Pathomechanism of Loss of Elasticity and Hypertrophy of Lumbar Ligamentum Flavum in Elderly Patients With Lumbar Spinal Canal Stenosis

Kosaka, Hirofumi; Sairyo, Koichi; Biyani, Ashok; Leaman, Douglas W.; Yeasting, Richard A.; Higashino, Kosaku; Sakai, Toshinori; Katoh, Shinsuke; Sano, Toshiaki; Goel, Vijay K.; Yasui, Natsuo

doi:10.1097/brs.0b013e31815b650f

Cited by 143 publications

(147 citation statements)

References 18 publications

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“…In this case, there was a notable increase in collagen and decrease in elastic fibers, with a loss of the parallel arrangement of cells. The latter change increases ligament volume and has also been described in humans as age-related changes (Kosaka et al 2007, Schräder et al 1999. Fibrosis is a type of scarring resulting from injury.…”

Section: Discussionmentioning

confidence: 98%

“…The extracellular matrix of normal LF is composed of parallel elastin and collagen fibers (e.g. in humans, elastin:collagen are in a 2:1 ratio) (Kosaka et al 2007). The elastin fibers provide elasticity and the collagen provides stiffness and stability (Kosaka et al 2007).…”

Section: Discussionmentioning

confidence: 99%

“…in humans, elastin:collagen are in a 2:1 ratio) (Kosaka et al 2007). The elastin fibers provide elasticity and the collagen provides stiffness and stability (Kosaka et al 2007). In cases of LF hypertrophy, this ratio decreases resulting in a poor elasticity and augmented stiffness or fibrosis (Kosaka et al 2007.…”

Section: Discussionmentioning

confidence: 99%

“…The elastin fibers provide elasticity and the collagen provides stiffness and stability (Kosaka et al 2007). In cases of LF hypertrophy, this ratio decreases resulting in a poor elasticity and augmented stiffness or fibrosis (Kosaka et al 2007. The causes of LF hypertrophy are multifactorial and include age, ac tivity levels, and mechanical stress.…”

Section: Discussionmentioning

confidence: 99%

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Surgical correction of degenerative lumbosacral stenosis in a puma (Puma concolor araucana)

et al. 2011

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COMMUNICATION Surgical correction of degenerative lumbosacral stenosis in a puma(Puma concolor araucana) RESUMENUn ejemplar de puma (Puma concolor araucana) macho intacto, adulto (12 años), fue evaluado debido a una paraparesis y deambulación anormal de los miembros pélvicos. Al examen neurológico se determinó una paraparesia progresiva, ataxia simétrica de los miembros pélvicos y parálisis de la cola. Se obtuvieron radiografías simples y una tomografía computarizada (TC) del segmento lumbosacro como exámenes diagnósticos para determinar posibles causas. El examen de TC confirmó una estenosis del canal vertebral en el segmento vertebral L7-S1. Se realizó una laminectomía dorsal con el fin de descomprimir el área afectada. Se tomaron muestras de tejido blando del área afectada para su análisis histopatológico. El material colectado presentó moderadas células inflamatorias e hipertrofia del ligamento flavum. Dos semanas después de la cirugía, el animal mostró un mejoramiento neurológico progresivo y retornó a una ambulación normal.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical correction of degenerative lumbosacral stenosis in a puma (Puma concolor araucana)

et al. 2011

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“…2 The pathological mechanism of LF degeneration and hypertrophy are unknown, but may involve agerelated degeneration, mechanical (flexion, extension, axial loading) stretch, and activities. [3][4][5] Cyclic stretch plays role in the growth, maintenance, remodeling and disease onset in the viscoelastic tissues of the spine. 6 As a risk factor for low back disorder, cyclic stretch causes the hypertrophy of LF, leading to degenerative spinal canal stenosis.…”

Section: Introductionmentioning

confidence: 99%

Cyclic stretch enhances apoptosis in human lumbar ligamentum ﬂavum cells via the induction of reactive oxygen species generation

Chen

Liu

Zhong

et al. 2016

The Journal of Spinal Cord Medicine

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Objective: The lumbar ligamentum flavum (LF) is an important part of the spine to maintain the stability of the spine. In this study we aimed to examine whether mechanical force by cyclic stretch could induce apoptosis in human LF cells and investigate the underlying mechanism. Methods: LF cells were isolated from six young patients undergoing spinal surgery and then cultured in vitro. LF cells were subjected to cyclic stretch and the poptosis was detected by flow cytometry. The level of intracellular reactive oxygen species (ROS) and caspase-9 activity were measured. Results: Cyclic stretch at a frequency of 0.5 Hz with 20% elongation induced the apoptosis of human LF cells in vitro, and this was correlated with increased ROS generation and activation of caspase-9. Conclusion: Our study suggests that cyclic stretch-induced apoptosis in human LF cells may be mediated by ROS generation and the activation of caspase-9.

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The thickness of the ligamentum flavum in relation to age and gender

et al. 2009

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Hypertrophy of the ligamentum flavum (LF) can reduce the diameter of the spinal canal posteriorly. Such stenosis may significantly compress the dural sac and nerve roots, resulting in symptoms, even without a bulging anulus fibrosus or herniated nucleus pulposus. We conducted an anatomical study to determine the influence of age and gender on the thickness of the LF at the lower lumbar levels using magnetic resonance imaging (MRI). The thickness of 1,280 ligaments was determined at the L4-L5 and L5-S1 levels from MRIs. We screened 320 patients (152 males [47.5%] and 168 females [52.5%]) between 21 and 82 years of age. There were no significant differences in LF thickness with respect to gender (P > 0.05). Age was not correlated with the thicknesses of the LF. The left LF at the L4-L5 and L5-S1 levels was significantly thicker than on the right side (P < 0.05). Furthermore, the LF thicknesses at L5-S1 bilaterally were significantly greater than on the corresponding sides at L4-L5 (P < 0.05). The LF is an important anatomical structure, which might cause low back or leg pain. Therefore, the thickness of the LF should be measured and evaluated carefully in the case of spinal stenosis.

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Pathomechanism of Loss of Elasticity and Hypertrophy of Lumbar Ligamentum Flavum in Elderly Patients With Lumbar Spinal Canal Stenosis

Abstract: Decreased elasticity of LF in the elderly is due to the loss of elastic fibers and a concomitant increase of collagenous fibers in the dorsal aspect. LF hypertrophy could be due to the thickening of the normal elastic layer as well as of the abnormal collagenous layer.

Cited by 143 publications

References 18 publications

Surgical correction of degenerative lumbosacral stenosis in a puma (Puma concolor araucana)

Surgical correction of degenerative lumbosacral stenosis in a puma (Puma concolor araucana)

Cyclic stretch enhances apoptosis in human lumbar ligamentum ﬂavum cells via the induction of reactive oxygen species generation

The thickness of the ligamentum flavum in relation to age and gender

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