In Vivo Intradiscal Pressure Measurement in Healthy Individuals and in Patients With Ongoing Back Problems

Sato, Katsuhiko; Kikuchi, Shinichi; Yonezawa, Takeshi

doi:10.1097/00007632-199912010-00008

Cited by 518 publications

(433 citation statements)

References 20 publications

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“…NZ/wPTs in the compression groups were lower than that in the sham group, while NZ/woPTs in compression groups were greater than that in the sham group studies using the tail model [25], which reported that disc degenerations were induced under continuous compressive stresses of 1 MPa applied for 7-14 days. This magnitude of stress was observed in human lumbar discs in daily activity [32,37,43,44]. Hence, the compressive stress of 0.5 and 1.0 MPa in our experiment was within the physiological level, although the loading period was longer than the physiological one [30].…”

Section: Rationale Of the Experimentssupporting

confidence: 74%

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

et al. 2009

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Intervertebral disc degeneration induced by mechanical compression is an important issue in spinal disorder research. In this study, the biomechanical aspect of the rat tail model was investigated. An external loading device equipped with super-elastic TiNi springs was developed to apply a precise load to the rat tail. By using this device, rat tail discs were subjected to compressive stress of 0.5 or 1.0 MPa for 2 weeks. Discs in the sham group received an attachment of the device but no loading. After the experimental period, first the intact tail with peripheral tissues (PT) such as tendon and skin and then the retrieved disc without PT were subjected to a uniaxial tension-compression test; biomechanical characteristics such as range of motion (ROM), neutral zone (NZ), and hysteresis loss (HL) were evaluated. Furthermore, the loadbearing contribution of PT in the intact tail was estimated by comparing the load-displacement curves obtained by the mechanical tests performed with and without PT. The experimental findings revealed that the continuous compressive stress induced reduction in disc thickness. The intact tail demonstrated decreases in ROM and NZ as well as increases in HL. On the other hand, the retrieved disc demonstrated increases in ROM, NZ, and HL. Further, a significant increase in the load-bearing contribution of PT was indicated. These findings suggest that the load-bearing capacity of the disc was seriously deteriorated by the application of compressive stress of 0.5 or 1.0 MPa for 2 weeks.

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Section: Rationale Of the Experimentssupporting

confidence: 74%

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

et al. 2009

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“…Although the high range of physiological IVD pressure was not expected, the interindividual range of pressure at corresponding levels of the non-treated rabbit spine was far less extensive. Most reported studies on IVD pressure measurements examined one single disc [2,14,15,[20][21][22]30] or the adjacent discs to fusion [4,5,16,25,29]. We conclude that it is important to compare only corresponding levels of the spine with respect to intradiscal pressure measurements.…”

Section: Discussionmentioning

confidence: 81%

“…Sato et al [21] performed disc pressure measurements in subjects with or without ongoing back pain after assessing the degree of disc degeneration by MRI. The intradiscal pressure in subjects with significant disc degeneration was significantly reduced compared with that of healthy discs.…”

Section: Discussionmentioning

confidence: 99%

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Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

et al. 2005

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“…Several recent papers describing intradiscal pressure measurements reported that good results were obtained using strain-gauge technology [9,13]. The diameter of the needles in the reported studies was 1.2-1.5 mm -too large for using in our study.…”

Section: Discussionmentioning

confidence: 70%

Intradiscal pressure after repeat intradiscal injection of hypertonic saline: an experimental study

2001

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IntroductionChemonucleolysis with chymopapain, which was first clinically used by Smith [12], is an effective treatment for intervertebral disc herniation. However, anaphylactic reactions, in particular, have limited the use of this treatment. To prevent anaphylactic reactions, skin testing and the use of H1 and H2 blocking agents have been recommended. Anaphylactic reactions to chymopapain have decreased in frequency over the years [5]. However, the risk of anaphylaxis still remains. Accordingly, an alternative substance for chemonucleolysis has been sought.Proteoglycans are major structural components of the intervertebral disc, and their concentration and organization in the extracellular matrix have a considerable influence on its mechanical properties. Bayliss et al. [2] described a reduction in proteoglycan synthesis rates when disc hydration was decreased.Shioda [11] suggested a mechanism for a decrease in the intradiscal pressure after hypertonic saline injection, by which partial cell necrosis leads to a decrease in matrix production. Released lysosomal enzymes from the cells could then cause partial proteolysis. As a result, the amount of proteoglycan decreases, which means the water-binding capacity decreases. He suggested that the direct effect of hypertonic saline on the matrix was minimal.We have previously reported intradiscal pressure after intradiscal injection of hypertonic saline in rabbits, but the results of the study found that hypertonic saline injected Abstract Chemonucleolysis with chymopapain is an effective alternative to an operation for the treatment of some patients who have a lumbar intervertebral disc herniation. However, chymopapain is associated with rare but serious complications. Accordingly, alternative substances for chemonucleolysis have been sought. The main beneficial effect of chemonucleolysis derives from the decrease in the intradiscal pressure. We have previously reported that hypertonic saline injected into the intervertebral discs decreased the intradiscal pressure, but only temporarily. The present experimental study investigated changes in the intradiscal pressure after a repeat intradiscal injection of hypertonic saline. The lumbar intervertebral discs of 18 living rabbits were examined: 10% hypertonic saline was injected intradiscally just once in 12 rabbits, and the same dosage was injected again, 4 weeks later, in the same animals. The intradiscal pressure was measured at 1, 4, 8, and 12 weeks after the second injection. The remaining six rabbits were used as controls, without puncture and without injection. The intradiscal pressure of the group with repeat hypertonic saline injection at 4 weeks was significantly lower than that of the control group. The decreased pressure showed a tendency to increase at 8 weeks, and it had recovered at 12 weeks. The results of this study suggest that repeat hypertonic saline injections may be clinically useful.

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In Vivo Intradiscal Pressure Measurement in Healthy Individuals and in Patients With Ongoing Back Problems

Cited by 518 publications

References 20 publications

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

Effects of compressive loading on biomechanical properties of disc and peripheral tissue in a rat tail model

Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model

Intradiscal pressure after repeat intradiscal injection of hypertonic saline: an experimental study

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