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Mizukoshi R, Yagi M, Yamada Y, Yokoyama Y, Yamada M, Watanabe K, Nakamura M, Nagura T, Jinzaki M. Gender differences in spinal mobility during postural changes: a detailed analysis using upright CT. Sci Rep 2024; 14:9154. [PMID: 38644423 PMCID: PMC11033253 DOI: 10.1038/s41598-024-59840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/16/2024] [Indexed: 04/23/2024] Open
Abstract
Lumbar spinal alignment is crucial for spine biomechanics and is linked to various spinal pathologies. However, limited research has explored gender-specific differences using CT scans. The objective was to evaluate and compare lumbar spinal alignment between standing and sitting CT in healthy individuals, focusing on gender differences. 24 young and 25 elderly males (M) and females (F) underwent standing and sitting CT scans to assess lumbar spinal alignment. Parameters measured and compared between genders included lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), pelvic incidence (PI), lordotic angle (LA), foraminal height (FH), and bony boundary area (BBA). Females showed significantly larger changes in SS and PT when transitioning from standing to sitting (p = .044, p = .038). A notable gender difference was also observed in the L4-S LA among the elderly, with females showing a significantly larger decrease in lordotic angle compared to males (- 14.1° vs. - 9.2°, p = .039*). Females consistently exhibited larger FH and BBA values, particularly in lower lumbar segments, which was more prominent in the elderly group (M vs. F: L4/5 BBA 80.1 mm2 [46.3, 97.8] vs. 109.7 mm2 [74.4, 121.3], p = .019 in sitting). These findings underline distinct gender-related variations in lumbar alignment and flexibility, with a focus on noteworthy changes in BBA and FH in females. Gender differences in lumbar spinal alignment were evident, with females displaying greater pelvic and sacral mobility. Considering gender-specific characteristics is crucial for assessing spinal alignment and understanding spinal pathologies. These findings contribute to our understanding of lumbar spinal alignment and have implications for gender-specific spinal conditions and treatments.
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Affiliation(s)
- Ryo Mizukoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Mitsuru Yagi
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan.
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.
| | - Yoshitake Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Yoichi Yokoyama
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Minoru Yamada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi Shinjyuku, Tokyo, Japan.
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Şimşek AT, Baysal B, Adam BE, Çalış F, Topçam A, Demirkol M, Doğan MB, Binguler AHE, Karaarslan N, Balak N. Morphological changes after open lumbar microdiscectomy at 2-year follow-up. J Back Musculoskelet Rehabil 2024; 37:75-87. [PMID: 37599519 DOI: 10.3233/bmr-220371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
BACKGROUND It is known that a possible decrease in disc height (DH) and foraminal size after open lumbar microdiscectomy (OLM) may cause pain in the long term. However, there is still insufficient information about the short- or long-term pathoanatomical and morphological effects of microdiscectomy. For example, the exact temporal course of the change in DH is not well known. OBJECTIVE The purpose of this study was to examine morphological changes in DH and foramen dimensions after OLM. METHODS In patients who underwent OLM for single-level lumbar disc herniation, MRI scans were obtained before surgery, and at an average of two years after surgery. In addition to DH measurements, foraminal area (FA), foraminal height (FH), superior foraminal width (SFW), and inferior foraminal width (IFW), were measured bilaterally. RESULTS A postoperative increase in DH was observed at all vertebral levels, with an average of 5.5%. The mean right FHs were 15.3 mm and 15.7 mm before and after surgery, respectively (p= 0.062), while the left FHs were 14.8 mm and 15.8 mm before and after surgery (p= 0.271). The mean right SFW was 5.4 mm before surgery and 5.7 mm after surgery, while the mean right IFW ranged from 3.6 mm to 3.9 mm. The mean left SFW was 4.8 mm before surgery and 5.2 mm after surgery, while the mean left IFW ranged from 3.5 mm to 3.9 mm. Before surgery, the FAs were, on average, 77.1 mm2 and 75.6 mm2 on the right and left sides, respectively. At the 2-year follow-up, the mean FAs were 84.0 mm2 and 80.2 mm2 on the right and left sides, respectively. CONCLUSIONS Contrary to prevalent belief, in patients who underwent single-level unilateral OLM, we observed that there may be an increase rather than a decrease in DH or foramen size at the 2-year follow-up. Our findings need to be confirmed by studies with larger sample sizes and longer follow-ups.
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Affiliation(s)
- Abdullah Talha Şimşek
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Begümhan Baysal
- Department of Radiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Baha Eldin Adam
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Fatih Çalış
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Arda Topçam
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mahmut Demirkol
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mahmut Bilal Doğan
- Department of Radiology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ayse Hande Erol Binguler
- Department of Industrial Engineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Numan Karaarslan
- Department of Neurosurgery, Istanbul Haliç University, Istanbul, Turkey
| | - Naci Balak
- Department of Neurosurgery, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Cho SS, Farber SH, DiDomenico JD, Teng CW, Park MT, Chang SW, Snyder LA, Mirzadeh Z, Uribe JS, Turner JD. Radiographic and Clinical Outcomes After Stand-Alone Anterior Lumbar Interbody Fusion for Symptomatic L5-S1 Retrolisthesis. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00979. [PMID: 38038471 DOI: 10.1227/ons.0000000000001001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/06/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Degenerative lumbar spondylolisthesis is associated with significant pain and disability. The literature on the treatment options and clinical outcomes for lumbar anterolisthesis is robust, but very few reports specifically evaluate lumbar retrolisthesis. This study investigated surgical outcomes for symptomatic L5-S1 retrolisthesis treated with stand-alone L5-S1 anterior lumbar interbody fusion (ALIF). METHODS All patients with symptomatic L5-S1 retrolisthesis treated with stand-alone L5-S1 ALIF at a single institution over a 7-year period were identified. Exhaustive nonoperative management had failed for all patients. Patients with previous lumbar fusion were excluded. Preoperative and postoperative radiographic images and patient-reported outcome measures for 20 patients (14 males and 6 females; mean [SD] age, 50.3 [13.7] years) were analyzed. RESULTS The mean (SD) follow-up was 43.0 (23.7) months (range, 12.1-102.5 months). Patients experienced postoperative improvements in L5-S1 retrolisthesis (P = .048), L5-S1 disk height and angle (P < .001), L5 foraminal height (P < .001), L5-S1 lordosis (P < .001), and lumbar lordosis (P = .01). There were no significant changes in spinopelvic parameters. At the most recent follow-up, minimal clinically important differences in Oswestry Disability Index score, 36-Item Short-Form Survey (SF-36), and numerical rating scale score for leg pain were achieved in 11 of 20 (55%), 7 of 14 (50%), and 7 of 13 (54%) patients, respectively. All patients demonstrated fusion with no graft subsidence at up to 32 months. No patient experienced intraoperative complications, was readmitted, or required a subsequent posterior decompression or fusion because of refractory symptoms. CONCLUSION In our cohort, stand-alone L5-S1 ALIF was associated with radiographic and clinical improvement in patients with symptomatic L5-S1 retrolisthesis.
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Affiliation(s)
- Steve S Cho
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - S Harrison Farber
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Joseph D DiDomenico
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Clare W Teng
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marian T Park
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Steve W Chang
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Laura A Snyder
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Zaman Mirzadeh
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Juan S Uribe
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Jay D Turner
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Zhandarov K, Blinova E, Ogarev E, Sheptulin D, Terekhina E, Telpukhov V, Vasil’ev Y, Nelipa M, Kytko O, Chilikov V, Panyushkin P, Drakina O, Meilanova R, Mirontsev A, Shimanovsky D, Bogoyavlenskaya T, Dydykin S, Nikolenko V, Kashtanov A, Aliev V, Kireeva N, Enina Y. Intervertebral Canals and Intracanal Ligaments as New Terms in Terminologia anatomica. Diagnostics (Basel) 2023; 13:2809. [PMID: 37685348 PMCID: PMC10486485 DOI: 10.3390/diagnostics13172809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
This study addresses the cervical part of the vertebral column. Clinical pictures of dystrophic diseases of the cervical part of the vertebral column do not always correspond only to the morphological changes-they may be represented by connective tissue formation and nerve and vessel compression. To find out the possible reason, this morphometric study of the cervical part of the vertebral column in 40 cadavers was performed. CT scans were performed on 17 cadaveric material specimens. A total of 12 histological samples of connective tissue structures located in intervertebral canals (IC) were studied. One such formation, an intracanal ligament (IL) located in the IC, was found. Today, there is no term "intervertebral canal", nor is there a detailed description of the intervertebral canal in the cervical part of the vertebral column. Cervical intervertebral canals make up five pairs in segments C2-C7. On cadavers, the IC lateral and medial apertures were 0.9-1.5 cm and 0.5-0.9 cm, correspondingly. According to our histological study, the connective tissue structures in the IC are ligaments-IL. According to the presence of these ligaments, ICs were classified into three types. Complete regional anatomy characterization of the IC of the cervical part of the vertebral column with a description of its constituent anatomical elements was provided. The findings demonstrate the need to include the terms "intervertebral canal" and "intervertebral ligament" in the Terminologia anatomica.
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Affiliation(s)
- Kirill Zhandarov
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Ekaterina Blinova
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Egor Ogarev
- National Medical Research Center of Traumatology and Orthopedics N.N. Pirogova, Moscow 117198, Russia
| | - Dmitry Sheptulin
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Elizaveta Terekhina
- Department of Medical Elementology, Peoples’ Friendship University of Russia, Moscow 117198, Russia
| | - Vladimir Telpukhov
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Yuriy Vasil’ev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Mikhail Nelipa
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Olesya Kytko
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Valery Chilikov
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Peter Panyushkin
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Olga Drakina
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Renata Meilanova
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Artem Mirontsev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Denis Shimanovsky
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Tatyana Bogoyavlenskaya
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Sergey Dydykin
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Vladimir Nikolenko
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Artem Kashtanov
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Vladimir Aliev
- Department of Anesthesiology and Intensive Care, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia
| | - Natalia Kireeva
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
| | - Yulianna Enina
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia; (K.Z.)
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Liu M, Zhang L, Zang W, Zhang K, Li H, Gao Y. Pharmacological Effects of Resveratrol in Intervertebral Disc Degeneration: A Literature Review. Orthop Surg 2022; 14:3141-3149. [PMID: 36303427 PMCID: PMC9732612 DOI: 10.1111/os.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/26/2022] [Accepted: 09/15/2022] [Indexed: 12/14/2022] Open
Abstract
Intervertebral disc degeneration (IDD) is a high incidence disease of musculoskeletal system that often leads to stenosis, instability, pain and even deformity of the spinal segments. IDD is an important cause of discogenic lower back pain and often leads to large economic burden to families and society. Currently, the treatment of IDD is aimed at alleviating symptoms rather than blocking or reversing pathological progression of the damaged intervertebral disc. Resveratrol (RSV) is a polyphenol phytoalexin first extracted from the Veratrum grandiflflorum O. Loes and can be found in various plants and red wine. Owing to the in-depth study of pharmacological mechanisms, the therapeutic potential of RSV in various diseases such as osteoarthritis, neurodegenerative diseases, cardiovascular diseases and diabetes have attracted the attention of many researchers. RSV has anti-apoptotic, anti-senescent, anti-inflammatory, anti-oxidative, and anabolic activities, which can prevent further degeneration of intervertebral disc cells and enhance their regeneration. With high safety and various biological functions, RSV might be a promising candidate for the treatment of IDD. This review summarizes the biological functions of RSV in the treatment of IDD and to facilitate further research.
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Affiliation(s)
- Ming‐yang Liu
- Present address:
Henan Province Intelligent Orthopedic Technology Innovation and Transformation International Joint Laboratory, Henan Key Laboratory for Intelligent Precision Orthopedics, Department of Surgery of Spine and Spinal Cord, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University, People's Hospital of Henan UniversityZhengzhouChina
| | - Liang Zhang
- Present address:
Henan Province Intelligent Orthopedic Technology Innovation and Transformation International Joint Laboratory, Henan Key Laboratory for Intelligent Precision Orthopedics, Department of Surgery of Spine and Spinal Cord, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University, People's Hospital of Henan UniversityZhengzhouChina
| | - Wei‐dong Zang
- Department of Human Anatomy, School of Basic Medical SciencesZhengzhou UniversityZhengzhouChina
| | - Kai‐guang Zhang
- Present address:
Henan Province Intelligent Orthopedic Technology Innovation and Transformation International Joint Laboratory, Henan Key Laboratory for Intelligent Precision Orthopedics, Department of Surgery of Spine and Spinal Cord, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University, People's Hospital of Henan UniversityZhengzhouChina
| | - Hai‐jun Li
- Department of Immunity, Institute of Translational MedicineThe First Hospital of Jilin UniversityJilinChina
| | - Yan‐zheng Gao
- Present address:
Henan Province Intelligent Orthopedic Technology Innovation and Transformation International Joint Laboratory, Henan Key Laboratory for Intelligent Precision Orthopedics, Department of Surgery of Spine and Spinal Cord, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University, People's Hospital of Henan UniversityZhengzhouChina
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Liu MY, Li HJ, Yang C, Zang WD, Liu ZD, Zhang L, Li PH, Zhu YJ, Zhao YY, Liu RZ, Gao YZ. Insight into the pharmacological effects of andrographolide in musculoskeletal disorders. Biomed Pharmacother 2021; 146:112583. [PMID: 34954644 DOI: 10.1016/j.biopha.2021.112583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
Andrographis paniculata (A. paniculata) is a traditional herbal medicine that has been widely used in Asian countries for hundreds of years. Andrographolide (AG) is a diterpene lactone extracted from A. paniculata. Owing to the in-depth study of pharmacological mechanisms, the therapeutic potential of AG, including its anti-inflammatory, anti-tumor, and immunoregulatory attributes, has attracted the attention of many researchers. Studies testing the therapeutic effects of AG have demonstrated desirable results in the treatment of a variety of clinical diseases. With high safety and various biological functions, AG might be a promising candidate for the treatment of musculoskeletal disorders. Here, we review all available literatures to summarize the pharmacological effects of AG and facilitate further researches on musculoskeletal diseases.
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