Biomechanical properties of lumbar endplates and their correlation with MRI findings of lumbar degeneration

Liu, Junhui; Lü, Hao; Suyou, Letu; Shan, Zhi; Mamuti, Maiwulanjiang; Li, Shengyun; Wang, Chongyan; Fan, Shunwu; Zhao, Fengdong

doi:10.1016/j.jbiomech.2016.01.019

Cited by 30 publications

(27 citation statements)

References 34 publications

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“…Furthermore, an animal model confirmed that chronic compression led to significantly increased vertebral bone marrow oedema in mice [6]. In addition, a biomechanical testing on 27 human cadaveric lumbar spines found that in the presence of MC (or degenerative disc) the strength and stiffness of the bony endplate decreased greatly, by up to 46% [27]. Therefore, it should be evident that biomechanical stress leads to MC in the case of disc herniation, considering that loss of nucleus material (by herniation or more violently by surgery) reduces intradiscal pressure [28] and subsequently alters the pressure load distribution over the disc [29].…”

Section: Discussionmentioning

confidence: 78%

New insights into the natural course and clinical relevance of Modic changes over 2 years following lumbar limited discectomy: analysis of prospective collected data

et al. 2019

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Purpose Few retrospective studies have addressed Modic changes (MC) following lumbar spine surgery, though it is usually assumed that MC increase in grade and incidence. To test this conventional wisdom, we investigated the natural course of MC following primary lumbar limited discectomy with two-year follow-up. In addition, a possible clinical relevance to those changes was assessed. Methods The data of the control group (278 subjects) of a prospective randomized, controlled trial (RCT) were evaluated retrospectively. Results We did not observe a simple increase in MC with regard to grade. There is variable activity observed in Type 2 (at 12 months) and in Type 1 (at 24 months). Conversion from one grade to another may occur and may be upward or downward. The incidence of MC increased slightly over time, as after surgery a decreasing percentage of the study group remained without MC over two years (1 year: 34% (85/250); 2 years: 30% (72/237)). Radiological parameters (rotation, translation, and spondylolisthesis) had no significant correlation to MC or MC subtypes. Lastly, we found that neither the different MC types nor their changes were correlated with clinical parameters (VAS back, VAS leg, ODI score) preoperatively or during follow-up. Conclusion The pattern of Modic changes following lumbar limited discectomy is complex, not simply increasing. There is variable activity in MC Types 1 and 2 at the different time points of follow-up, and conversion from a higher grader to a lower one or vice versa is possible. Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. Key points 1. Although Modic changes (MC) have widely investigated in conservative treatment, few retrospective studies have addressed Modic changes following lumbar spine surgery. 2. Usually it is assumed, that Modic changes should increase in quality and quantity.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Affiliations

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Section: Discussionmentioning

confidence: 78%

New insights into the natural course and clinical relevance of Modic changes over 2 years following lumbar limited discectomy: analysis of prospective collected data

et al. 2019

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“…Peripheral regions have increased endplate thickness and bone density, as compared to the center of the endplate [34,35]. A study by Liu et al [36] found that the strength and stiffness was greater by 17% in the outer regions, as compared to the inner regions of the lumbar endplate. Although the anterior rim can provide reduction forces, care must be taken and the whole process should be completed under fluoroscopy.…”

Section: Discussionmentioning

confidence: 99%

A new lever reduction technique for the surgical treatment of elderly patients with lumbar degenerative Spondylolisthesis

Kong

Wang

et al. 2020

BMC Musculoskelet Disord

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Background: Proper reduction method for Lumbar degenerative spondylolisthesis (LDS) is still controversial. The aim of this study was to determine the safety and effectiveness of lever reduction combined with traditional elevating-pull reduction technique for the treatment of elderly patients with LDS. Methods: From May 2015 to December 2017, 142 elderly patients (≥65 years) diagnosed with LDS were enrolled in this study with a mean follow-up of 25.42 ± 8.31 months. All patients were operated using lever reduction combined with traditional elevating-pull reduction technique. Patient age, sex, body mass index, bone mineral density, preoperative comorbidities, surgical duration, blood loss, and surgical complications were collected form patient charts. Clinical data as visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short Form Health Survey (SF-36) were collected preoperatively, 1 month postoperatively, and at the final follow-up. Radiographic evaluation included slip percentage, slip angle (SA), lumbar lordosis (LL), and fusion status. Results: The clinical parameters of VAS back , VAS leg , ODI, and SF-36 had significantly improved at both followups after surgery. A significant improvement was indicated for slippage reduction at both follow-ups, showing no significant correction loss after surgery. SA significantly increased after surgery and was well maintained at the final follow-up. LL was not affected by the surgery. At the final follow-up, complete fusion was obtained in 121 patients (85.2%) and partial fusion in 21 (14.8%). Revision surgery was performed for one patient. Screw loosening was observed in 3 (2.11%) cases. No nerve root injury or adjacent segment disease was observed. Conclusions: This new lever reduction combined with traditional elevating-pull reduction technique for the surgical treatment of elderly patients with LDS is both safe and effective. Satisfactory correction and fusion rates were achieved with acceptable correction loss and reduction-related complications.

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“…A study [16] enrolled 2449 volunteers to explore the possible factors associated with MC, and the results confirmed that disc displacement and a higher disc degeneration score were associated with MC at the upper lumbar levels (L1/L2-L3/L4) (p<.01), while MC at the lowest 2 lumbar levels (L4/L5-L5/S1) were associated with the presence of Schmorl nodes, older patient age, disc degeneration or displacement, and historical lumbar injury. Research showed that cartilage and osseous endplate play an important role in biomechanics of the spine; the volume and shape of the disc is affected as the load on the spine increases, resulting in bending deformation of cartilage, the osseous endplate, and trabecular bone under the endplate [17][18][19][20]. MC may happen with the occurrence of these irreversible deformable injuries and microfracture of the cartilage, osseous endplate, and trabecular bone under the endplate [21][22][23][24][25].…”

Section: E919667-4mentioning

confidence: 99%

Analysis of the Relationship Between Modic Change and Spinopelvic Parameters in the Sagittal Plane

Lian

et al. 2020

Med Sci Monit

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Departmental sources Background: This study explored relationship between Modic change and spinopelvic parameters in the sagittal plane. Material/Methods: We divided 80 patients into 4 groups: 60 subjects diagnosed with Modic changes (MC) were enrolled in the MC groups (MC1, MC2, and MC3) with each MC type consisting of 20 subjects, and 60 healthy subjects were enrolled in the control group. Spinopelvic parameters in the sagittal plane were calculated to assess their associations with MC. Multivariate logistic regression was used to explore possible risk factors for MC. Results: PI and LL in the MC groups were significant smaller than in the control group (p<0.05). PI, SS, and PT were significantly correlated with LL with a correlation coefficient of 0.75 PI , 0.71 SS and 0.69 PT (p<0.05). Multivariate logistic regression of the significant variables showed that PI (less than 43.2°) is an independent significant risk factor for MC. ROC analysis showed that moderate diagnostic value was obtained for the significant variable, with an area under the curve (AUC) of 0.80 (p>0.05). Conclusions: We concluded that PI is risk factor for MC, and smaller PI is associated with higher incidence of MC.

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Biomechanical properties of lumbar endplates and their correlation with MRI findings of lumbar degeneration

Cited by 30 publications

References 34 publications

New insights into the natural course and clinical relevance of Modic changes over 2 years following lumbar limited discectomy: analysis of prospective collected data

New insights into the natural course and clinical relevance of Modic changes over 2 years following lumbar limited discectomy: analysis of prospective collected data

A new lever reduction technique for the surgical treatment of elderly patients with lumbar degenerative Spondylolisthesis

Analysis of the Relationship Between Modic Change and Spinopelvic Parameters in the Sagittal Plane

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