Colorimetric detection and efficient monitoring of a potential biomarker of lumbar disc herniation using carbon nanotube-based probe

A systematic review evaluating the association of atherosclerosis and lumbar degenerative disc disease

Introduction

Lumbar disc herniation (LDH) and disc degeneration (DD) are associated with low back pain (LBP) and sciatica, which are common health problems. Emerging evidence suggests a link between vascular health, specifically abdominal aortic calcification (AAC) and systemic lipid profiles, and these spinal conditions.

Research question

This study investigates the associations between AAC, systemic lipid profiles, lumbar Modic Changes (MC), DD/LDH, and the occurrence of LBP or sciatica.

Material and methods

A literature search was performed (up to August 2023) in PubMed, Embase, Web of Science, Emcare, Cochrane Library, and Academic Search Premier utilizing a sensitive search strategy. Studies were chosen based on predefined criteria and assessed for bias using an adapted Cochrane checklist. Specifically, studies exploring the relationship between AAC or lipid status and DD/LDH and/or LBP/Sciatica were included.

Results

Twenty-seven studies were included. Eight studies assessed the association between atherosclerosis or lipid status and clinical LBP/sciatica, with four showing a positive association between AAC/lumbar artery stenosis and these conditions. Twenty-one studies assessed atherosclerosis and DD/LDH, with seven showing a positive association between AAC and DD/LDH. Eight trials found a positive association between lipid status and DD/LDH, and two trails identified ApoL1 as a biomarker for LDH recovery.

Discussion and conclusion

Evidence supports the hypothesis that inadequate blood supply contributes to disc degeneration, inflammation and clinical symptoms. Both local vascular issues and systemic lipid profiles appear to influence lumbar degeneration, highlighting the need for further research to better understand these relationships and develop preventive and therapeutic strategies.

Modic Changes in the Lumbar Spine: Exploring Their Association with Abdominal Aortic Calcification as a Potential Indicator of Systemic Atherosclerosis

BACKGROUND

This was a cross-sectional study on the correlation between abdominal aortic calcification (AAC) and Modic changes (MC). Little is known regarding the etiology of MC in the lumbar spine. Currently, insufficient vascularization of the endplate has been proposed to contribute to the appearance of MC. Our objective was to investigate whether AAC, a marker for a poor vascular status, is associated with MC in patients suffering from degenerative disc disease.

METHODS

Radiologic images of patients (n = 130) suffering from degenerative lumbar disc disease were reviewed. Type and severity of MC were assessed using magnetic resonance images, and severity of AAC was evaluated using computed tomography images or fluoroscopy. Both items were dichotomized into minimal and relevant grades. The correlation between them was studied using Spearman's correlation test, with age as a covariate.

RESULTS

Of the patients, 113 (87%) demonstrated MC (31% type I, 63% type II, and 6% type III) (55% relevant grade), and 68% had AAC (44% relevant grade). Spearman statistical analysis revealed that AAC was correlated with age (P < 0.001), whereas MC were not (P = 0.142). AAC severity was significantly correlated with MC, remaining so after age adjustment (P < 0.05). While MC type I lacked correlation with AAC, MC type II were significantly correlated with AAC (0.288, P = 0.015); however, this association lost significance after adjusting for age (P = 0.057).

CONCLUSIONS

AAC and MC (mainly MC type II) are associated, indicating that reduced blood supply or even a poor systemic vascularization status due to atherosclerotic disease may play a role in the formation of MC. Future studies focusing on the etiology of MC should pay more attention to patients' vascular status and determinants of abdominal aorta calcification.