Analysis of factors influencing ligamentum flavum thickness in lumbar spine - A radiological study of 1070 disc levels in 214 patients

Sudhir, G.; Jayabalan, Surulivel Vignesh; Gadde, Saikrishna; Kumar, Girish; Kailash, Karthik

doi:10.1016/j.clineuro.2019.04.023

Cited by 15 publications

(19 citation statements)

References 18 publications

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“…[40][41][42] could induce aberrant mechanical loading of lumbar spine, and finally lead to IVDD. Moreover, decompensated changes in lumbar spine structure result from abnormal mechanical environment, such as proliferation of facet joints 43 , formation of osteophytes 44 , hypertrophy of ligamentum flavum 45 or calcification of longitudinal ligament 46,47 , will fail to resist aberrant mechanical loading and eventually accelerate the process of IVDD in patients. Since there is no desirable model to mimic the clinical development process of aberrant mechanical loading induced-IVDD more accurately, the underlying molecular events of IVDD pathogenesis remains largely elusive.…”

Section: Discussionmentioning

confidence: 99%

Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth

Bao²,

Yao

et al. 2021

Sci Rep

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Aberrant mechanical factor is one of the etiologies of the intervertebral disc (IVD) degeneration (IVDD). However, the exact molecular mechanism of spinal mechanical loading stress-induced IVDD has yet to be elucidated due to a lack of an ideal and stable IVDD animal model. The present study aimed to establish a stable IVDD mouse model and evaluated the effect of aberrant spinal mechanical loading on the pathogenesis of IVDD. Eight-week-old male mice were treated with lumbar spine instability (LSI) surgery to induce IVDD. The progression of IVDD was evaluated by μCT and Safranin O/Fast green staining analysis. The metabolism of extracellular matrix, ingrowth of sensory nerves, pyroptosis in IVDs tissues were determined by immunohistological or real-time PCR analysis. The apoptosis of IVD cells was tested by TUNEL assay. IVDD modeling was successfully produced by LSI surgery, with substantial reductions in IVD height, BS/TV, Tb.N. and lower IVD score. LSI administration led to the histologic change of disc degeneration, disruption of the matrix metabolism, promotion of apoptosis of IVD cells and invasion of sensory nerves into annulus fibrosus, as well as induction of pyroptosis. Moreover, LSI surgery activated Wnt signaling in IVD tissues. Mechanical instability caused by LSI surgery accelerates the disc matrix degradation, nerve invasion, pyroptosis, and eventually lead to IVDD, which provided an alternative mouse IVDD model.

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Section: Discussionmentioning

confidence: 99%

Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth

Bao²,

Yao

et al. 2021

Sci Rep

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“…67 Some evidence suggests that LF hypertrophy is resulted from increased mechanical stress caused by DD with aging. 7,68 Of note, the LF thickness at all levels was significantly greater in LDH patients than in those without LDH. 46 Moreover, LF was significantly thicker in LSCS patients than in those with LDH.…”

Section: Lumbar Disk Herniationmentioning

confidence: 90%

“…74 As described above, DD is positively related to LF thickness. 7,68 Logically, it may be speculated that obesity may also affect the LF thickness. As such, it is found that the LF thickness at L3-L4 is greatly increased in patients with BMI of 25 kg/m 2 or greater than those of BMI less than 25 kg/m 2 .…”

Section: Obesitymentioning

confidence: 99%

Ligamentum flavum fibrosis and hypertrophy: Molecular pathways, cellular mechanisms, and future directions

et al. 2020

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Hypertrophy of ligamentum flavum (LF), along with disk protrusion and facet joints degeneration, is associated with the development of lumbar spinal canal stenosis (LSCS). Of note, LF hypertrophy is deemed as an important cause of LSCS. Histologically, fibrosis is proved to be the main pathology of LF hypertrophy. Despite the numerous studies explored the mechanisms of LF fibrosis at the molecular and cellular levels, the exact mechanism remains unknown. It is suggested that pathophysiologic stimuli such as mechanical stress, aging, obesity, and some diseases are the causative factors. Then, many cytokines and growth factors secreted by LF cells and its surrounding tissues play different roles in activating the fibrotic response. Here, we summarize the current status of detailed knowledge available regarding the causative factors, pathology, molecular and cellular mechanisms implicated in LF fibrosis and hypertrophy, also focusing on the possible avenues for anti-fibrotic strategies.

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“…Disk volume is relevant to the study of disk degeneration and other aspects of spinal pathology. 107 The volume of a normal lumbar intervertebral disk is $ 10 cm 3 when measured in the evening and $ 11 cm 3 when measuring in the morning after a night's rest. In other words, the disk, through the effect of its hydrophilic proteoglycan molecules, attaches $ 0.9 cm 3 of water into the disk overnight.…”

Section: Disk Volume and Degenerationmentioning

confidence: 99%

“…Most ligamentum flavum hypertrophy is caused by reduced disk height bulking the ligament rather than true hypertrophy of the ligament. 107,117 Hypertrophy of the ligamentum flavum reduces the size of the central canal, lateral recesses, and exit foramina, compressing the descending and exiting nerve roots, and leading to radiculopathy. Average thickness of the ligamentum flavum in the cervical spine is 2.2 AE 0.4 mm, thinnest at C2-C3 and thickest in the lower cervical region.…”

Section: Ligamentum Flavum Thicknessmentioning

confidence: 99%

Advanced Quantitative Spine Imaging

Griffith¹

2020

Semin Musculoskelet Radiol

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Although advanced quantitative imaging may not be currently used to any degree in the routine reporting of spinal examinations, this situation will change in the not too distant future. Advanced quantitative imaging has already allowed us to understand a great deal more regarding spinal development, marrow physiology, and disease pathogenesis. Radiologists are ideally suited to drive this research forward. To speed up this process and optimize the impact of studies reporting spine quantitative data, we should work toward universal standards on the acquisition of spine data that will allow quantitative studies to be more easily compared, contrasted, and amalgamated.

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Analysis of factors influencing ligamentum flavum thickness in lumbar spine - A radiological study of 1070 disc levels in 214 patients

Cited by 15 publications

References 18 publications

Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth

Aberrant spinal mechanical loading stress triggers intervertebral disc degeneration by inducing pyroptosis and nerve ingrowth

Ligamentum flavum fibrosis and hypertrophy: Molecular pathways, cellular mechanisms, and future directions

Advanced Quantitative Spine Imaging

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