Epidural Fat and Its Association with Pain, Physical Function, and Disability Among Older Adults with Low Back Pain and Controls

Sions, Jaclyn Megan; Rodriguez, Christina Angelica; Pohlig, Ryan T.; Hicks, Gregory E.; Coyle, Peter C

doi:10.1093/pm/pnx163

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…Although some studies have suggested the histopathological features of the EF, subsequent studies have rarely reported a better definition of its function. Spine physicians rarely pay attention to EF, and it is mostly linked to epidural fibrosis formation after spinal surgery [ 17 – 26 ] and clinically uncharacterized back pain [ 24 , 27 , 28 ]. Recently, novel studies with different views on EF have focused on its regenerative or immunomodulatory function, especially with respect to MSCs derived from EF.…”

Section: Discussionmentioning

confidence: 99%

Isolation and Characterization of Extracellular Vesicle from Mesenchymal Stem Cells of the Epidural Fat of the Spine

et al. 2022

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An experimental study with extracellular vesicles (EVs) from mesenchymal stem cell (MSC) of the epidural fat (EF) of the spine. Purpose: This study aims to isolate the exosomes from epidural fat-derived mesenchymal stem cells (EF-MSCs) and fully characterize the EF-MSC-EVs. Overview of Literature: EF-MSCs were reported in 2019, and a few studies have shown the positive outcomes of using EF-MSCs to treat specific spine pathologies. However, MSCs have significant limitations for conducting basic studies or developing therapeutic agents. Although EVs are an emerging research topic, no studies have focused on EVs, especially exosomes, from EF and EF-MSCs. Methods: In this study, we isolated the exosomes using the tangential flow filtration (TFF) system with exosome-depleted fetal bovine serum and performed the characterization tests via western blotting, reverse transcription-polymerase chain reaction, nanoparticle tracking analysis (NTA), and transmission electron microscopy. Results: In transmission electron microscopy, the exosome had a diameter of approximately 100-200 nm and had a spherical shape, whereas in the NTA, the exosome had an average diameter of 142.8 nm with a concentration of 1.27×10 10 particles/mL. The flow cytometry analysis showed the expression of CD63 and CD81. The western blotting analysis showed the positive markers. Conclusions: These findings showed that isolating the exosomes via TFF resulted in high-quality EF-MSC exosome yield. Further studies with exosomes from EF-MSC are needed to evaluate the function and role of the EF tissue.

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Section: Discussionmentioning

confidence: 99%

Isolation and Characterization of Extracellular Vesicle from Mesenchymal Stem Cells of the Epidural Fat of the Spine

et al. 2022

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“…There is a clear correlation between degree of movement and the size (and presence) of paramedullary diverticula; in birds, the greatest range of motion is within the neck, where diverticula associated with the spinal cord are largest and present in the most taxa, while the vertebrae become increasingly fused and modular moving to the posterior end of the body, where paramedullary diverticula are most commonly absent. Here, paramedullary diverticula may be functioning to cushion the spinal cord as it is jostled around within the vertebral canal, functioning in a similar way to extra‐dural adipose tissue in the vertebral canal in mammals (Beaujeux et al, 1997 ; Megan Sions et al, 2018 ; Reina et al, 2009 ).…”

Section: Discussionmentioning

confidence: 99%

A computed tomography‐based survey of paramedullary diverticula in extant Aves

Atterholt

Wedel

2022

The Anatomical Record

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Avian respiratory systems are comprised of rigid lungs connected to a hierarchically organized network of large, regional air sacs, and small diverticula that branch from them. Paramedullary diverticula are those that rest in contact with the spinal cord, and frequently invade the vertebral canal. Here, we review the historical study of these structures and provide the most diverse survey to date of paramedullary diverticula in Aves, consisting of observations from 29 taxa and 17 major clades. These extensions of the respiratory system are present in nearly all birds included in the study, with the exception of falconiforms, gaviiforms, podicipediforms, and piciforms. When present, they share connections most commonly with the intertransverse and supravertebral diverticula, but also sometimes with diverticula arising directly from the lungs and other small, more posterior diverticula. Additionally, we observed much greater morphological diversity of paramedullary airways than previously known. These diverticula may be present as one to four separate tubes (dorsal, lateral, or ventral to the spinal cord), or as a single large structure that partially or wholly encircles the spinal cord. Across taxa, paramedullary diverticula are largest and most frequently present in the cervical region, becoming smaller and increasingly absent moving posteriorly. Finally, we observe two osteological correlates of paramedullary diverticula (pneumatic foramina and pocked texturing inside the vertebral canal) that can be used to infer the presence of these structures in extinct taxa with similar respiratory systems.

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“…Sions et al reported that the average EFD across levels L2/3 through L5/S1 was 4.67 AE 1.57 mm in elderly patients. 25 Therefore, the autologous EFT grafting at the surgical site of lumbar levels has feasibility for clinical application. In addition, Xu J et al reported that an engineered adipose tissue composed of autologous adipo-induced adipose-derived stem cells (ASCs) and porous poly-lactide-co-glycolide acid scaffold could be successfully used to regenerate the epidural fat to inhibit the formation of epidural scar after laminectomy.…”

Section: Discussionmentioning

confidence: 99%

“…We could harvest enough EFT to cover a laminectomy defect in the patient whose epidural fat diameter at level L2/3 was 4.51 mm (Supplement Figure 1B, http://links.lww.com/BRS/B830). Sions et al reported that the average EFD across levels L2/3 through L5/S1 was 4.67 ± 1.57 mm in elderly patients 25 . Therefore, the autologous EFT grafting at the surgical site of lumbar levels has feasibility for clinical application.…”

Section: Discussionmentioning

confidence: 99%

Epidural Fat Tissue Is More Effective for Scar Prevention Than Conventional Subcutaneous Fat Grafting After Laminectomy in a Mouse Model

Hata

Kobayakawa

Saiwai

et al. 2021

Spine

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Study Design. Basic science study.Objective. The aim of this study was to examine whether epidural fat tissue (EFT) transplantation can prevent epidural adhesion after laminectomy more efficiently than subcutaneous fat tissue (SFT) transplantation. Summary of Background Data. Epidural adhesion is almost inevitable after laminectomy. Although many materials have been used to prevent adhesion, none has been widely accepted.As EFT is an ectopic fat tissue located on the dura mater and there is no adhesion between EFT and the dura mater, we focused on the efficacy of EFT for adhesion prevention. Methods. We examined the differences in histology and gene expression between EFT and SFT of mice. We performed laminectomy at the 10 th thoracic level and immediately transplanted EFT or SFT to the dura mater in mice. At 6 weeks after transplantation, we performed histological and gene expression analyses and evaluated the adhesion tenacity. In addition, we examined the characteristic differences between human EFT and SFT.Results. The adipocytes of EFT were significantly smaller than those of SFT in mice and humans. The gene expression of inflammatory cytokine and fibrosis-related factors was signifi-cantly higher in SFT than in EFT. At 6 weeks after transplantation, the percentage of the remaining fat area over the dura mater was significantly greater in the EFT group than in SFT group, and the adhesion tenacity score was significantly lower in the EFT group than that in the SFT group. An RNA sequencing analysis revealed 1921 differentially expressed genes (DEGs) between human EFT and SFT, and a Gene Ontology term associated with the inflammatory response was most highly enriched in SFT. Conclusion. EFT has different molecular and histological profiles from SFT and EFT grafting is more effective for epidural adhesion prevention than conventional SFT transplantation after laminectomy in a mouse model.

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Epidural Fat and Its Association with Pain, Physical Function, and Disability Among Older Adults with Low Back Pain and Controls

Abstract: Increased epidural fat may help explain better function among older adults with chronic axial back pain, but not among those who also report leg pain.

Cited by 8 publications

References 21 publications

Isolation and Characterization of Extracellular Vesicle from Mesenchymal Stem Cells of the Epidural Fat of the Spine

Isolation and Characterization of Extracellular Vesicle from Mesenchymal Stem Cells of the Epidural Fat of the Spine

A computed tomography‐based survey of paramedullary diverticula in extant Aves

Epidural Fat Tissue Is More Effective for Scar Prevention Than Conventional Subcutaneous Fat Grafting After Laminectomy in a Mouse Model

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