Increasing BMI increases lumbar intervertebral disc deformation following a treadmill walking stress test

Coppock, James A.; Danyluk, Stephanie T.; Englander, Zoë A.; Spritzer, Charles E.; Goode, Adam P.; DeFrate, Louis E.

doi:10.1016/j.jbiomech.2021.110392

Cited by 10 publications

(16 citation statements)

References 34 publications

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“…The db/+ mice in our cohort had an average body mass of 23.32 g while the db/db mice averaged a significantly higher body mass of 53.34 g (Figure S1 B, P < .05). Obesity has been implicated as a major risk factor for DDD as well as a common comorbidity for diabetes 28 , 33 , 83 , 84 and as such the effects may be difficult to divorce from those arising as a result of diabetic hyperglycemia alone. However, as the discs were extracted from the tails of the animals, any loading effects resulting from obesity are likely minimal.…”

Section: Discussionmentioning

confidence: 99%

The degenerative impact of hyperglycemia on the structure and mechanics of developing murine intervertebral discs

et al. 2022

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Introduction: Diabetes has long been implicated as a major risk factor for intervertebral disc (IVD) degeneration, interfering with molecular signaling and matrix biochemistry, which ultimately aggravates the progression of the disease. Glucose content has been previously shown to influence structural and compositional changes in engineered discs in vitro, impeding fiber formation and mechanical stability.Methods: In this study, we investigated the impact of diabetic hyperglycemia on young IVDs by assessing biochemical composition, collagen fiber architecture, and mechanical behavior of discs harvested from 3-to 4-month-old db/db mouse caudal spines.Results: We found that discs taken from diabetic mice with elevated blood glucose levels demonstrated an increase in total glycosaminoglycan and collagen content, but comparable advanced glycation end products (AGE) levels to wild-type discs. Diabetic discs also contained ill-defined boundaries between the nucleus pulposus and annulus fibrosus, with the latter showing a disorganized and unaligned collagen fiber network at this same boundary.Conclusions: These compositional and structural changes had a detrimental effect on function, as the diabetic discs were twice as stiff as their wild-type counterparts and demonstrated a significant resistance to deformation. These results indicate that diabetes may predispose the young disc to DDD later in life by altering patterns of extracellular matrix deposition, fiber formation, and motion segment mechanics independently of AGE accumulation.

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Section: Discussionmentioning

confidence: 99%

The degenerative impact of hyperglycemia on the structure and mechanics of developing murine intervertebral discs

et al. 2022

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“…Meanwhile, the group mean disc compression force is significantly higher in severely obese patients as compared with the normal-weight group (41). Coppock et al developed non-invasive magnetic resonance imaging and solid modeling techniques to measure the in vivo intervertebral disc (IVD) deformation following treadmill walking stress test, and the study showed the highest statistical significant association between BMI and compressive deformation in the L5-S1 IVD (R2 = 0.61, p < 0.05), and the association became weaker in the L3-L4 and L4-L5 IVDs (42). Another study showed that as body weight increased from 51 to 119 kg, the L5-S1 compression increased by ~80%-147% with no load in hands and by ~46%-52% in load holding tasks in flexed postures.…”

Section: Discussionmentioning

confidence: 99%

Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study

Zhou

Peng

et al. 2021

Front. Endocrinol.

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The role of obesity in the development of dorsopathies is still unclear. In this study, we assessed the associations between body mass index (BMI) and several dorsopathies including intervertebral disc degeneration (IVDD), low back pain (LBP), and sciatica by using the Mendelian randomization method. We also assessed the effect of several obesity-related traits on the same outcomes. Single-nucleotide polymorphisms associated with the exposures are extracted from summary-level datasets of previously published genome-wide association studies. Summary-level results of IVDD, LBP, and sciatica were from FinnGen. In our univariable Mendelian randomization analysis, BMI is significantly associated with increased risks of all dorsopathies including sciatica (OR = 1.33, 95% CI, 1.21–1.47, p = 5.19 × 10-9), LBP (OR = 1.28, 95% CI, 1.18–1.39, p = 6.60 × 10-9), and IVDD (OR = 1.23, 95% CI, 1.14–1.32, p = 2.48 × 10-8). Waist circumference, hip circumference, whole-body fat mass, fat-free mass, and fat percentage, but not waist–hip ratio, were causally associated with increased risks of IVDD and sciatica. Higher hip circumference, whole-body fat mass, fat-free mass, and fat percentage increased the risk of LBP. However, only whole-body fat-free mass remained to have a significant association with the risk of IVDD after adjusting for BMI with an odds ratio of 1.57 (95% CI, 1.32–1.86, p = 2.47 × 10-7). Proportions of BMI’s effect on IVDD, sciatica, and LBP mediated by leisure sedentary behavior were 41.4% (95% CI, 21.8%, 64.8%), 33.8% (95% CI, 17.5%, 53.4%), and 49.7% (95% CI, 29.4%, 73.5%), respectively. This study provides evidence that high BMI has causal associations with risks of various dorsopathies. Weight control is a good measure to prevent the development of dorsopathies, especially in the obese population.

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“…24 intervertebral disc deformation following physical activity, such as treadmill walking, increases with increasing BMI, particularly at the L5 to S1 level. 25 Biomechanical modeling studies have also shown that increased BMI significantly increases loading in the lumbar intervertebral disks. [26][27][28] This implies that the axial stress on the endplate and the implanted cage increases after TLIF, 29 potentially contributing to the occurrence of postoperative sclerotic MCs.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Sclerotic Modic Changes after Transforaminal Lumbar Interbody Fusion

Xiao,

Zhu,

Xiu

et al. 2023

Spine

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Study Design. A retrospective cohort study. Objective. This study aimed to assess postoperative sclerotic Modic changes (MCs) following transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative disc disease (LDD), investigating their prevalence, risk factors and association with clinical outcomes. Summary of Background Data. Sclerotic MCs may occur in patients with LDD after lumbar interbody fusion. The incidence and characteristics of postoperative sclerotic MCs, as well as their clinical impact, are unknown. Methods. The study included 467 patients (510 levels) who underwent single or two-level TLIF surgery, divided into a postoperative sclerotic MC group (60 patients, 66 levels) and non-MC group (407 patients, 444 levels). The time of development and location of postoperative sclerotic MCs, fusion rate, cage subsidence, bilateral process decompression, and cross-link usage were recorded. Preoperative, postoperative, and follow-up VAS and ODI scores were collected. Multivaraible logistic regression was used to evaluate factors associated with the development of postoperative sclerotic MCs. Results. The prevalence of postoperative sclerotic MCs was 12.8%. The postoperative sclerotic MC group had higher BMI. The postoperative sclerotic MC group demonstrated a fusion rate of 47%, significantly lower than that of the non-MC group (71%) at 6 months post-operation. At final follow-up, the fusion rate in the postoperative sclerotic MC group was 62%, significantly lower than that of the non-MC group (86%). Post-operative VAS and ODI scores were significantly higher in the group with postoperative sclerotic MCs. BMI and osteoporosis were significantly associated with the development of postoperative sclerotic MCs. Conclusion. Postoperative sclerotic MCs generally appear within the first year after surgery, with a prevalence of 12.8%. The presence of postoperative sclerotic MCs can adversely impact post-operative outcomes. To prevent postoperative sclerotic MCs, we postulate extending the immobilization period with external bracing and improving the management of BMI and osteoporosis in the peri-operative time window.

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Increasing BMI increases lumbar intervertebral disc deformation following a treadmill walking stress test

Cited by 10 publications

References 34 publications

The degenerative impact of hyperglycemia on the structure and mechanics of developing murine intervertebral discs

The degenerative impact of hyperglycemia on the structure and mechanics of developing murine intervertebral discs

Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study

Postoperative Sclerotic Modic Changes after Transforaminal Lumbar Interbody Fusion

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