Degenerative Anular Changes Induced by Puncture Are Associated With Insufficiency of Disc Biomechanical Function

Hsieh, Adam H.; Hwang, David G.; Ryan, David; Freeman, Anike K.; Kim, Hyunchul

doi:10.1097/brs.0b013e31819c09c4

Cited by 89 publications

(95 citation statements)

References 65 publications

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“…Furthermore, recent studies have shown that the degenerative process within a disc can be initiated with a mere needle puncture, i.e. performed during lumbar discography [27,[38][39][40][41][42][43][44][45][46]. Therefore, discography was not employed as a diagnostic tool in the present study.…”

Section: Preoperative Diagnosis and Patient Selectionmentioning

confidence: 99%

“…Degenerative changes resulting from lumbar degenerative disc disease (DDD) have been associated with a negative impact on the clinical manifestation of LBP. Hereditary as well as mechanical factors have been discussed in the pathogenesis of DDD, and experimental studies demonstrated that the degenerative cascade can be initiated with a mere needle puncture into the disc [27,38,40,[43][44][45][46][61][62][63]. Once initiated, the degenerative process is progressive, irreversible and closely associated with a mechanical dysfunction of the affected segment.…”

Section: Lumbar Degenerative Disc Diseasementioning

confidence: 99%

See 1 more Smart Citation

Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation

Siepe¹,

Heider²,

Haas

et al. 2012

Eur Spine J

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Section: Preoperative Diagnosis and Patient Selectionmentioning

confidence: 99%

Section: Lumbar Degenerative Disc Diseasementioning

confidence: 99%

Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation

Siepe¹,

Heider²,

Haas

et al. 2012

Eur Spine J

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“…For the MRI assessment, the caudal segments 5/6 and 7/8 from the same rat tail were interchangeably used for the gel alone treatment and HGF treatment. After identifying the level of the caudal segments by fluoroscopy, a puncture was made parallel to the endplates through the annulus fibrosus (AF) into the NP by a syringe needle (21-gauge) (12). The needle was then rotated by 180˚ and held for 5 sec.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intradiscal hepatocyte growth factor injection for the treatment of intervertebral disc degeneration

Zou

Jiang

et al. 2013

Molecular Medicine Reports

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Abstract.A poor nutritional supply to the cells of the avascular intervertebral discs, caused by dehydration of the extracellular matrix, is a major cause of intervertebral disc degeneration (IDD). Since hepatocyte growth factor (HGF) has been shown to exert antifibrotic effects, we hypothesized that HGF treatment may be capable of retarding IDD. The present study aimed to evaluate the efficacy of HGF treatment in retarding IDD in a rat tail model of disc degeneration. The disc degeneration models were induced by needle puncture of the rat tail discs. Four weeks following needle puncture, a triblock poly(lactide-co-glycolide)-poly(ethyleneglycol)-poly(lactide-co-glycolide; PLGA-PEG-PLGA) polymer gel loaded with HGF or the gel alone was injected into rat tail discs. The efficacy of HGF in retarding IDD was assessed by magnetic resonance imaging (MRI), histological and immunohistochemical evaluation of the type I collagen, type II collagen and bone morphogenetic protein-2 (BMP-2) expression levels. Following injection of the HGF-loaded gel into the nucleus pulposus (NP), a significant trend towards an increase in T2 signal intensity (P=0.028), type II collagen staining in the NP and the number of BMP-2-positive cells in the annulus fibrosus was observed. In addition, the results demonstrated a significant trend towards a decrease in the histological score (P=0.025) and type I collagen staining in the NP compared with segments treated with the gel alone, following the induction of disc degeneration by stab injury. Following treatment with HGF, a tendency for the level of disc height to be maintained was also observed (no statistical significance). By MRI, histological and immunohistochemical evaluation, the present study demonstrated that HGF-loaded PLGA-PEG-PLGA gel was able to retard disc degeneration when injected into the degenerative discs of rat tail models.

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“…However, in another study using the same animal model, only 18 gauge needle punctures led to significant changes in disc biomechanics; these changes were not seen in 22-and 26-gauge punctured discs [37].…”

Section: Further Development Of the Micro-osmometer Techniquementioning

confidence: 99%

A needle micro-osmometer for determination of glycosaminoglycan concentration in excised nucleus pulposus tissue

et al. 2013

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Purpose Aggrecan is one of the major macromolecular components of the intervertebral disc (IVD) and its loss is an early sign of degeneration. Restoration of aggrecan, and hence of biomechanical properties, is a major objective of biological therapies. At present, assessment of aggrecan concentration via its glycosaminoglycan (GAG) content is accomplished using biochemical and histological methods which require sacrifice of tissue. A minimally invasive method for assessing GAG, and hence aggrecan, which can avoid destruction of tissue, would be of benefit. Methods We have developed a needle micro-osmometer that is capable of measuring flux of saline into excised human nucleus pulposus (NP) tissue. Using the isotropic osmotic stress technique to assess the swelling pressure of the excised NP tissue and assuming negligible collagen tensile stress, we were able to relate the flux to the tissue fixed charge density (FCD). GAG concentration is evaluated from its FCD via the radioactive tracer technique.Samples representing different ages (28-59 years) and degeneration grades (1-4) were analyzed. Results The flux is controlled by both the osmotic pressure difference across the probe's semi-permeable membrane and by the tissue permeability. A linear correlation was found between flux and the tissue FCD. The equation describing the linear fit is FCD/(total tissue hydration) = 1.97 9

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Degenerative Anular Changes Induced by Puncture Are Associated With Insufficiency of Disc Biomechanical Function

Cited by 89 publications

References 65 publications

Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation

Influence of lumbar intervertebral disc degeneration on the outcome of total lumbar disc replacement: a prospective clinical, histological, X-ray and MRI investigation

Efficacy of intradiscal hepatocyte growth factor injection for the treatment of intervertebral disc degeneration

A needle micro-osmometer for determination of glycosaminoglycan concentration in excised nucleus pulposus tissue

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