1
|
Vaill M, Kawanishi K, Varki N, Gagneux P, Varki A. Comparative physiological anthropogeny: exploring molecular underpinnings of distinctly human phenotypes. Physiol Rev 2023; 103:2171-2229. [PMID: 36603157 PMCID: PMC10151058 DOI: 10.1152/physrev.00040.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
Anthropogeny is a classic term encompassing transdisciplinary investigations of the origins of the human species. Comparative anthropogeny is a systematic comparison of humans and other living nonhuman hominids (so-called "great apes"), aiming to identify distinctly human features in health and disease, with the overall goal of explaining human origins. We begin with a historical perspective, briefly describing how the field progressed from the earliest evolutionary insights to the current emphasis on in-depth molecular and genomic investigations of "human-specific" biology and an increased appreciation for cultural impacts on human biology. While many such genetic differences between humans and other hominids have been revealed over the last two decades, this information remains insufficient to explain the most distinctive phenotypic traits distinguishing humans from other living hominids. Here we undertake a complementary approach of "comparative physiological anthropogeny," along the lines of the preclinical medical curriculum, i.e., beginning with anatomy and considering each physiological system and in each case considering genetic and molecular components that are relevant. What is ultimately needed is a systematic comparative approach at all levels from molecular to physiological to sociocultural, building networks of related information, drawing inferences, and generating testable hypotheses. The concluding section will touch on distinctive considerations in the study of human evolution, including the importance of gene-culture interactions.
Collapse
Affiliation(s)
- Michael Vaill
- Center for Academic Research and Training in Anthropogeny, University of California, San Diego, La Jolla, California
- Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, California
- Glycobiology Research and Training Center, University of California, San Diego, La Jolla, California
| | - Kunio Kawanishi
- Center for Academic Research and Training in Anthropogeny, University of California, San Diego, La Jolla, California
- Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, California
- Department of Experimental Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nissi Varki
- Center for Academic Research and Training in Anthropogeny, University of California, San Diego, La Jolla, California
- Glycobiology Research and Training Center, University of California, San Diego, La Jolla, California
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Pascal Gagneux
- Center for Academic Research and Training in Anthropogeny, University of California, San Diego, La Jolla, California
- Glycobiology Research and Training Center, University of California, San Diego, La Jolla, California
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Ajit Varki
- Center for Academic Research and Training in Anthropogeny, University of California, San Diego, La Jolla, California
- Department of Cellular and Molecular Medicine, University of California, San Diego, La Jolla, California
- Glycobiology Research and Training Center, University of California, San Diego, La Jolla, California
| |
Collapse
|
2
|
Morphable models of the lumbar spine to vary geometry based on pathology, demographics, and anatomical measurements. J Biomech 2023; 146:111421. [PMID: 36603365 DOI: 10.1016/j.jbiomech.2022.111421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 12/25/2022]
Abstract
The shape of the lumbar spine influences its function and dysfunction. Yet examining the influence of geometric differences associated with pathology or demographics on lumbar biomechanics is challenging in vivo where these effects cannot be isolated, and the use of simple anatomical measurements does not fully capture the complex three-dimensional geometry. The goal of this work was to develop and share morphable models of the lumbar spine that allow geometry to be varied according to pathology, demographics, or anatomical measurements. Partial least squares regression was used to generate statistical shape models that quantify geometric differences associated with pathology, demographics, and anatomical measurements from the lumbar spines of 87 patients. To determine if the morphable models detected meaningful geometric differences, the ability of the morphable models to classify spines was compared with models generated from random labels. The models for disc herniation (p < 0.04), spondylolisthesis (p < 0.001), and sex (p < 0.01) all performed significantly better than the random models. Age was predicted with a root mean square error of 14.1 years using the age-based model. The morphable models for anatomical measurements were able to produce instances with root mean square errors less than 0.8°, 0.3 cm2, and 0.7 mm between desired and resulting measurements. This method can be used to produce morphable models that enable further analysis of the relationship among shape, pathology, demographics, and function through computational simulations. The morphable models and code are available at https://github.com/aclouthier/morphable-lumbar-model.
Collapse
|
3
|
Azzouzi H, Ichchou L. Schmorl's nodes: demystification road of endplate defects-a critical review. Spine Deform 2022; 10:489-499. [PMID: 34825353 DOI: 10.1007/s43390-021-00445-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schmorl's nodes (SN) were the first vertebral endplate defects described. Debate continues about their epidemiology, physiopathology, and clinical significance. The purpose of this work was to summarize and discuss available literature about SN. METHODS We have searched for relevant papers about SN until April 2020, with 104 articles have been reviewed. RESULTS More than half of the available literature described the epidemiological aspects of SN or reported rare clinical presentations and treatment options. The lack of a consensual definition of SN, among other endplate defects, contributed to difficulties in literature results' interpretation. Summing up, SN is a frequent vertebral defect at the thoracolumbar juncture, with ethnic and gender influence. Lumbar Schmorl's nodes were frequently associated with disc degenerative disease and back pain. Their physiopathology remains unknown. However, strain energy changes in the spine along with morphological aspects of the vertebra, the genetic background, and the osteoimmunology may constitute possible clues. New SN could be confused in malignancy context with bone metastasis. The literature describes some imaging techniques to differentiate them, avoiding invasive approaches. Treatment options for rare painful presentations remain few with low evidence. Further studies are needed to establish a consensual definition for SN, understand clinical aspects, and provide adequate therapeutic strategies.
Collapse
Affiliation(s)
- Hamida Azzouzi
- Department of Rheumatology, Faculty of Medicine, Mohammed VI University Hospital of Oujda, Université Mohammed Premier, Oujda, Morocco.
| | - Linda Ichchou
- Department of Rheumatology, Faculty of Medicine, Mohammed VI University Hospital of Oujda, Université Mohammed Premier, Oujda, Morocco
| |
Collapse
|
4
|
Loïc T, Nastassia N, Mkhitaryan K, Emmanuelle J, Kathryn Z, Guillemette GK, Marc-Antoine C, Claude G. DI-5-Cuffs: Lumbar Intervertebral Disc Proteoglycan and Water Content Changes in Humans after Five Days of Dry Immersion to Simulate Microgravity. Int J Mol Sci 2020; 21:ijms21113748. [PMID: 32466473 PMCID: PMC7312650 DOI: 10.3390/ijms21113748] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/13/2020] [Accepted: 05/22/2020] [Indexed: 12/17/2022] Open
Abstract
Most astronauts experience back pain after spaceflight, primarily located in the lumbar region. Intervertebral disc herniations have been observed after real and simulated microgravity. Spinal deconditioning after exposure to microgravity has been described, but the underlying mechanisms are not well understood. The dry immersion (DI) model of microgravity was used with eighteen male volunteers. Half of the participants wore thigh cuffs as a potential countermeasure. The spinal changes and intervertebral disc (IVD) content changes were investigated using magnetic resonance imaging (MRI) analyses with T1-T2 mapping sequences. IVD water content was estimated by the apparent diffusion coefficient (ADC), with proteoglycan content measured using MRI T1-mapping sequences centered in the nucleus pulposus. The use of thigh cuffs had no effect on any of the spinal variables measured. There was significant spinal lengthening for all of the subjects. The ADC and IVD proteoglycan content both increased significantly with DI (7.34 ± 2.23% and 10.09 ± 1.39%, respectively; mean ± standard deviation), p < 0.05). The ADC changes suggest dynamic and rapid water diffusion inside IVDs, linked to gravitational unloading. Further investigation is needed to determine whether similar changes occur in the cervical IVDs. A better understanding of the mechanisms involved in spinal deconditioning with spaceflight would assist in the development of alternative countermeasures to prevent IVD herniation.
Collapse
Affiliation(s)
- Treffel Loïc
- Institut NeuroMyogène, Faculté de Médecine Lyon Est, 69008 Lyon, France;
- Correspondence:
| | - Navasiolava Nastassia
- Centre de Recherche Clinique, Centre Hospitalier Universitaire d’Angers, 49100 Angers, France; (N.N.); (C.M.-A.)
| | - Karen Mkhitaryan
- Siemens Healthinners, Service Application, 93210 Saint-Denis, France;
| | | | - Zuj Kathryn
- Department of Kinesiology, University of Waterloo, Waterloo, ON N2L3G1, Canada;
| | | | - Custaud Marc-Antoine
- Centre de Recherche Clinique, Centre Hospitalier Universitaire d’Angers, 49100 Angers, France; (N.N.); (C.M.-A.)
- MitoVasc UMR INSERM 1083-CNRS 6015, Université d’Angers, 49100 Angers, France
| | - Gharib Claude
- Institut NeuroMyogène, Faculté de Médecine Lyon Est, 69008 Lyon, France;
| |
Collapse
|
5
|
Plomp KA, Dobney K, Collard M. Spondylolysis and spinal adaptations for bipedalism: The overshoot hypothesis. EVOLUTION MEDICINE AND PUBLIC HEALTH 2020; 2020:35-44. [PMID: 32153781 PMCID: PMC7053264 DOI: 10.1093/emph/eoaa003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/08/2020] [Indexed: 12/19/2022]
Abstract
Background and objectives The study reported here focused on the aetiology of spondylolysis, a vertebral pathology usually caused by a fatigue fracture. The goal was to test the Overshoot Hypothesis, which proposes that people develop spondylolysis because their vertebral shape is at the highly derived end of the range of variation within Homo sapiens. Methodology We recorded 3D data on the final lumbar vertebrae of H. sapiens and three great ape species, and performed three analyses. First, we compared H. sapiens vertebrae with and without spondylolysis. Second, we compared H. sapiens vertebrae with and without spondylolysis to great ape vertebrae. Lastly, we compared H. sapiens vertebrae with and without spondylolysis to great ape vertebrae and to vertebrae of H. sapiens with Schmorl’s nodes, which previous studies have shown tend to be located at the ancestral end of the range of H. sapiens shape variation. Results We found that H. sapiens vertebrae with spondylolysis are significantly different in shape from healthy H. sapiens vertebrae. We also found that H. sapiens vertebrae with spondylolysis are more distant from great ape vertebrae than are healthy H. sapiens vertebrae. Lastly, we found that H. sapiens vertebrae with spondylolysis are at the opposite end of the range of shape variation than vertebrae with Schmorl’s nodes. Conclusions Our findings indicate that H. sapiens vertebrae with spondylolysis tend to exhibit highly derived traits and therefore support the Overshoot Hypothesis. Spondylolysis, it appears, is linked to our lineage’s evolutionary history, especially its shift from quadrupedalism to bipedalism. Lay summary: Spondylolysis is a relatively common vertebral pathology usually caused by a fatigue fracture. There is reason to think that it might be connected with our lineage’s evolutionary shift from walking on all fours to walking on two legs. We tested this idea by comparing human vertebrae with and without spondylolysis to the vertebrae of great apes. Our results support the hypothesis. They suggest that people who experience spondylolysis have vertebrae with what are effectively exaggerated adaptations for bipedalism.
Collapse
Affiliation(s)
- Kimberly A Plomp
- Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.,Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool L69 7WZ, UK
| | - Keith Dobney
- Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.,Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool L69 7WZ, UK.,Department of Archaeology, University of Aberdeen, St Mary's, Elphinstone Road, Aberdeen AB24 3UF, UK
| | - Mark Collard
- Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
| |
Collapse
|
6
|
Korpinen N, Oura P, Väre T, Niskanen M, Niinimäki J, Karppinen J, Junno JA. Temporal Trends in Vertebral Dimensions - a case study from Finland. Sci Rep 2020; 10:1635. [PMID: 32005864 PMCID: PMC6994481 DOI: 10.1038/s41598-020-58340-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022] Open
Abstract
Vertebral fractures and other back problems represent a major, increasing worldwide health problem. This has increased the need to better understand the reasons behind this phenomenon. In addition to a reduction in bone mineral density and overall size of the vertebral body, research has indicated a possible association between the shape of the endplate and spinal disorders. As one previous study has shown changes in vertebral body dimensions between contemporary people and their medieval counterparts, we wanted to examine the potential temporal trends in vertebral size and dimensions in Finnish samples of archaeological and contemporary individuals. To conduct this study, we utilized three archaeological populations from the 16th–19th century and clinical materials from two population-based Finnish birth cohorts. As the average height of people has increased greatly since the first time period, we also height-adjusted the dimensions to provide a clearer picture of the dimensional changes that have occurred in the later temporal group. Our results were in agreement with those of the earlier study. The archaeological samples had a larger vertebral size than the contemporary population when height was adjusted for. Vertebral mediolateral width in particular had decreased, and the shape of the vertebral body had changed.
Collapse
Affiliation(s)
- Niina Korpinen
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland.
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Tiina Väre
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland
| | - Markku Niskanen
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Juho-Antti Junno
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Faculty of Medicine, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| |
Collapse
|
7
|
Plomp KA, Dobney K, Weston DA, Strand Viðarsdóttir U, Collard M. 3D shape analyses of extant primate and fossil hominin vertebrae support the ancestral shape hypothesis for intervertebral disc herniation. BMC Evol Biol 2019; 19:226. [PMID: 31842740 PMCID: PMC6916256 DOI: 10.1186/s12862-019-1550-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/29/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Recently we proposed an evolutionary explanation for a spinal pathology that afflicts many people, intervertebral disc herniation (Plomp et al. [2015] BMC Evolutionary Biology 15, 68). Using 2D data, we found that the bodies and pedicles of lower vertebrae of pathological humans were more similar in shape to those of chimpanzees than were those of healthy humans. Based on this, we hypothesized that some individuals are more prone to intervertebral disc herniation because their vertebrae exhibit ancestral traits and therefore are less well adapted for the stresses associated with bipedalism. Here, we report a study in which we tested this "Ancestral Shape Hypothesis" with 3D data from the last two thoracic and first lumbar vertebrae of pathological Homo sapiens, healthy H. sapiens, Pan troglodytes, and several extinct hominins. RESULTS We found that the pathological and healthy H. sapiens vertebrae differed significantly in shape, and that the pathological H. sapiens vertebrae were closer in shape to the P. troglodytes vertebrae than were the healthy H. sapiens vertebrae. Additionally, we found that the pathological human vertebrae were generally more similar in shape to the vertebrae of the extinct hominins than were the healthy H. sapiens vertebrae. These results are consistent with the predictions of the Ancestral Shape Hypothesis. Several vertebral traits were associated with disc herniation, including a vertebral body that is both more circular and more ventrally wedged, relatively short pedicles and laminae, relatively long, more cranio-laterally projecting transverse processes, and relatively long, cranially-oriented spinous processes. We found that there are biomechanical and comparative anatomical reasons for suspecting that all of these traits are capable of predisposing individuals to intervertebral disc herniation. CONCLUSIONS The results of the present study add weight to the hypothesis that intervertebral disc herniation in H. sapiens is connected with vertebral shape. Specifically, they suggest that individuals whose vertebrae are towards the ancestral end of the range of shape variation within H. sapiens have a greater propensity to develop the condition than other individuals. More generally, the study shows that evolutionary thinking has the potential to shed new light on human skeletal pathologies.
Collapse
Affiliation(s)
- Kimberly A Plomp
- Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK.,Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada
| | - Keith Dobney
- Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK.,Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.,Department of Archaeology, School of Geosciences, University of Aberdeen, St Mary's, Elphinstone Road, Scotland, UK, AB24 3UF, Aberdeen
| | - Darlene A Weston
- Department of Anthropology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada
| | - Una Strand Viðarsdóttir
- Biomedical Center, University of Iceland, Læknagarður, Vatnsmýrarvegi 16, 101, Reykjavík, Iceland
| | - Mark Collard
- Department of Archaeology, Simon Fraser University, 8888 University Dr, Burnaby, BC, V5A 1S6, Canada.
| |
Collapse
|
8
|
Plomp K, Viðarsdóttir US, Dobney K, Weston D, Collard M. Potential adaptations for bipedalism in the thoracic and lumbar vertebrae of Homo sapiens: A 3D comparative analysis. J Hum Evol 2019; 137:102693. [PMID: 31711026 DOI: 10.1016/j.jhevol.2019.102693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/12/2019] [Accepted: 10/12/2019] [Indexed: 10/25/2022]
Abstract
A number of putative adaptations for bipedalism have been identified in the hominin spine. However, it is possible that some have been overlooked because only a few studies have used 3D and these studies have focused on cervical vertebrae. With this in mind, we used geometric morphometric techniques to compare the 3D shapes of three thoracic and two lumbar vertebrae of Homo sapiens, Pan troglodytes, Gorilla gorilla, and Pongo pygmaeus. The study had two goals. One was to confirm the existence of traits previously reported to distinguish the thoracic and lumbar vertebrae of H. sapiens from those of the great apes. The other was to, if possible, identify hitherto undescribed traits that differentiate H. sapiens thoracic and lumbar vertebrae from those of the great apes. Both goals were accomplished. Our analyses not only substantiated a number of traits that have previously been discussed in the literature but also identified four traits that have not been described before: (1) dorsoventrally shorter pedicles in the upper thoracic vertebrae; (2) dorsoventrally longer laminae in all five of the vertebrae examined; (3) longer transverse processes in the upper thoracic vertebrae; and (4) craniocaudally 'pinched' spinous process tips in all of the vertebrae examined. A review of the biomechanical literature suggests that most of the traits highlighted in our analyses can be plausibly linked to bipedalism, including three of the four new ones. As such, the present study not only sheds further light on the differences between the spines of H. sapiens and great apes but also enhances our understanding of how the shift to bipedalism affected the hominin vertebral column.
Collapse
Affiliation(s)
- Kimberly Plomp
- Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada; Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK.
| | - Una Strand Viðarsdóttir
- Biomedical Center, University of Iceland, Læknagarður, Vatnsmýrarvegi 16, 101 Reykjavík, Iceland
| | - Keith Dobney
- Department of Archaeology, Classics and Egyptology, University of Liverpool, 14 Abercromby Square, Liverpool, L69 7WZ, UK
| | - Darlene Weston
- Department of Anthropology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC V6T 1Z1, Canada
| | - Mark Collard
- Department of Archaeology, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada.
| |
Collapse
|
9
|
Block JE, Lavelle WF, Nunley PD. Toward a cure for lumbar spinal stenosis: The potential of interspinous process decompression. Med Hypotheses 2019; 132:109357. [PMID: 31421414 DOI: 10.1016/j.mehy.2019.109357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 11/24/2022]
Abstract
There is a growing impetus to treat aging as a disease in the quest to significantly extend the human life span through cellular regeneration methods. This approach, while promising, overlooks the fact that the evolutionary adaptation to bipedalism puts the human body in a distinctively vulnerable biomechanical and functional position. Orthograde human posture places unusually-high axial compressive loads on the weight-bearing joints of the skeleton, resulting in arthritic deterioration with aging. The effects are particularly robust in the lumbar spine were age-related degeneration, most commonly lumbar spinal stenosis (LSS), is ubiquitous among the elderly. It is postulated that re-establishing a favorable mechanical environment via interventions that unload the affected spinal joint complex may mitigate and potentially reverse the structural damage that is the cardinal pathoanatomical feature of this disease. The hypothesis of this paper is that a minimally-invasive surgical procedure, interspinous process decompression (IPD), which utilizes a stand-alone intervertebral spacer, effectively unloads the diseased spinal motion segment providing a healthy micro-environment to reverse and repair age-related and genetic deterioration of the spinal motion segment. Several lines of supporting evidence are provided from long-term follow-up results of a randomized controlled trial of IPD safety and effectiveness of the Superion® device including clinical outcomes, reoperation rates, opioid analgesic usage and advanced imaging utilization. All of these outcomes show uniquely-favorable trends with time that imply that the benefits of IPD are structural. The compendium of evidence suggests that IPD offers both a durable palliative effect due to direct blocking of back extension and a disease-modifying effect due to unloading of the spinal joint complex.
Collapse
Affiliation(s)
- Jon E Block
- 2210 Jackson Street, Ste. 401, San Francisco, CA 94115, United States.
| | - William F Lavelle
- Upstate Bone and Joint Center, East Syracuse, NY 13057, United States.
| | - Pierce D Nunley
- Spine Institute of Louisiana, Shreveport, LA 71101, United States.
| |
Collapse
|
10
|
Shapiro LJ, Kemp AD. Functional and developmental influences on intraspecific variation in catarrhine vertebrae. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 168:131-144. [DOI: 10.1002/ajpa.23730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/13/2018] [Accepted: 09/26/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Liza J. Shapiro
- Department of Anthropology University of Texas at Austin Austin Texas
| | - Addison D. Kemp
- Department of Anthropology University of Texas at Austin Austin Texas
| |
Collapse
|
11
|
Pettine KA, Suzuki RK, Sand TT, Murphy MB. Autologous bone marrow concentrate intradiscal injection for the treatment of degenerative disc disease with three-year follow-up. INTERNATIONAL ORTHOPAEDICS 2017; 41:2097-2103. [PMID: 28748380 DOI: 10.1007/s00264-017-3560-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/26/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study is to assess safety and feasibility of intradiscal bone marrow concentrate (BMC) injections to treat low back discogenic pain as an alternative to surgery with three year minimum follow-up. METHODS A total of 26 patients suffering from degenerative disc disease and candidates for spinal fusion or total disc replacement surgery were injected with 2 ml autologous BMC into the nucleus pulposus of treated lumbar discs. A sample aliquot of BMC was characterized by flow cytometry and CFU-F assay to determine progenitor cell content. Improvement in pain and disability scores and 12 month post-injection MRI were compared to patient demographics and BMC cellularity. RESULTS After 36 months, only six patients progressed to surgery. The remaining 20 patients reported average ODI and VAS improvements from 56.7 ± 3.6 and 82.1 ± 2.6 at baseline to 17.5 ± 3.2 and 21.9 ± 4.4 after 36 months, respectively. One year MRI indicated 40% of patients improved one modified Pfirrmann grade and no patient worsened radiographically. Cellular analysis showed an average of 121 million total nucleated cells per ml, average CFU-F of 2713 per ml, and average CD34+ of 1.82 million per ml in the BMC. Patients with greater concentrations of CFU-F (>2000 per ml) and CD34+ cells (>2 million per ml) in BMC tended to have significantly better clinical improvement. CONCLUSIONS There were no adverse events related to marrow aspiration or injection, and this study provides evidence of safety and feasibility of intradiscal BMC therapy. Patient improvement and satisfaction with this surgical alternative supports further study of the therapy.
Collapse
Affiliation(s)
- Kenneth A Pettine
- Elite Regenerative Stem Cell Specialists, 4795 Larimer Pkwy, Johnstown, CO, 80534, USA
| | - Richard K Suzuki
- Celling Biosciences, 93 Red River Street, Austin, TX, 78701, USA
| | - Theodore T Sand
- Celling Biosciences, 93 Red River Street, Austin, TX, 78701, USA
| | - Matthew B Murphy
- Celling Biosciences, 93 Red River Street, Austin, TX, 78701, USA. .,Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, 78705, USA.
| |
Collapse
|
12
|
Zhang H, Merrett DC, Jing Z, Tang J, He Y, Yue H, Yue Z, Yang DY. Osteoarthritis, labour division, and occupational specialization of the Late Shang China - insights from Yinxu (ca. 1250 - 1046 B.C.). PLoS One 2017; 12:e0176329. [PMID: 28464007 PMCID: PMC5413014 DOI: 10.1371/journal.pone.0176329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 04/10/2017] [Indexed: 11/27/2022] Open
Abstract
This research investigates the prevalence of human osteoarthritis at Yinxu, the last capital of the Late Shang dynasty (ca. 1250–1046 B.C.), to gain insights about lifeways of early urban populations in ancient China. A total of 167 skeletal remains from two sites (Xiaomintun and Xin’anzhuang) were analyzed to examine osteoarthritis at eight appendicular joints and through three spinal osseous indicators. High osteoarthritis frequencies were found in the remains with males showing significantly higher osteoarthritis on the upper body (compared to that of the females). This distinctive pattern becomes more obvious for males from Xiaomintun. Furthermore, Xiaomintun people showed significantly higher osteoarthritis in both sexes than those from Xin’anzhuang. Higher upper body osteoarthritis is speculated to be caused by repetitive lifting and carrying heavy-weight objects, disproportionately adding more stress and thus more osseous changes to the upper than the lower body. Such lifting-carrying could be derived from intensified physical activities in general and specialized occupations in particular. Higher osteoarthritis in males may reveal a gendered division of labour, with higher osteoarthritis in Xiaomintun strongly indicating an occupational difference between the two sites. The latter speculation can be supported by the recovery of substantially more bronze-casting artifacts in Xiaomintun. It is also intriguing that relatively higher osteoarthritis was noticed in Xiaomintun females, which seems to suggest that those women might have also participated in bronze-casting activities as a “family business.” Such a family-involved occupation, if it existed, may have contributed to establishment of occupation-oriented neighborhoods as proposed by many Shang archaeologists.
Collapse
Affiliation(s)
- Hua Zhang
- Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
- SFU-JLU Joint Centre for Bioarchaeological Research, Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
- * E-mail: (HZ); (DY); (ZJ)
| | - Deborah C. Merrett
- Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
- SFU-JLU Joint Centre for Bioarchaeological Research, Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Zhichun Jing
- Department of Anthropology, The University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail: (HZ); (DY); (ZJ)
| | - Jigen Tang
- Institute of Archaeology, Chinese Academy of Social Sciences, Beijing, China
| | - Yuling He
- Institute of Archaeology, Chinese Academy of Social Sciences, Beijing, China
| | - Hongbin Yue
- Institute of Archaeology, Chinese Academy of Social Sciences, Beijing, China
| | - Zhanwei Yue
- Institute of Archaeology, Chinese Academy of Social Sciences, Beijing, China
| | - Dongya Y. Yang
- Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
- SFU-JLU Joint Centre for Bioarchaeological Research, Department of Archaeology, Simon Fraser University, Burnaby, British Columbia, Canada
- * E-mail: (HZ); (DY); (ZJ)
| |
Collapse
|
13
|
Kishimoto M, Akeda K, Sudo A, Espinoza Orías AA, Inoue N. In vivo measurement of vertebral endplate surface area along the whole-spine. J Orthop Res 2016; 34:1418-30. [PMID: 27346338 PMCID: PMC6521950 DOI: 10.1002/jor.23354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/22/2016] [Indexed: 02/04/2023]
Abstract
Accurate determination of vertebral endplate surface area and diameters plays an important role in surgical procedures, spinal implant design and sizing. The objective of this study was to contribute with baseline information on the endplate geometrical parameters using subject-based 3D whole-spine computed tomography (CT) models based on myelogram CT images taken of 49 patients with spinal disorders. Superior and inferior bony endplate mesh-models were created from said 3D CT models and endplate geometrical parameters including total polygon-mesh areas, projected areas and antero posterior and transverse diameters of each endplate were measured. The position of each endplate was determined by the cumulative distance along the spinal column with respect to C2. Endplate area and diameters were analyzed by gender, spinal level, age and correlation with spinal position. Males had larger endplates than females at all levels (p < 0.05) but S1. While endplate areas and transverse diameters increased with age at C3-L5 in females, these increases were not consistent through the whole-spine and even decreases with age were found at T1-T3 in males. There was a strong linear correlation between endplate area and spinal position in males and females with correlation coefficient values of r = 0.938 and r = 0.911, respectively. However, multiple comparisons of the geometrical parameters through the whole-spine revealed localized reduction of the anteroposterior or transverse diameters at T4 and L5-S1 levels. These regional and age-related changes in endplate dimensions should be taken into account for safe interventional treatments at these sites. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1418-1430, 2016.
Collapse
Affiliation(s)
- Maho Kishimoto
- Faculty of Medical and Life Sciences, Doshisha University, Kyoto, Japan
| | - Koji Akeda
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan
| | - Akihiro Sudo
- Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan
| | | | - Nozomu Inoue
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|