Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,...Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.展开更多
Objective:To investigate the relationship between the expression of IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 in the disc tissue of patients with cervical disc degeneration.Methods:The expression levels of inflammatory fa...Objective:To investigate the relationship between the expression of IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 in the disc tissue of patients with cervical disc degeneration.Methods:The expression levels of inflammatory factors IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 were analyzed by RTPCR,and the correlation between inflammatory factors and Pfirrmann grade and inflammatory factors was analyzed.Results:The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were significantly higher in Pfirrmann grade IV-V than in Pfirrmann grade II-III(P<0.05),and IFN-a expression level in IV-V intervertebral disc samples was significantly lower than that in II-III discs(P<0.05);The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with pfirmann grading(P<0.05),IFN-a was negatively correlated with pfirmann grading(P<0.05),IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with each other(P<0.05),IFN-a was negatively correlated with IL-6,IL-8,IL-15,TNF-a and TRPC6(P<0.05).Conclusion:IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 are closely related to the degree of cervical disc degeneration.展开更多
背景:近期观察性研究发现局部脂肪量对于椎间盘退变评估有重要意义,而肥胖长期被认为是椎间盘退变的危险因素之一,作为肥胖核心因素的脂肪量在既往研究中与椎间盘退变的因果关系尚不明确。目的:探讨不同分布的脂肪量与椎间盘退变的因果...背景:近期观察性研究发现局部脂肪量对于椎间盘退变评估有重要意义,而肥胖长期被认为是椎间盘退变的危险因素之一,作为肥胖核心因素的脂肪量在既往研究中与椎间盘退变的因果关系尚不明确。目的:探讨不同分布的脂肪量与椎间盘退变的因果关系,以帮助增加对椎间盘退变发病机制的认知及制定预防、治疗及预后的策略。方法:从公开发表的IEU Open GWAS中以强相关性及满足连锁不平衡为条件提取躯干及下肢脂肪量的遗传位点作为工具变量,结合Finn Gen最新第9版数据库中选取椎间盘退变作为结局进行孟德尔随机化分析,通过逆方差加权法、MR-Egger回归、简单中位数法、加权中位数法和加权中值法等回归模型的OR值和95%CI评估躯干及下肢脂肪量与椎间盘退变间的因果关系。使用Cochran’s Q检验评估遗传工具变量的异质性,使用MR-Egger截距检验评估多效性,使用留一法评估作为工具变量的单核苷酸多态性对暴露和结局因果关系影响的敏感性。结果与结论:(1)逆方差加权法检测结果显示,躯干脂肪量与椎间盘退变发病风险呈正向因果关联(OR=1.25,95%CI:1.15-1.35,P<0.001),双下肢脂肪量与椎间盘退变发病风险呈反向因果关联(OR=0.7,95%CI:0.63-0.78,P<0.001;OR=0.69,95%CI:0.62-0.76,P<0.001);(2)MR-Egger截距分析未检测到潜在的水平多效性;(3)MR-PRESSO未检测到偏倚单核苷酸多态性,异质性检验存在,留一法敏感性分析提示分析结果可靠;(4)上述结果证实,躯干脂肪量与椎间盘退变有正向因果关系,随着躯干脂肪量增加,椎间盘退变的风险升高;双下肢脂肪量与椎间盘退变有反向因果关系,即随着双下肢脂肪量增加,椎间盘退变风险降低;脂肪的含量及分布会影响椎间盘退变的发病风险,应给予更多的关注。展开更多
Within the consistent daily rhythm of human life,intervertebral discs endure a variety of complex loads beyond the influences of gravity and muscle forces,leading to significant morphological changes(in terms of volum...Within the consistent daily rhythm of human life,intervertebral discs endure a variety of complex loads beyond the influences of gravity and muscle forces,leading to significant morphological changes(in terms of volume,area,and height)as well as biomechanical alterations,including an increase in disc stiffness and a decrease in intradiscal pressure.Remarkably,the discs demonstrate an ability to regain their original morphological and biomechanical characteristics after a period of nocturnal rest.The preservation of normal disc function is critically dependent on this recovery phase,which serves to forestall premature disc degeneration.This phenomenon of disc recovery has been extensively documented through numerous in vivo studies employing advanced clinical techniques such as Magnetic Resonance Imaging(MRI),stadiometry,and intradiscal pressure measurement.However,the findings from in vitro studies present a more complex picture,with reports varying between full recovery and only partial recuperation of the disc properties.Moreover,research focusing on degenerated discs in vitro has shed light on the quantifiable impact of degeneration on the disc ability to recover.Fluid dynamics within the disc are considered a primary factor in recovery,yet the disc intricate multiscale structure and its viscoelastic properties also play key roles.These elements interact in complex ways to influence the recovery mechanism,particularly in relation to the overall health of the disc.The objective of this review is to collate,analyze,and critically evaluate the existing body of in vivo and in vitro research on this topic,providing a comprehensive understanding of disc recovery processes.Such understanding offers a blueprint for future advancements in medical treatments and bionic engineering solutions designed to mimic,support,and enhance the natural recovery processes of intervertebral discs.展开更多
文摘Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.
基金This work was supported by the Project of the Department of Science and Technology in Shaanxi Province(2020JM-702)the Project of Scientific Research in Shaanxi University of Traditional Chinese Medicine(2020FS06).
文摘Objective:To investigate the relationship between the expression of IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 in the disc tissue of patients with cervical disc degeneration.Methods:The expression levels of inflammatory factors IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 were analyzed by RTPCR,and the correlation between inflammatory factors and Pfirrmann grade and inflammatory factors was analyzed.Results:The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were significantly higher in Pfirrmann grade IV-V than in Pfirrmann grade II-III(P<0.05),and IFN-a expression level in IV-V intervertebral disc samples was significantly lower than that in II-III discs(P<0.05);The mRNA expression levels of IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with pfirmann grading(P<0.05),IFN-a was negatively correlated with pfirmann grading(P<0.05),IL-6,IL-8,IL-15,TNF-a and TRPC6 were positively correlated with each other(P<0.05),IFN-a was negatively correlated with IL-6,IL-8,IL-15,TNF-a and TRPC6(P<0.05).Conclusion:IL-6,IL-8,IL-15,IFN-a,TNF-a and TRPC6 are closely related to the degree of cervical disc degeneration.
文摘背景:近期观察性研究发现局部脂肪量对于椎间盘退变评估有重要意义,而肥胖长期被认为是椎间盘退变的危险因素之一,作为肥胖核心因素的脂肪量在既往研究中与椎间盘退变的因果关系尚不明确。目的:探讨不同分布的脂肪量与椎间盘退变的因果关系,以帮助增加对椎间盘退变发病机制的认知及制定预防、治疗及预后的策略。方法:从公开发表的IEU Open GWAS中以强相关性及满足连锁不平衡为条件提取躯干及下肢脂肪量的遗传位点作为工具变量,结合Finn Gen最新第9版数据库中选取椎间盘退变作为结局进行孟德尔随机化分析,通过逆方差加权法、MR-Egger回归、简单中位数法、加权中位数法和加权中值法等回归模型的OR值和95%CI评估躯干及下肢脂肪量与椎间盘退变间的因果关系。使用Cochran’s Q检验评估遗传工具变量的异质性,使用MR-Egger截距检验评估多效性,使用留一法评估作为工具变量的单核苷酸多态性对暴露和结局因果关系影响的敏感性。结果与结论:(1)逆方差加权法检测结果显示,躯干脂肪量与椎间盘退变发病风险呈正向因果关联(OR=1.25,95%CI:1.15-1.35,P<0.001),双下肢脂肪量与椎间盘退变发病风险呈反向因果关联(OR=0.7,95%CI:0.63-0.78,P<0.001;OR=0.69,95%CI:0.62-0.76,P<0.001);(2)MR-Egger截距分析未检测到潜在的水平多效性;(3)MR-PRESSO未检测到偏倚单核苷酸多态性,异质性检验存在,留一法敏感性分析提示分析结果可靠;(4)上述结果证实,躯干脂肪量与椎间盘退变有正向因果关系,随着躯干脂肪量增加,椎间盘退变的风险升高;双下肢脂肪量与椎间盘退变有反向因果关系,即随着双下肢脂肪量增加,椎间盘退变风险降低;脂肪的含量及分布会影响椎间盘退变的发病风险,应给予更多的关注。
文摘Within the consistent daily rhythm of human life,intervertebral discs endure a variety of complex loads beyond the influences of gravity and muscle forces,leading to significant morphological changes(in terms of volume,area,and height)as well as biomechanical alterations,including an increase in disc stiffness and a decrease in intradiscal pressure.Remarkably,the discs demonstrate an ability to regain their original morphological and biomechanical characteristics after a period of nocturnal rest.The preservation of normal disc function is critically dependent on this recovery phase,which serves to forestall premature disc degeneration.This phenomenon of disc recovery has been extensively documented through numerous in vivo studies employing advanced clinical techniques such as Magnetic Resonance Imaging(MRI),stadiometry,and intradiscal pressure measurement.However,the findings from in vitro studies present a more complex picture,with reports varying between full recovery and only partial recuperation of the disc properties.Moreover,research focusing on degenerated discs in vitro has shed light on the quantifiable impact of degeneration on the disc ability to recover.Fluid dynamics within the disc are considered a primary factor in recovery,yet the disc intricate multiscale structure and its viscoelastic properties also play key roles.These elements interact in complex ways to influence the recovery mechanism,particularly in relation to the overall health of the disc.The objective of this review is to collate,analyze,and critically evaluate the existing body of in vivo and in vitro research on this topic,providing a comprehensive understanding of disc recovery processes.Such understanding offers a blueprint for future advancements in medical treatments and bionic engineering solutions designed to mimic,support,and enhance the natural recovery processes of intervertebral discs.
