The elastic fibre network of the human lumbar anulus fibrosus: architecture, mechanical function and potential role in the progression of intervertebral disc degeneration

Smith, Lachlan J.; Fazzalari, Nicola L.

doi:10.1007/s00586-009-0918-8

Cited by 85 publications

(71 citation statements)

References 69 publications

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“…Degenerative process is thought to start in the nucleus pulposus, exhibiting a decrease in its proteoglycan concentration [9,10] and gradual change in Type 1 collagen into a more fibrotic Type 2 collagen [11] . The arrangement of the elastic fibers plays a very important role in the overall mechanical properties of the anulus fibrosus [12] Elastic anisotropy in the anulus is maintained with degeneration, with posterolateral and outer lamellae regions having decreases of about 30-50% with advancing degeneration [13] . When degeneration is combined with extreme and constant spine movements it can end up in disc herniation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of lumbar disc herniation and disc degeneration in asymptomatic Indian subjects: An MRI based study

Kuppuswamy¹,

George²,

Chemmanam³

2017

Int. J. Orthop. Sci.

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Background: India is a country with a huge human resource been utilised for labour and also is a country of diversity in culture and religions. Thus we have numerous activities which involve bending and twisting of the spine. Therefore we expect more disc degeneration and disc herniation compared to the western world. Indian health care system has traditional medicine and modern medicine. Both systems has easy access to Magnetic Resonance Imaging (MRI) which in fact will display both physiological and pathological changes. This may miss-lead a less experienced health worker and can also create a bad mental impact on an otherwise normal individual. Aim: Analyse the prevalence of lumbar disc degeneration and herniation in asymptomatic Indian subjects using MRI Materials and Methods: this was an observational study where we selected subjects without any low back related symptoms and signs and allowed them to undergo lumbar spine screening using a 0.2 tesla machine. Results: We had 76 subjects with a mean age of 43.7 and studied 380 discs in 4 different age groups. Among disc herniation 273 discs (71.8%) were normal and 107 discs (28.2%) had pathological changes in the form of bulge 68(17.8%), protrusions 30(7.8%) and extrusions 9(2%). None of the subjects had sequestration. Among disc degeneration 256(67.3%) were Grade 1& 2 and 124 (32.7%) were Grade 3, 4&5. In the 76 subjects 37% had disc herniation and 33% had grade 3, 4 and 5 degeneration. Conclusion: The high prevalence of disc degeneration and disc herniation in MRI of normal subjects, emphasize the value of clinical history and clinical evaluation before starting precious treatment.Keywords: disc degeneration, herniation, MRI, asymptomatic subjects Introduction According to literature, the prevalence of lumbar pain at one time point was approximately 30-40% in Germany. The one year and lifetime prevalence was approximately 60-70% and more than 80%, respectively

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Section: Discussionmentioning

confidence: 99%

Prevalence of lumbar disc herniation and disc degeneration in asymptomatic Indian subjects: An MRI based study

Kuppuswamy¹,

George²,

Chemmanam³

2017

Int. J. Orthop. Sci.

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“…This predominantly anabolic response for elastin is consistent with the fact that elastin is one of the most resistant proteins in the body toward proteolysis. 6 However, elastin can also be degraded by other matrix metalloproteases43 including MMP-2, MMP-7, and MMP-9 which were not measured. This study quantified the effects of mechanical loading on gene expression, rather than directly measuring protein level changes since the short duration of the mechanical tests would not be expected to cause protein level changes.…”

Section: Discussionmentioning

confidence: 99%

Effects of Torsion on Intervertebral Disc Gene Expression and Biomechanics, Using a Rat Tail Model

Barbir

Godburn

Michalek

et al. 2011

Spine

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Study Design-In vitro and in vivo rat tail model to assess effects of torsion on intervertebral disc biomechanics and gene expression.Objective-Investigate effects of torsion on promoting biosynthesis and producing injury in rat caudal intervertebral discs.Summary of Background Data-Torsion is an important loading mode in the disc and increased torsional range of motion is associated with clinical symptoms from disc disruption. Altered elastin content is implicated in disc degeneration, but its effects on torsional loading are unknown. Although effects of compression have been studied, the effect of torsion on intervertebral disc gene expression is unknown.Methods-In vitro biomechanical tests were performed in torsion on rat tail motion segments subjected to 4 treatments: elastase, collagenase, genipin, control. In vivo tests were performed on rats with Ilizarov-type fixators implanted to caudal motion segments with five 90-minute loading groups: 1 Hz cyclic torsion to ±5°, ±15°, and ±30°, static torsion to +30°, and sham. Anulus and nucleus tissues were separately analyzed using qRT-PCR for gene expression of anabolic, catabolic, and proinflammatory cytokine markers.Results-In vitro tests showed decreased torsional stiffness following elastase treatment and no changes in stiffness with frequency. In vivo tests showed no significant changes in dynamic stiffness with time. Cyclic torsion upregulated elastin expression in the anulus fibrosus. Upregulation of TNF-α and IL-1β was measured at ±30°.Conclusion-We conclude that strong differences in the disc response to cyclic torsion and compression are apparent with torsion increasing elastin expression and compression resulting in a more substantial increase in disc metabolism in the nucleus pulposus. Results highlight the importance of elastin in torsional loading and suggest that elastin remodels in response to shearing. Torsional loading can cause injury to the disc at excessive amplitudes that are detectable biologically before they are biomechanically. ©2010, Lippincott Williams & WilkinsAddress correspondence and reprint requests to James C. Iatridis, PhD, University of Vermont, 33 Colchester Ave, 201 Perkins Hall, Burlington, VT 05405; James.iatridis@uvm.edu. NIH Public AccessAuthor Manuscript Spine (Phila Pa 1976 The causes of intervertebral disc (IVD) degeneration are multifaceted, with contributions from aging, mechanical, genetic, and nutritional factors. 1 IVD degeneration is manifested biochemically through a loss of glycosaminoglycans, regional changes in collagen matrix composition 2 as well as changes in elastin structure 3,4 and content. 5 An increase in expression of proteases and their inhibitors, 6,7 including MMP-3, ADAMTS-4, and TIMP-1 as well as cytokines IL-1β 8 and TNF-α 9 have also been associated with degeneration. Biomechanically, IVD degeneration is characterized by a decrease in intradiscal and osmotic pressure, 10,11 an altered range of motion and reduced neutral zone, 12-14 and a decrease in creep and creep rate. 15,16 Although...

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“…The arrangement of the elastic fibers plays a very important role in the overall mechanical properties of the anulus fibrosus. 30,31 Elastic anisotropy in the anulus 32 is maintained with degeneration, with posterolateral and outer lamellae regions having decreases of about 30–50% with advancing degeneration. 33–36 …”

Section: Materials Properties Of the Degenerative Intervertebral Disc mentioning

confidence: 99%

Biomechanics of Intervertebral Disk Degeneration

Inoue

Orías

2011

Orthopedic Clinics of North America

167

126

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The elastic fibre network of the human lumbar anulus fibrosus: architecture, mechanical function and potential role in the progression of intervertebral disc degeneration

Cited by 85 publications

References 69 publications

Prevalence of lumbar disc herniation and disc degeneration in asymptomatic Indian subjects: An MRI based study

Prevalence of lumbar disc herniation and disc degeneration in asymptomatic Indian subjects: An MRI based study

Effects of Torsion on Intervertebral Disc Gene Expression and Biomechanics, Using a Rat Tail Model

Biomechanics of Intervertebral Disk Degeneration

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