common clinical features were spastic tetraparesis more marked in the lower limbs, spinothalamic and posterior column sensory deficits of varying degree and sphincter disturbance in advanced cases. OPLL was diagnosed on plain radiographs and cord compression ascertained by conventional and computer-assisted myelography. Somatosensory evoked potentials correlated with posterior column signs and appeared to reflect the clinical course following treatment. While the cord pathology in OPLL is similar to that of cervical spondylotic myelopathy (CSM), the pathogenetic mechanism probably differs in one aspect. Compression by OPLL is the determining factor in most cases whereas the combined presence of a congenitally narrow canal and spondylosis is essential for the development of CSM. Other contributory factors include coexisting spondylosis, a congenitally narrow canal, friction between cord and OPLL during neck movement and acute trauma. Cord damage is probably mediated by ischaemia which is due to disturbances of the microcirculation caused by the mechanical factors.

Aged↗
PubMed1978

Kinematics of the cervical spine.

This has been a review of some of the movements of the cervical spine. Much data remain to be accumulated and certainly much work must be done to evaluate the effect of forces in various directions upon these movements. Perhaps an improved understanding of these movements in association with an understanding of the pathogenesis of disc degeneration will enable us to better understand the development of spondylosis. Most important this review uncovers the fallacy of laying the blame for the development of cervical spondylosis solely at the door of increased or decreased mobility at certain area. Physical stress and tissue degeneration must be playing a significant role.

Adult↗
PubMed2002

Risk factors for diffuse idiopathic skeletal hyperostosis: a case-control study.

OBJECTIVE: Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal disease characterized by ligamentous ossification of the anterolateral side of the spine. The aim of this study was to characterize risk factors associated with DISH. METHODS: Subjects were recruited for participation in a screening survey of vertebral osteoporosis. The cases were 69 men and 62 women with DISH and the controls were 69 men and 62 women with spondylosis over the age of 50 yr. Cases and controls were matched for age and sex. Radiographs were taken according to a standardized protocol and DISH was classified using the Resnick criteria. Laboratory parameters and an interviewer-administered questionnaire were used to obtain data about exposure. RESULTS: The mean ages of the populations with DISH and spondylosis were 65.2+/-8.8 and 65.0+/-9.1 yr respectively. Compared with controls, patients with DISH had a greater body mass index (27.8 vs 26.0 kg/m(2), P<0.05) and a higher serum level of uric acid (308 vs 288 micromol/l, P<0.05) and were more likely to have had diabetes mellitus (19.8 vs 9.1%, P<0.05). CONCLUSION: DISH is clearly a distinct disorder with risk factors that distinguish it from other spinal degenerative diseases.

Age Distribution↗
PubMed2000

A comparative study of surgical approaches for cervical compressive myelopathy.

Since 1986, the authors have used anterior decompression and fusion to treat patients with one- or two-level lesions without spinal canal stenosis (Group A) and laminoplasty for patients with more than three-level lesions or spinal canal stenosis (Group P). The aim of this study was to compare surgical outcomes of anterior and posterior approaches for patients with cervical myelopathy because of spondylosis and disc herniation and to determine the cause of poor neurologic recovery after surgery. One hundred thirty-six patients were followed up for an average of 5.6 years. There were no significant differences in gender, preoperative neurologic deficits, axial symptoms, or duration of symptoms before surgery between the two groups. Mean recovery rates for disc herniations were 71.1% and 71.9% in Groups A and P, respectively. For spondylosis, mean recovery rates were 49.0% and 58.6% in Groups A and P, respectively. There were no differences in recovery rate for patients with either spinal disorder between Groups A and P. The neurologic recovery of patients with kyphotic spinal cord was inferior to that of patients with lordotic or straight spinal cord. It is possible that acquisition and maintenance of lordosis result in improvement of clinical outcomes after surgery for patients with myelopathy.

Aged↗
PubMed1998

Exacerbated pain in cervical radiculopathy at axial rotation, flexion, extension, and coupled motions of the cervical spine: evaluation by kinematic magnetic resonance imaging.

RATIONALE AND OBJECTIVES: The authors evaluate the functional changes in patients with cervical radiculopathy and increasing symptoms after provocative maneuvers at flexion, extension, axial rotation, and coupled motions of the cervical spine. METHODS: Twenty-one patients with cervical disc herniation (n = 17) or cervical spondylosis (n = 4) in whom symptoms were elicited at flexion, extension, axial rotation, and coupled motions of the cervical spine were studied. The patients were examined inside a positioning device by using a circular surface coil for signal reception. At neutral position (0 degrees) and at provocative positions sagittal T2-weighted turbo spin-echo, axial T2-weighted two-dimensional flash sequence, sagittal three-dimensional (3D) fast imaging with steady state precision sequence and coronal 3D double-echo-in-the-steady-state sequences were obtained. The 3D sequences were reformatted in the axial and oblique coronal planes perpendicular to the exiting nerve roots. The images were evaluated for the size of disc herniations, the foraminal size and cervical cord rotation or displacement at provocative position compared with neutral position (0 degrees). RESULTS: Compared with neutral position (0 degrees), change in size of disc herniation was not found in any (0%) of the provocative positions. In five (24%) patients cervical cord rotation or displacement was noted at axial rotation. The foraminal size increased at flexion, axial rotation to the opposite side of pain and flexion combined with axial rotation to the opposite side of the pain. The foraminal size decreased at extension combined with axial rotation to the side of the pain. A decrease or no change in foraminal size was observed at either extension or axial rotation to the side of the pain. CONCLUSIONS: In patients with cervical disc herniation or cervical spondylosis, exacerbated pain at defined provocative maneuvers is related more to changes in the foraminal size and to nerve root motion with, in some cases, cervical cord rotation or displacement than to changes in the size of herniated discs.

Adult↗
PubMedDate not supplied

Quantification of cord deformation and dynamics during flexion and extension of the cervical spine using MR imaging.

The magnetic resonance (MR) cine display of flexion and extension (F/E) manoeuvres in the cervical spine has proved useful in the evaluation of cord compression due to bone and joint instability, spondylosis, and multiple tumours. It has advantages over X-ray F/E and CT myelography in that it is noninvasive and produces images with high soft tissue contrast. The MR F/E technique does have its limitations, however, in that each structure in the images has a degree of independent movement and rotation that can make visual interpretation difficult. It also does not address the problem of assessing the relative significance of each lesion where numerous lesions may be present, for example, in compression due to spondylosis, rheumatoid arthritis, or neurofibromatosis. In this paper a novel technique is described that produces quantitative indices of cord deformation and dynamics during MR F/E. A computer program automatically calculates a series of contiguous profiles perpendicular to the cord throughout its length and for each image in the manoeuvre. Orthogonal polynomial curve fitting techniques are used to fit these profiles and extract statistical parameters that are quantitative indices of deformation and dynamics. The four main parameters calculated are kurtosis as an index of bilateral cord compression, skewness as an index of unilateral or asymmetric contact pressure, angulation as a measure of cord deformation about a lesion, and anteroposterior cord width as a direct measure of indentation and attenuation. Illustrative examples of results from normal volunteers and patients suffering from cervical myelopathy are presented. The technique may prove particularly useful to the spinal surgeon in assessing the relative significance of individual lesions and may also be a powerful research tool in the study of cord biomechanics in the living body.

Adult↗
PubMed1991

Magnetic resonance imaging in the preoperative evaluation of cervical radiculopathy.

Forty patients with cervical radiculopathy were examined preoperatively with magnetic resonance imaging (MRI). MRI was used alone in 27 (68%) of the 40 patients; the remainder also had computed tomography in conjunction with myelography. The primary criterion on MRI for a clinically significant lesion was asymmetrical narrowing of the subarachnoid space in the region of the nerve root. Surgical confirmation of the abnormality was obtained in all 40 cases. The operative findings were a herniated nucleus pulposus (32 of 40 patients), spondylosis (2 of 40 patients), or a combination of the two (6 of 40 patients). MRI identified a surgical lesion (herniated nucleus pulposus, spondylosis, or both) in 37 of the 40 (92%) patients. We think MRI is the only preoperative imaging examination necessary in most cases of cervical radiculopathy.

Adult↗
PubMed1996

False localizing signs in upper cervical spinal cord compression.

Proprioceptive loss, paresthesias, and atrophy of the hands can occur with disorders afflicting the upper cervical spinal cord. The diagnosis might be erroneous, because compression in this region might produce signs and symptoms that seem to originate in the lower cervical cord. This article reviews the clinical presentation and radiographic data of a consecutive series of 11 patients who presented between 1992 and 1994 with an extradural lesion above the C4 level. Each patient had a characteristic syndrome of finger and hand dysesthesia, hand atrophy, and occipital or cervical pain. These complaints usually preceded the development of spasticity and gait disturbance. Initial diagnoses included brachial plexopathy, shoulder dysfunction, viral syndrome, and cervical spondylosis at a lower segment. Cervical spondylosis or a herniated disc was the most common pathogenesis. The most commonly involved level was C3-C4. Nine patients underwent a surgical procedure; eight showed significant postoperative improvement (mean time of follow-up examination, 9.7 mo; follow-up range, 1-24 mo). One patient was lost to follow-up. Although the pathophysiology of these findings is unknown, theories include anterior spinal artery ischemia, venous obstruction, and differential decussation of the forelimb and hindlimb fibers of the corticospinal tract. Recognition of this syndrome might prevent inappropriate operative intervention in patients with coexisting pathological conditions of the lower cervical spinal cord.

Aged↗
PubMed2002

Anterior cervical plating enhances arthrodesis after discectomy and fusion with cortical allograft.

OBJECTIVE: Anterior plate fixation has gained widespread acceptance for the treatment of cervical spondylosis, theoretically enhancing the rate of arthrodesis. There are few studies comparing fusion rates after anterior cervical discectomy and fusion (ACDF) with and without a plate. The purpose of this study was to evaluate the efficacy of anterior cervical plating for fusion enhancement after one- and two-level ACDF with cortical allograft. METHODS: A retrospective review was performed with 251 patients who underwent one- or two-level ACDF with cortical allograft and plate stabilization between 1993 and 1999. An independent surgeon reviewer determined fusion status and complications. A successful fusion was defined by the absence of lucency around the graft, evidence of bridging bone between the endplate and the graft, and the absence of movement on dynamic imaging scans. Follow-up data, ranging from 9 months to 3.6 years, were available for 233 patients. A control group of 289 patients who underwent ACDF without plating was described in a previously published report by the senior author (RWH). Therefore, a total of 540 patients were evaluated for determination of the efficacy of anterior cervical plating with cortical allograft bone. Statistical significance was determined by chi(2) test. RESULTS: The fusion rates for one- and two-level ACDF with anterior fixation were 96 and 91%, respectively, compared with 90 and 72% for one- and two-level ACDF without anterior fixation. The observed increases in fusion rates for both one- and two-level procedures proved to be statistically significant (P < 0.05). There were no recorded infectious, neurological, or graft-related complications among the cohort treated with anterior cervical plating. Compared with the results for the cohort treated without anterior cervical plates, there was a statistically significant decrease in the graft-related complication rate with the application of plates (P < 0.001). Two patients who received plates were noted to have adjacent-segment degenerative changes that required surgical intervention. No hardware fractures were noted; however, one patient was noted to have a single displaced screw, without clinical consequences. CONCLUSION: The use of anterior cervical plating after one- and two-level ACDF with allograft cortical bone significantly enhanced arthrodesis. The improved fusion rate and negligible complication rate associated with anterior cervical plating are compelling factors justifying its use in the treatment of cervical spondylosis.

Adult↗