Risk of Herniated Nucleus Pulposus Among U.S. Astronauts

Johnston, Smith L.; Campbell, Mark; Scheuring, Rick; Feiveson, Alan H.

doi:10.3357/asem.2427.2010

Cited by 123 publications

(138 citation statements)

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“…Although we cannot rule out an impact of spaceflight on medium to long-term IVD degeneration post-flight in the relatively short duration of a spaceflight the IVD is not likely to degenerate. Thus, the spike of IVD herniation incidence observed by Johnston et al [1] immediately after spaceflight emphasises the mechanics of internal IVD forces and influence of external forces on IVD herniation.…”

Section: What Can Astronaut Ivd Herniations Tell Us About Herniationsmentioning

confidence: 91%

“…Apollo and Shuttle astronauts (top panels) walked immediately after landing, whereas astronauts and cosmonauts coming back with the Soyuz vessel (bottom panels) were carried out of the capsule. The data presented by Johnston et al [1] suggested that those astronauts who performed upright activities immediately after spaceflight were at a higher risk of IVD herniation. Photo credits: NASA (top left and right, bottom right), ESA (bottom left) their previous sporting pursuits, are at risk for IVD problems.…”

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

“…Johnston et al [1] observed an increased risk of IVD herniation upon entering the astronaut program. This could potentially be due to pre-existing conditions or the training program itself.…”

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

“…Since a number of astronauts had previously been fighter pilots, Johnston et al [1] evaluated whether this prior history may be a predictive factor for IVD herniation, but they did not find any significant relationship. Performing high-G manoeuvres [41], pilot ejection [42], and helicopter vibration [43] present risk factors for injury to the neck.…”

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

“…The problem: disc herniations in astronauts A recent publication [1] from the National Aeronautics and Space Administration (NASA) showed an increased risk of intervertebral disc (IVD) herniations in US astronauts (Fig. 1).…”

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confidence: 99%

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Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

et al. 2015

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Purpose Recent work showed an increased risk of cervical and lumbar intervertebral disc (IVD) herniations in astronauts. The European Space Agency asked the authors to advise on the underlying pathophysiology of this increased risk, to identify predisposing factors and possible interventions and to suggest research priorities. Methods The authors performed a narrative literature review of the possible mechanisms, and conducted a survey within the team to prioritize research and prevention approaches.Results and conclusions Based on literature review the most likely cause for lumbar IVD herniations was concluded to be swelling of the IVD in the unloaded condition during spaceflight. For the cervical IVDs, the knowledge base is too limited to postulate a likely mechanism or recommend approaches for prevention. Basic research on the impact of (un)loading on the cervical IVD and translational research is needed. The highest priority prevention approach for the lumbar spine was post-flight care avoiding activities involving spinal flexion, followed by passive

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Section: What Can Astronaut Ivd Herniations Tell Us About Herniationsmentioning

confidence: 91%

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

Section: Cumulative Injury To the Ivd Prior To Spaceflightmentioning

confidence: 99%

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confidence: 99%

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Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

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Microgravity Stress: Bone and Connective Tissue

Bloomfield

Martinez

Boudreaux

et al. 2016

Comprehensive Physiology

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The major alterations in bone and the dense connective tissues in humans and animals exposed to microgravity illustrate the dependency of these tissues' function on normal gravitational loading. Whether these alterations depend solely on the reduced mechanical loading of zero g or are compounded by fluid shifts, altered tissue blood flow, radiation exposure, and altered nutritional status is not yet well defined. Changes in the dense connective tissues and intervertebral disks are generally smaller in magnitude but occur more rapidly than those in mineralized bone with transitions to 0 g and during recovery once back to the loading provided by 1 g conditions. However, joint injuries are projected to occur much more often than the more catastrophic bone fracture during exploration class missions, so protecting the integrity of both tissues is important. This review focuses on the research performed over the last 20 years in humans and animals exposed to actual spaceflight, as well as on knowledge gained from pertinent ground-based models such as bed rest in humans and hindlimb unloading in rodents. Significant progress has been made in our understanding of the mechanisms for alterations in bone and connective tissues with exposure to microgravity, but intriguing questions remain to be solved, particularly with reference to biomedical risks associated with prolonged exploration missions.

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Changes in Vertebral Bone Density and Paraspinal Muscle Morphology Following Spaceflight and 1 Year Readaptation on Earth

Coulombe,

Johannesdottir,

Burkhart

et al. 2023

JBMR Plus

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Astronauts have an increased risk of back pain and disc herniation upon returning to Earth. Thus, it is imperative to understand the effects of spaceflight and readaptation to gravity on the musculoskeletal tissues of the spine. Here we investigated whether ~6 months of spaceflight led to regional differences in bone loss within the vertebral body. Additionally, we evaluated the relationships between vertebral bone density and paraspinal muscle morphology before flight, after flight, and after readaptation on Earth. We measured vertebral trabecular bone mineral density (Tb.BMD), paraspinal muscle cross‐sectional area (CSA), and muscle density in 17 astronauts using computed tomography (CT) images of the lumbar spine obtained before flight (before flight, n = 17), after flight (spaceflight, n = 17), and ~12 months of readaptation to gravitational loading on Earth (follow‐up, n = 15). Spaceflight‐induced declines in Tb.BMD were greater in the superior region of the vertebral body (−6.7%) than the inferior (−3.1%, p = 0.052 versus superior region) and transverse regions (−4.3%, p = 0.057 versus superior region). After a year of readaptation to Earth's gravity, Tb.BMD in the transverse region remained significantly below preflight levels (−4.66%, p = 0.0094). Paraspinal muscle CSA and muscle density declined −1.0% (p = 0.005) and −0.83% (p = 0.001) per month of spaceflight, respectively. Ultimately, bone loss in the superior vertebral body, along with fatty infiltration of paraspinal muscles and incomplete recovery even after a year of readaptation on Earth, may contribute to spinal pathology in long‐duration astronauts. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

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Risk of Herniated Nucleus Pulposus Among U.S. Astronauts

Abstract: Astronauts are at higher risk of incurring HNP, especially immediately following spaceflight.

Cited by 123 publications

References 0 publications

Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

Microgravity Stress: Bone and Connective Tissue

Changes in Vertebral Bone Density and Paraspinal Muscle Morphology Following Spaceflight and 1 Year Readaptation on Earth

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