Background: Spinal instability, including lumbar degenerative spondylolisthesis (DS), mainly results from degeneration of intervertebral discs (IVD) and the facet joints (FJ). Characterization of the relationship betw...Background: Spinal instability, including lumbar degenerative spondylolisthesis (DS), mainly results from degeneration of intervertebral discs (IVD) and the facet joints (FJ). Characterization of the relationship between IVD degeneration in cases of lumbar degenerative spondylolisthesis (DS), and T2 values may be useful for accurate noninvasive evaluation and subsequent treatment. Thus, the goal of this study was to measure T2 values of IVDs in cases with (DS) and without (NS) spondylolisthesis, and to characterize changes of IVDs in DS. Methods: A total of 40 subjects who presented with L4 spondylolisthesis comprised the DS group. Another 40 subjects who did not have lumbar spondylolisthesis, constituted the NS group. T2 values of IVDs were measured and compared in these groups. Results: T2 values for IVDs tended to be lower in the DS group than in the NS group, and these values were significantly different (p < 0.01) within the anterior annulus fibrosus (AF). No significant differences in T2 values between Meyerding grades I and II were observed in any areas of IVDs. Conclusions: It is speculated that in the early stages, the degeneration of the anterior AF develops and is related to the onset of lumbar spondylolisthesis, while in later stages, degeneration of facet joints influences the progression of spondylolisthesis.展开更多
The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in ...The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in the structure of the intervertebral disc.Its constituent cells,the chondrocytes in the endplate,may also be involved in the process of the intervertebral disc degeneration and their role is central both under physiological and pathological conditions.They main functions include a role in homeostasis of the extracellular environment of the intervertebral disc,metabolic support and nutrition of the discal nucleus and annulus beneath and the preservation of the extracellular matrix.Therefore,it is understandable that the cells in the endplate have been in the centre of research from several viewpoints,such as development,degeneration and growth,reparation and remodelling,as well as treatment strategies.In this article,we briefly review the importance of vertebral endplate,which are often overlooked,in the intervertebral disc degeneration.展开更多
Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopath...Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopathy,spinal stenosis,degenerative spondylolisthesis,and herniations.Its etiology is complex and multifactorial.Although genetics influence more dominant,the occupational and mechanical influences still persist as a major risk factor.This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational,lifestyle factors,and genetic polymorphisms.展开更多
Objective To test the possibility of modification of human degenerative lumbar disc cells by the exogenous growth factor gene, transforming growth factor β_1 (TGF-β_ 1) cDNA, and the expression of the encoded prote...Objective To test the possibility of modification of human degenerative lumbar disc cells by the exogenous growth factor gene, transforming growth factor β_1 (TGF-β_ 1) cDNA, and the expression of the encoded protein. Methods Nucleus pulposus samples were surgically obtained from 8 patients with degenerat ive lumbar disc disease. The cells were cultured and directly infected by two a denoviral constructs, Ad/CMV-EGFP containing the enhanced green fluorecence pro tein (EGFP) gene (marker gene) and Ad/CMV-TGF-β_1 containing the potentially therapeutic TGF-β_1 gene. Transgene expression was analyzed by fluorescence production and immunohistochemical staining (Ad/CMV-TGF-β_1). Results Culture cells transducted by Ad/CMV-EGFP showed specific green fluorescence und er the fluoroscope and expression sustained for at least 4 weeks. When infe cted by Ad/CMV-TGF-β_1, approximally 30% of cultured cells were staind brown (+) with TGF-β_1 staining. Conclusion This study established the strategy of delivering a potentially therapeutic gene , TGF-β_1, by using an adenoviral vector to human degenerative lumbar interve rtebral disc cells.展开更多
Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying...Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the retative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study. Methods From January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2Wl sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray. Results In scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side （P 〈0.001）. The vertebral body height on the convex side was greater than the height on the concave side （P=0.016） There was a significant difference between the scoliosis group and the control group （P=0.003）, and between T-value and the rate of osteoporosis between the two groups （both P 〈0.001）. Results were verified using multiple linear regression analysis. Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis and the disc index, the degree of degeneration of the intervertebral disc, and a negative correlation between the angle of scoliosis and bone density.展开更多
Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantati...Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 （AAV2）-mediated connective tissue growth factor （CTGF） and tissue inhibitor of metalloproteinases 1 （TIMP1） genes in vitro. Methods Computer tomography （CT）-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits, rAAV2-CTGF-IRES-TIMPI-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs （transplantation group）, phosphate-buffered saline （PBS） was injected into degenerative lumbar intervertebral discs （degeneration control group） and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index （DHI） and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging （MRI） analysis The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type II collagen and proteoglycan was detected by RT-PCR. Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture. Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen II mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the degeneration control group （P 〈0.05）. Conclusions CT-guided percutaneous puncture can successfully build rabbit degenerative intervertebral disc models. Both CTGF and TIMPl-transfected cell transplantation helps to maintain disc height, and promotes the biosynthesis of tvDe II collaQen and proteoalvcan in intervertebral discs, reversinq the de（：ieneration of intervertebral discs.展开更多
沉默信息调节因子2同源蛋白1(silent mating type information regulation 2 homolog 1,SIRT1/sirtuin 1)是组蛋白去乙酰化酶,参与表观遗传修饰调节,促进多种细胞的生存,但目前对椎间盘髓核细胞的作用未见研究.为了阐明临床不同来源的...沉默信息调节因子2同源蛋白1(silent mating type information regulation 2 homolog 1,SIRT1/sirtuin 1)是组蛋白去乙酰化酶,参与表观遗传修饰调节,促进多种细胞的生存,但目前对椎间盘髓核细胞的作用未见研究.为了阐明临床不同来源的椎间盘髓核手术标本SIRT1的表达变化,用免疫组化、定量RT-PCR、Western blot方法对中老年腰椎间盘突出症病人及青壮年腰椎骨折病人术中髓核标本进行研究,表明老年人髓核SIRT1的mRNA及蛋白质水平均显著低于青壮年的髓核.同时,用resveratrol(SIRT1激动剂)、烟碱(SIRT1抑制剂)、SIRT1-siRNA对培养的退变髓核细胞进行处理或转染后,用流式细胞仪检测凋亡率变化,结果表明resveratrol能显著促进退变髓核细胞生存,相反,当烟碱或SIRT1-siRNA转染后则显著促进髓核细胞凋亡.为了进一步分析SIRT1抑制退变髓核细胞凋亡的分子机制,应用Western blot及抑制剂方法研究表明,当SIRT1-siRNA转染髓核细胞后能降低磷酸化Akt蛋白的表达,而白藜芦醇处理则促进磷酸化Akt蛋白的表达,当用LY294002(PI3K抑制剂)或Akt-siRNA转染后显著抑制髓核细胞的生存率.研究结果表明,SIRT1通过Akt通路能显著抑制髓核细胞凋亡,为深入揭示退变性椎间盘疾病的病理生理及生物治疗提供新的思路和靶点.展开更多
文摘Background: Spinal instability, including lumbar degenerative spondylolisthesis (DS), mainly results from degeneration of intervertebral discs (IVD) and the facet joints (FJ). Characterization of the relationship between IVD degeneration in cases of lumbar degenerative spondylolisthesis (DS), and T2 values may be useful for accurate noninvasive evaluation and subsequent treatment. Thus, the goal of this study was to measure T2 values of IVDs in cases with (DS) and without (NS) spondylolisthesis, and to characterize changes of IVDs in DS. Methods: A total of 40 subjects who presented with L4 spondylolisthesis comprised the DS group. Another 40 subjects who did not have lumbar spondylolisthesis, constituted the NS group. T2 values of IVDs were measured and compared in these groups. Results: T2 values for IVDs tended to be lower in the DS group than in the NS group, and these values were significantly different (p < 0.01) within the anterior annulus fibrosus (AF). No significant differences in T2 values between Meyerding grades I and II were observed in any areas of IVDs. Conclusions: It is speculated that in the early stages, the degeneration of the anterior AF develops and is related to the onset of lumbar spondylolisthesis, while in later stages, degeneration of facet joints influences the progression of spondylolisthesis.
文摘The degenerative disease of the intervertebral disc is nowadays an important health problem,which has still not been understood and solved adequately.The vertebral endplate is regarded as one of the vital elements in the structure of the intervertebral disc.Its constituent cells,the chondrocytes in the endplate,may also be involved in the process of the intervertebral disc degeneration and their role is central both under physiological and pathological conditions.They main functions include a role in homeostasis of the extracellular environment of the intervertebral disc,metabolic support and nutrition of the discal nucleus and annulus beneath and the preservation of the extracellular matrix.Therefore,it is understandable that the cells in the endplate have been in the centre of research from several viewpoints,such as development,degeneration and growth,reparation and remodelling,as well as treatment strategies.In this article,we briefly review the importance of vertebral endplate,which are often overlooked,in the intervertebral disc degeneration.
文摘Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging,which has been found to be a contributing factor for low back pain and might cause radiculopathy,myelopathy,spinal stenosis,degenerative spondylolisthesis,and herniations.Its etiology is complex and multifactorial.Although genetics influence more dominant,the occupational and mechanical influences still persist as a major risk factor.This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational,lifestyle factors,and genetic polymorphisms.
文摘Objective To test the possibility of modification of human degenerative lumbar disc cells by the exogenous growth factor gene, transforming growth factor β_1 (TGF-β_ 1) cDNA, and the expression of the encoded protein. Methods Nucleus pulposus samples were surgically obtained from 8 patients with degenerat ive lumbar disc disease. The cells were cultured and directly infected by two a denoviral constructs, Ad/CMV-EGFP containing the enhanced green fluorecence pro tein (EGFP) gene (marker gene) and Ad/CMV-TGF-β_1 containing the potentially therapeutic TGF-β_1 gene. Transgene expression was analyzed by fluorescence production and immunohistochemical staining (Ad/CMV-TGF-β_1). Results Culture cells transducted by Ad/CMV-EGFP showed specific green fluorescence und er the fluoroscope and expression sustained for at least 4 weeks. When infe cted by Ad/CMV-TGF-β_1, approximally 30% of cultured cells were staind brown (+) with TGF-β_1 staining. Conclusion This study established the strategy of delivering a potentially therapeutic gene , TGF-β_1, by using an adenoviral vector to human degenerative lumbar interve rtebral disc cells.
文摘Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the retative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study. Methods From January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2Wl sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray. Results In scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side （P 〈0.001）. The vertebral body height on the convex side was greater than the height on the concave side （P=0.016） There was a significant difference between the scoliosis group and the control group （P=0.003）, and between T-value and the rate of osteoporosis between the two groups （both P 〈0.001）. Results were verified using multiple linear regression analysis. Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis and the disc index, the degree of degeneration of the intervertebral disc, and a negative correlation between the angle of scoliosis and bone density.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30471750）.
文摘Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 （AAV2）-mediated connective tissue growth factor （CTGF） and tissue inhibitor of metalloproteinases 1 （TIMP1） genes in vitro. Methods Computer tomography （CT）-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits, rAAV2-CTGF-IRES-TIMPI-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs （transplantation group）, phosphate-buffered saline （PBS） was injected into degenerative lumbar intervertebral discs （degeneration control group） and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index （DHI） and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging （MRI） analysis The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type II collagen and proteoglycan was detected by RT-PCR. Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture. Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen II mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the degeneration control group （P 〈0.05）. Conclusions CT-guided percutaneous puncture can successfully build rabbit degenerative intervertebral disc models. Both CTGF and TIMPl-transfected cell transplantation helps to maintain disc height, and promotes the biosynthesis of tvDe II collaQen and proteoalvcan in intervertebral discs, reversinq the de（：ieneration of intervertebral discs.
