Temporal Evolution of Disc in Young Patients with Low Back Pain and Stress Reaction in Lumbar Vertebrae

Sharma, Aseem; Sargar, Kiran; Salter, Amber

doi:10.3174/ajnr.a5237

Cited by 13 publications

(17 citation statements)

References 46 publications

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“…none supported a negative correlation. Outcomes were consistent throughout the clinical studies that showed a positive correlation, with all studies using MRI to diagnose bony stress and IVD degeneration (6,7,(18)(19)(20)(21) (7), which may suggest the importance of diagnosing early signs of bony stress even if the healing occurs in subsequent follow-up scans. Bony stress may also be a contributing factor to the non-speci c LBP, due to its association with IVD degeneration or due to the microtrabecular injury alone or both.…”

Section: Discussionsupporting

confidence: 70%

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Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Chepurin

Chamoli

Diwan

2020

Preprint

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BackgroundMultiple components of the lumbar spine interact during the normal and pathological function. Bony stress in the lumbar spine is recognised as a factor in the development of pars defects and stress fractures, but its relationship with intervertebral disc (IVD) degeneration is not well understood. Therefore, a translational review encompassing basic science and clinical evidence was conducted to examine the relationship between bony stress in the lumbar spine and IVD degeneration.MethodsOnline databases Scopus, PubMed and MEDLINE via OVID were searched for relevant studies published between January 1980 – February 2020, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two authors independently analysed the data, noting study characteristics and bias.ResultsThirty-two articles were included in the review: eight human studies, nine finite element analysis studies, three in-vivo biomechanical testing studies, and twelve in-vitro biomechanical testing studies. Of the 32 articles, 19 supported, four rejected and nine made no conclusion on the hypothesis that there is a positive associative relationship between IVD degeneration and bony stress. However, not enough evidence was available to confirm or reject a causal relationship.ConclusionMost studies suggest that the prevalence of IVD degeneration increases with the presence of bony stress, but whether a causal relationship exists is unclear. The literature recommends early diagnosis and clinical suspicion of IVD degeneration and bony stress. Longitudinal studies are required to explore causal relationships between IVD degeneration bony stress.

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Section: Discussionsupporting

confidence: 70%

“…The authors recognised early phases of bony stress on MRI and concluded that early imaging assessment may prevent a complete fracture non-union from occurring. Bony stress is thought to either alter load transmission throughout the IVD or occur secondary to the altered load distribution following IVD degeneration (7).…”

Section: Introductionmentioning

confidence: 99%

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Chepurin

Chamoli

Diwan

2020

Preprint

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“…Finite Element (FE) modeling studies making use of imaging data from living human subjects or human cadaveric material Other discs in the lumbar spine, including the L5-S1 disc that normally experiences the greatest axial load, are spared from degeneration. 7 Image courtesy Sharma et al 2017.…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…Bony stress is thought to either alter load transmission throughout the IVD or occur secondary to the altered load distribution following IVD degeneration. 7 Whether IVD degeneration is a causative factor for discogenic LBP is unclear. [8][9][10] Discogenic LBP may arise from not only the structural failure of the IVD but also from nociceptive neurotransmitters, and neural and vascular ingrowth in the outer annulus fibrosus.…”

Section: Introductionmentioning

confidence: 99%

“…(A) T2 weighted mid-sagittal cut on magnetic resonance imaging (MRI) of a 12-year-old female patient showing edema in the L4 right pedicle (red arrow). MRI from initial presentation (B) and 47-month follow up (C) shows the progression of L4-L5 disc degeneration (blue arrows).Other discs in the lumbar spine, including the L5-S1 disc that normally experiences the greatest axial load, are spared from degeneration 7. Image courtesy Sharma et al 2017.…”

mentioning

confidence: 99%

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Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: A Systematic Review of Clinical and Basic Science Studies

Chepurin

Chamoli

Diwan

2021

Global Spine Journal

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Study Design: Translational review encompassing basic science and clinical evidence. Objectives: Multiple components of the lumbar spine interact during its normal and pathological function. Bony stress in the lumbar spine is recognized as a factor in the development of pars interarticularis defect and stress fractures, but its relationship with intervertebral disc (IVD) degeneration is not well understood. Therefore, we conducted a systematic review to examine the relationship between bony stress and IVD degeneration. Methods: Online databases Scopus, PubMed and MEDLINE via OVID were searched for relevant studies published between January 1980-February 2020, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Two authors independently analyzed the data, noting characteristics and biases in various studies. Results: Thirty-two articles were included in the review: 8 clinical studies, 9 finite element modeling studies, 3 in-vivo biomechanical testing studies, and 12 in-vitro biomechanical testing studies. Of the 32 articles, 19 supported, 4 rejected and 9 made no conclusion on the hypothesis that there is a positive associative relationship between IVD degeneration and bony stress. However, sufficient evidence was not available to confirm or reject a causal relationship. Conclusions: Most studies suggest that the prevalence of IVD degeneration increases in the presence of bony stress; whether a causal relationship exists is unclear. The literature recommends early diagnosis and clinical suspicion of IVD degeneration and bony stress. Longitudinal studies are required to explore causal relationships between IVD degeneration and bony stress.

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Bony stress in the lumbar spine is associated with intervertebral disc degeneration and low back pain: a retrospective case–control MRI study of patients under 25 years of age

et al. 2019

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Temporal Evolution of Disc in Young Patients with Low Back Pain and Stress Reaction in Lumbar Vertebrae

Abstract: Stressed discs exhibit a higher burden of nuclear and annular degeneration at baseline. These discs have a higher risk of progressive nuclear degeneration irrespective of improvement or worsening of stress-related bony changes.

Cited by 13 publications

References 46 publications

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: a Review of Clinical and Basic Science Studies

Bony Stress and Its Association With Intervertebral Disc Degeneration in the Lumbar Spine: A Systematic Review of Clinical and Basic Science Studies

Bony stress in the lumbar spine is associated with intervertebral disc degeneration and low back pain: a retrospective case–control MRI study of patients under 25 years of age

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