Age-Related Incidence of Cervical Spondylosis in Residents of Jeju Island

Radiological Assessment of Morphological Changes of Lumbar Spine: From First to 9th Decade of Life

STUDY DESIGN

Analysis of lumbar spine radiograms of 1,496 Jeju islanders of Korea.

PURPOSE

To look into the age- and gender-matched incidences of morphological changes and their severities.

OVERVIEW OF LITERATURE

There have been several prior research on the prevalence and severity of age-related diseases, both related and unrelated. Those offer some fundamental clinical data for clinicians.

METHODS

Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers.

RESULTS

The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs.

CONCLUSIONS

It has been shown that the morphology of the lumbar spine changes throughout time.

Genetic Variations in IL-1β, TNF-α, and TGF-β Associated with the Severity of Chronic Cervical Spondylitis in Patients

Chronic cervical spondylitis (CCS), a degenerative disorder of the spine, is known for causing disability among old and young people. Single-nucleotide polymorphisms (SNPs) in various cytokine genes have demonstrated an impactful association with several inflammatory disorders. In the present study, we have investigated the SNPs and allelic distribution of the three most prevalent cytokines genes, IL-1β (-511C/T), TNF-α (-308G/A), and TGF-β (-509C/T), along with serum levels of these cytokines in 252 subjects. SNPs were analyzed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and digested fragments were separated and visualized using agarose gel electrophoresis and Native Polyacrylamide gel electrophoresis (PAGE). The serum cytokine levels were analyzed with a flow cytometer using a customized multiplex bead-based assay. It was observed that these SNPs did not reflect the susceptibility to CCS but were associated with susceptibility to CCS. We found a significant association between the C/C and G/G genotypes and the C and G alleles of IL-1β and TNF-α, respectively, suggesting a lower risk of CCS. The frequency distribution of risk alleles (-511T) and (-308A) were simultaneously higher in CCS compared to the control, reflecting the susceptibility to CCS. TGF-β showed a significant association with disease susceptibility, along with a significant correlation between age and the chronicity of CCS. The serum cytokine levels were significantly different in CCS and controls.

Return to golf after adult degenerative and deformity spine surgery: a preliminary case series of how surgery impacts golf play and performance

Background

Golf is a commonly played sport among older adults, and degenerative and/or deformity spine pathology can severely impact older individuals' ability to play golf. In a cohort of self-identified, avid golfers undergoing degenerative or deformity spine surgery, we report their: (I) presentation, (II) operative treatment, and (III) return-to-play (RTP) process.

Methods

A retrospective case series of self-identified, avid golfers undergoing spine surgery at a single institution from 2015-2019 was undertaken. Demographic, presenting, operative, RTP data, along with numerical rating scale (NRS) pain scores were collected. The first and full RTP time postoperatively, in addition to the following golf metrics: 18-hole rounds per month, handicap, and self-perceived effort/performance were obtained.

Results

A total of 6 golfers were included, 3 undergoing each degenerative and deformity operations. Mean age was 60 years, and 5 of 6 (83%) patients were female. All patients were self-identified, avid golfers with a mean experience of 31 years. Mean preoperative NRS back/neck pain was 9.7, which decreased to 0.8 postoperatively (P<0.001). Players undergoing smaller operations (lumbar fusion/cervical laminoplasty) returned to golf sooner than patients undergoing larger deformity corrections, with a mean first RTP of 4.3 months for degenerative patients vs. 9.7 months among deformity patients. All patients played either the same or more rounds of golf after surgery once they reached full RTP. The handicap of all players improved after surgery to better than before surgery, except for one high-level golfer with a handicap of 9 preoperatively that went to 15 postoperatively following an extensive revision deformity reconstruction.

Conclusions

All patients returned to playing golf at or more frequently than their preoperative status. Degenerative patients returned to play sooner than deformity patients. All patients performed at a higher level after surgery, except for one high-level golfer whose handicap worsened slightly. These data provide baseline information for future prospective studies of golfers undergoing spine surgery.