Early histologic changes in lower lumbar discs and facet joints and their correlation

Gries, N. C.; Berlemann, U.; Moore, Robert J.; Vernon‐Roberts, B.

doi:10.1007/s005860050004

Cited by 88 publications

(67 citation statements)

References 26 publications

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“…This was [4]. Another histological study from Gries et al [7] showed no correlation between early histological changes in lumbar disks and the associated facet joints (Fig. 8).…”

Section: Discussionmentioning

confidence: 85%

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Quint

Wilke

2008

Eur Spine J

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Degenerative instability affecting the functional spinal unit is discussed as a cause of symptoms. The value of imaging signs for assessing the resulting functional impairment is still unclear. To determine the relationship between slight degrees of degeneration and function, we performed a biomechanical study with 18 multisegmental (L2-S2) human lumbar cadaveric specimens. The multidirectional spinal deformation was measured during the continuous application of pure moments of flexion/extension, bilateral bending and rotation in a spine tester. The three flexibility parameters neutral zone, range of motion and neutral zone ratio were evaluated. Different grading systems were used: (1) anteroposterior and lateral radiographs (degenerative disk disease) (2) oblique radiographs (facet joint degeneration) (3) macroscopic and (4) microscopic evaluation. The most reliable correlation was between the grading of microscopic findings and the flexibility parameters; the imaging evaluation was not as informative.

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“…This was [4]. Another histological study from Gries et al [7] showed no correlation between early histological changes in lumbar disks and the associated facet joints (Fig. 8).…”

Section: Discussionmentioning

confidence: 85%

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Quint

Wilke

2008

Eur Spine J

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“…Another important cause of axial back pain is facet joint osteoarthritis, which consists in the decrease of the thickness and regularity of the cartilage layer of the facet joints, also called apophyseal or zygoapophysial joints. Disc degeneration and facet joint osteoarthritis are commonly observed together in the same patient and spinal level [20,26,35] and a possible correlation between these two pathologies is currently debated [62].…”

Section: Discogenic Painmentioning

confidence: 99%

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

et al. 2014

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Purpose Degeneration of the intervertebral disc is associated with various morphological changes of the disc itself and of the adjacent structures, such as reduction of the water content, collapse of the intervertebral space, disruption and tears, and osteophytes. These morphological changes of the disc are linked to alterations of the spine flexibility. This paper aims to review the literature about the ageing and degenerative changes of the intervertebral disc and their link with alterations in spinal biomechanics, with emphasis on flexibility. Methods Narrative literature review. Results Clinical instability of the motion segment, usually related to increased flexibility and hypothesized to be connected to early, mild disc degeneration and believed to be responsible for low back pain, was tested in numerous in vitro studies. Despite some disagreement in the findings, a trend toward spinal stiffening with the increasing degeneration was observed in most studies. Tests about tears and fissures showed inconsistent results, as well as for disc collapse and dehydration. Vertebral osteophytes were found to be effective in stabilizing the spine in bending motions. Conclusions The literature suggests that the degenerative changes of the intervertebral disc and surrounding structures lead to subtle alteration of the mechanical properties of the functional spinal unit. A trend toward spinal stiffening with the increasing degeneration has been observed in most studies.

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“…Any imbalance might lead to impaired functional properties. From a histologic point of view, the occurrence of clefts and tears are the major hallmarks of disc degeneration, [5,6,7,9,10,11,15,18,36,40,41,42,43], but there is very little (almost no) evidence that invading cells might contribute to this process of matrix degradation. Therefore, it can be assumed that local cells are involved in any degradation process.…”

Section: Introductionmentioning

confidence: 99%

2002 SSE Award Competition in Basic Science: Expression of major matrix metalloproteinases is associated with intervertebral disc degradation and resorption

et al. 2002

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During the process of degeneration, the intervertebral disc (IVD) shows a progressive and significant reduction in height due to tissue resorption. Intradiscal clefts and tears are major hallmarks of disc degeneration. Matrix-degrading enzymes such as matrix metalloproteinases (MMPs) are assumed to play a pivotal role in disc tissue degradation and resorption. The objective of this study was therefore to investigate the potential role of MMPs in extracellular matrix degradation leading to disc degeneration. This study was conducted on 30 formalin-fixed and EDTA-decalcified complete crosssections of lumbar IVDs from cadavers of individuals aged between 0 and 86 years. Tissue sections were used for the immunolocalization of MMPs-1, -2, -3 and -9. The number of labeled cells was assessed by morphometric analyses, and was statistically correlated with the formation of clefts and tears, cellular proliferation, granular matrix changes and mucous degeneration. Furthermore, 30 disc specimens obtained during spinal surgery were used for in situ hybridization of MMP-2 and -3-mRNA. In addition, the enzymatic gelatinolytic activity was determined by in situ zymography in autopsy material. Immunohistochemistry showed the intradiscal expression of all four MMPs, which was confirmed by in situ hybridization, providing clear evidence for the synthesis of the enzymes within nucleus pulposus and annulus fibrosus cells. Gelatinolytic enzymatic activity was verified by in situ zymography. IVDs from infants and young adolescents remained almost completely unlabeled for all MMPs tested, while more MMPs-1 and -3 were seen in disc cells of younger adults than in those of a more advanced age; MMP-2 remained unchanged over the adult age periods, and MMP-9 was expressed in only relatively few cells. This pattern significantly correlated with the occurrence of clefts and tears. This correlation was strongest for MMP-1 (P<0.0001), MMP-2 (P<0.0017) and MMP-3 (P<0.0005) in the nucleus, and MMP-1 (P<0.0001) and MMP-2 (P<0.038) in the annulus. In parallel, the proliferation of disc cells and matrix degeneration (granular changes and mucous degeneration) were related to MMP expression. Likewise, enzymatic activity was seen in association with cleft formation. Our data suggest that major MMPs play an important role in the degradation of the IVD. This is evidenced by the high correlation of MMP expression with the formation of clefts and tears. These findings implicate a leading function for MMPs in IVD degeneration resulting in the loss of normal disc function, eventually leading to low-back pain.

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Early histologic changes in lower lumbar discs and facet joints and their correlation

Cited by 88 publications

References 26 publications

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Ageing and degenerative changes of the intervertebral disc and their impact on spinal flexibility

2002 SSE Award Competition in Basic Science: Expression of major matrix metalloproteinases is associated with intervertebral disc degradation and resorption

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