Association between Annular Tears and Disk Degeneration: A Longitudinal Study

Sharma, Aseem; Pilgram, Thomas K.; Wippold, Franz J.

doi:10.3174/ajnr.a1411

Cited by 63 publications

(41 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The similarity in the mean degeneration grade of these pediatric disks to the previously reported value of 3.1 in the adult population also suggests that the temporal course of nuclear degeneration in the pediatric and adult populations is probably similar, having more to do with the time of onset of the degenerative process rather than with the age of the patient. 5 Our results highlight the importance of radial tears in the process of disk degeneration, as has been stressed by previous authors. 2,9,15 In our study, the appearance of nuclear degeneration was restricted mainly to the disks with radial tears.…”

Section: Discussionsupporting

confidence: 72%

“…Similar distribution of signal intensity and degeneration grades in disks with and without annular tears has been described in the adult population. 5 These results are, however, discordant with the observations of some prior investigators. 9,12 Haefeli et al 9 found that radial tears were relatively rare in first 2 decades of life, and nuclear clefts preceded radial and concentric tears.…”

Section: Discussioncontrasting

confidence: 51%

“…A previously described ordinal scale was used to assess the extent of signal-intensity loss on T2-weighted images involving the central aspect of the disk, from grade 1 through 6. 5 Disks were graded after assessing their entire extent on sagittal T2-weighted turbo spin-echo images. Grade 1 was assigned to the disks demonstrating normal bright signal intensity in the central portion, whereas grade 6 implied complete absence of bright signal intensity in the central portion of the disk.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies, mainly in adults, have demonstrated a strong association between annular tears and nuclear degeneration [2][3][4] and a faster nuclear degeneration in disks with annular tears. 5 Intervertebral disks in the adult population have a high prevalence of both advanced nuclear degeneration and annular pathology, making it difficult to establish whether annular pathology precedes the nuclear degeneration or vice versa. A study focused on the pediatric population can be expected to provide a glimpse of the early stages of disk degeneration.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Temporal Association of Annular Tears and Nuclear Degeneration: Lessons from the Pediatric Population

Sharma

Parsons²,

Pilgram³

2009

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 72%

Section: Discussioncontrasting

confidence: 51%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Temporal Association of Annular Tears and Nuclear Degeneration: Lessons from the Pediatric Population

Sharma

Parsons²,

Pilgram³

2009

AJNR Am J Neuroradiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…If strict classification guidelines are guaranteed, MRI is an excellent tool to define disc degeneration 7,20,24) . In our study, grading of MRI abnormality was correlated with that of CT discogram except grade 5 (p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Findings of Discogenic Low Back Pain Confirmed by Automated Pressure-Controlled Discography

Kim

Shin

Kim

et al. 2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : Few studies on the clinical spectrum of automated pressure-controlled discography (APCD)-defined positive discs have been reported to date. Thus, the present study was undertaken to analyze clinical parameters critical for diagnosis of discogenic pain and to correlate imaging findings with intradiscal pressures and pain responses in patients with APCD-positive discs. Methods : Twenty-three patients who showed APCD-positive discs were selected for analysis. CT discogram findings and the degrees of nuclear degeneration seen on MRI were analyzed in comparison to changes of intradiscal pressure that provoked pain responses; and clinical pain patterns and dynamic factors were evaluated in relation to pain provocation. Results : Low back pain (LBP), usually centralized, with diffuse leg pain was the most frequently reported pattern of pain in these patients. Overall, LBP was most commonly induced by sitting posture, however, standing was highly correlated with L5/S1 disc lesions (p < 0.01). MRI abnormalities were statistically correlated with grading of CT discogram results (p < 0.05); with most pain response observed in CT discogram Grades 3 and 4. Pain-provoking pressure was not statistically correlated with MRI grading. However, it was higher in Grade 3 than Grade 4. Conclusion : APCD-positive discs were demonstrated in patients reporting centralized low back pain with diffuse leg pain, aggravated by sitting and standing. MRI was helpful to assess the degree of nuclear degeneration, yet it could not guarantee exact localization of the painful discs. APCD was considered to be more useful than conventional discography for diagnosis of discogenic pain.

show abstract

Differential Effect of Long-Term Systemic Exposure of TNFα on Health of the Annulus Fibrosus and Nucleus Pulposus of the Intervertebral Disc

Gorth

Ottone

Shapiro

et al. 2019

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

The inflammatory cytokine tumor necrosis factor alpha (TNFα) is considered to play a key role in the pathogenesis of intervertebral disc disease. To evaluate the importance of this cytokine we examined the inflammatory environment and spinal phenotype of 9‐month‐old human TNFα overexpressing transgenic (hTNFα‐TG) mice. The mice evidenced increased circulating levels of interleukin‐1β (IL‐1β), IL‐2, keratinocyte chemoattractant/human growth‐regulated oncogene (KC/GRO), and monocyte chemoattractant protein‐1 (MCP‐1) along with thinning of the cortical and trabecular vertebral bone. Surprisingly, although the nucleus pulposus (NP) of these mice was intact and healthy, the caudal annulus fibrosus (AF) evidenced robust cell death and immune cell infiltration. Despite these differences, there were no obvious alterations in the collagen or aggrecan content in the NP and AF. However, there was a reduction in cartilage oligomeric matrix protein (COMP), suggesting destabilization of the AF matrix. Microarray analysis of the NP from hTNFα‐TG mice cells revealed minimal changes in global gene expression. These findings lend support to the notion that NP tissue is isolated from systemic inflammation. In contrast, the severe AF phenotype suggests that systemic inflammation interferes with AF health, predisposing discs to herniation as opposed to directly causing NP degeneration. © 2020 American Society for Bone and Mineral Research.

show abstract

Association between Annular Tears and Disk Degeneration: A Longitudinal Study

Cited by 63 publications

References 38 publications

Temporal Association of Annular Tears and Nuclear Degeneration: Lessons from the Pediatric Population

Temporal Association of Annular Tears and Nuclear Degeneration: Lessons from the Pediatric Population

Clinical and Radiological Findings of Discogenic Low Back Pain Confirmed by Automated Pressure-Controlled Discography

Differential Effect of Long-Term Systemic Exposure of TNFα on Health of the Annulus Fibrosus and Nucleus Pulposus of the Intervertebral Disc

Contact Info

Product

Resources

About