Does Lumbar Disc Degeneration on Magnetic Resonance Imaging Associate With Low Back Symptom Severity in Young Finnish Adults?

Takatalo, Jani; Karppinen, Jaro; Niinimäki, Jaakko; Taimela, Simo; Näyhä, Simo; Mutanen, Pertti; Sequeiros, Roberto Blanco; Kyllönen, Eero; Tervonen, Osmo

doi:10.1097/brs.0b013e3182077122

Cited by 173 publications

(137 citation statements)

References 51 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…The strong associations found here between disc degeneration and uneven intervertebral motion in patients, but not in controls, seem consistent with this. It is also consistent with other recent research, which found that disc degeneration was associated with low back pain, especially when associated with end-plate signal change [11,44,45]. However, unlike the present work, these studies used MRI disc degeneration grading, while radiographic grading based on structural aspects rather than biochemical changes may be better correlated with pain when considered alongside intervertebral motion patterns.…”

Section: Discussionsupporting

confidence: 91%

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Breen

2017

Eur Spine J

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 91%

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Breen

2017

Eur Spine J

View full text Add to dashboard Cite

“…Unfortunately, many of those with LBP suffer from disability (1). Multiple causes could lead to LBP; however, intervertebral disc degeneration (IDD) and disc herniation are reported to be the two most common diagnoses and targets for intervention (2), with IDD being deemed as the main cause of LBP (3,4). IDD is a multifactorial process that is characterized by cellular and biochemical changes in the disc tissue, consequently generating structural failure (5).…”

Section: Introductionmentioning

confidence: 99%

Overexpression of growth and differentiation factor-5 inhibits inflammatory factors released by intervertebral disc cells

Shen

Han

et al. 2018

Exp Ther Med

View full text Add to dashboard Cite

Abstract. Low back pain (LBP) is one of the most common musculoskeletal diseases in the world. The incidence is ~70% in adults and many of them suffer from disability. Recently, intervertebral disc degeneration (IDD) has been deemed as a main cause of LBP. The present study aimed to investigate the potentials of growth and differentiation factor-5 (GDF-5) in IDD. The protein levels of prostaglandin-E2 (PGE2), tumor necrosis factor (TNF)-α and interleukin (IL)-1β in culture medium were evaluated by ELISA. mRNA and protein expression levels in nucleus pulposus (NP) cells were evaluated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting, respectively. Griess reaction was applied to test the nitric oxide (NO) concentration in the culture supernatant. The expression levels of inducible NO synthase (iNOS) and cyclooxygenase-2 (COX-2) in NP cells were measured by RT-qPCR. Collagen-II, aggrecan, IκBα and phosphorylated (p)-p65 expression levels were detected by western blotting. Compared with the control group, protein expression levels of TNF-α, IL-1β and PGE2, and NO concentration in culture medium were upregulated by LPS, which were significantly repressed by GDF-5 overexpression (P<0.05). Additionally, GDF-5 overexpression reduced lipopolysaccharide-induced upregulation of TNF-α, IL-1β, iNOS, COX-2, collagen-II, aggrecan, IκBα and p-p65 expression levels in NP cells. IntroductionLow back pain (LBP) is one of the most common musculoskeletal diseases in the world, with an incidence of ~70% in adults (1). Unfortunately, many of those with LBP suffer from disability (1). Multiple causes could lead to LBP; however, intervertebral disc degeneration (IDD) and disc herniation are reported to be the two most common diagnoses and targets for intervention (2), with IDD being deemed as the main cause of LBP (3,4). IDD is a multifactorial process that is characterized by cellular and biochemical changes in the disc tissue, consequently generating structural failure (5).A normal disc is composed of two types of tissues, the nucleus pulposus (NP) and the annulus fibrosus (AF), and they serve different roles in load bearing. Gelatinous NP is predominantly composed of type II collagen and proteoglycans, and its relatively higher water content (compared to AF tissues) is responsible for its resistance to compressive forces and hydrostatic pressurization (6,7). In degeneration, loss of proteoglycans and water signal intensity is detected by changes in disc height and T2-weighted magnetic resonance imaging (MRI) signal in the NP (8), which may lead to redistribution of load onto fibrochondrocyte-like cells in the AF (9).As IDD is associated with normal aging, many people with IDD indications on MRI do not suffer with pain or disability (10,11). However, current treatments for IDD, including surgery, steroid injection and physical therapy, treat symptoms and not disc structure/function regeneration.Inflammation is correlated with IDD and it involves various cells and molecules (12). Multiple g...

show abstract

“…Disc degeneration is markedly common, but a definitive and widely accepted definition remains unclear. In clinical studies using MRI, disc degenera-tion has been suggested to be one of the most remarkable risk factors for discogenic low back pain [60][61][62][63] . Many papers identified genetic influences and unidentified factors, which include complex and unpredictable interactions for the presence of disc degeneration, besides, disc degeneration might not be induced by most environmental factors [64][65][66][67][68] .…”

Section: Mechanical Hypermobilitymentioning

confidence: 99%

Sensory nerve ingrowth, cytokines, and instability of discogenic low back pain: A review

Ohtori

Miyagi

Inoue

2018

Spine Surg Relat Res

View full text Add to dashboard Cite

Abstract:Introduction: Many patients suffer from discogenic low back pain. However, the mechanisms, diagnosistic strategy, and treatment of discogenic low back pain all remain controversial. The purpose of this paper was to review the pathological mechanisms of discogenic low back pain.Methods: Many authors have investigated the pathological mechanisms of discogenic low back pain using animal models and examining human patients. Central to most investigations is understanding the innervation and instabilities of diseased intervertebral discs and the role of inflammatory mediators. We discuss three pathological mechanisms of discogenic low back pain: innervation, inflammation, and mechanical hypermobility of the intervertebral disc.Results: Sensory nerve fibers include C-fibers and A delta-fibers, which relay pain signals from the innervated outer layers of the intervertebral disc under normal conditions. However, ingrowth of these sensory nerve fibers into the inner layers of intervertebral disc occurs under disease conditions. Levels of neurotrophic factors and some cytokines are significantly higher in diseased discs than in normal discs. Stablization of the segmental hypermobility, which can be induced by intervertebral disc degeneration, suppresses inflammation and prevents sensitization of sensory nerve fibers innervating the disc.Conclusions: Pathological mechanisms of discogenic low back pain include sensory nerve ingrowth into inner layers of the intervertebral disc, upregulation of neurotrophic factors and cytokines, and instability. Inhibition of these mechanisms is important in the treatment of discogenic low back pain.

show abstract

Does Lumbar Disc Degeneration on Magnetic Resonance Imaging Associate With Low Back Symptom Severity in Young Finnish Adults?

Abstract: Intervertebral DD was associated with low back symptom severity among young adults, suggesting that the symptoms may have a discogenic origin at this age. However, DD was also found in one-third of asymptomatic subjects.

Cited by 173 publications

References 51 publications

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Uneven intervertebral motion sharing is related to disc degeneration and is greater in patients with chronic, non-specific low back pain: an in vivo, cross-sectional cohort comparison of intervertebral dynamics using quantitative fluoroscopy

Overexpression of growth and differentiation factor-5 inhibits inflammatory factors released by intervertebral disc cells

Sensory nerve ingrowth, cytokines, and instability of discogenic low back pain: A review

Contact Info

Product

Resources

About