JOR Spine最新文献

{"title":"The Cross-Sectional Areas and Anterior–Posterior Balance of the Cervical Paraspinal Muscles in Dropped Head Syndrome and Cervical Spondylotic Myelopathy: A Propensity Score-Matched Analysis","authors":"Takashi Sono,&nbsp;Kenta Ijiri,&nbsp;Kensaku Kakehi,&nbsp;Soichiro Masuda,&nbsp;Takayoshi Shimizu,&nbsp;Koichi Murata,&nbsp;Shuichi Matsuda,&nbsp;Bungo Otsuki","doi":"10.1002/jsp2.70047","DOIUrl":"10.1002/jsp2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Dropped head syndrome (DHS) is characterized by weakness of the neck extensor muscles. However, few studies have assessed the cross-sectional areas (CSAs) of the cervical paraspinal muscles (CPM) and their anterior–posterior balance in DHS. This study aimed to elucidate the pathognomonic findings of DHS by comparing the CSAs and anterior–posterior balance of the CPM in patients with DHS and cervical spondylotic myelopathy (CSM), using magnetic resonance imaging (MRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared the CSAs and anterior–posterior balance of the CPM in patients with DHS and CSM using MRI. Patients with CSM were selected in an age- and sex-matched manner, using the propensity score. The longus colli (LC) muscle was selected as the anterior muscle; and the semispinalis cervicis (SSC), splenius capitis (SC), and multifidus muscles (MM) were selected as the posterior muscles. We calculated LC/SSC, LC/SC, LC/MM, and LC/(SSC + SC + MM), as indicators of neck muscle balance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The DHS and the CSM cohort comprised 26 and 52 patients, respectively. Both cohorts had a mean age of 71-year-old. There were no significant differences in the CSAs and most of the indicators of neck balance between the two cohorts. However, the LC/SSC was significantly higher in the DHS cohort than that in the CSM cohort (40.3% and 29.1%, respectively; <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study highlights a unique anterior–posterior imbalance in the CPM of DHS patients, differing from CSM patients. Strengthening the SSC muscle could be a key to preventing DHS progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in ECM Topography, Fiber Alignment, Mechanical Stiffness, and Cellular Composition Between Ventral and Dorsal Ligamentum Flavum Layers: Insights Into Hypertrophy Pathogenesis","authors":"Ting-Yuan Tu,&nbsp;Yu-Chia Hsu,&nbsp;Chia-En Yang,&nbsp;Yan-Jye Shyong,&nbsp;Cheng-Hsiang Kuo,&nbsp;Yuan-Fu Liu,&nbsp;Shu-Shien Shih,&nbsp;Cheng-Li Lin","doi":"10.1002/jsp2.70033","DOIUrl":"10.1002/jsp2.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have suggested that changes in the composition of the extracellular matrix (ECM) play a significant role in the development of ligamentum flavum hypertrophy (LFH) and the histological differences between the ventral and dorsal layers of the hypertrophied ligamentum flavum. Although LFH is associated with increased fibrosis in the dorsal layer, comprehensive research exploring the characteristics of the ECM and its mechanical properties in both regions is limited. Furthermore, the distribution of fibrosis-associated myofibroblasts within LFH remains poorly understood. This study aimed to bridge the existing knowledge gap concerning the intricate relationships between ECM characteristics, mechanical properties, and myofibroblast expression in LFH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Histological staining, scanning electron microscopy, and atomic force microscopy were used to analyze the components, alignment, and mechanical properties of the ECM. Immunostaining and western blot analyses were performed to assess the distribution of myofibroblasts in LF tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were notable differences between the dorsal and ventral layers of the hypertrophic ligamentum flavum. Specifically, the dorsal layer exhibited higher collagen content and disorganized fibrous alignment, resulting in reduced stiffness. Immunohistochemistry analysis revealed a significantly greater presence of α-smooth muscle actin (αSMA)-stained cells, a marker for myofibroblasts, in the dorsal layer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study offers comprehensive insights into LFH by elucidating the distinctive ECM characteristics, mechanical properties, and cellular composition disparities between the ventral and dorsal layers. These findings significantly enhance our understanding of the pathogenesis of LFH and may inform future research and therapeutic strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explorative Study of Modulatory Effects of Notochordal Cell-Derived Extracellular Vesicles on the IL-1β-Induced Catabolic Cascade in Nucleus Pulposus Cell Pellets and Explants","authors":"J. C. van Maanen,&nbsp;F. C. Bach,&nbsp;J. W. Snuggs,&nbsp;K. Ito,&nbsp;M. H. M. Wauben,&nbsp;C. L. Le Maitre,&nbsp;M. A. Tryfonidou","doi":"10.1002/jsp2.70043","DOIUrl":"10.1002/jsp2.70043","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cell-free regenerative strategies, such as notochordal cell (NC)-derived extracellular vesicles (EVs), are an attractive alternative in developing new therapies for intervertebral disc (IVD) degeneration. NC-EVs have been reported to elicit matrix anabolic effects on nucleus pulposus cells from degenerated IVDs cultured under basal conditions. However, the degenerative process is exacerbated by pro-inflammatory cytokines contributing to the vicious degenerative cycle. Therefore, this study explores whether NC-EVs modulate interleukin (IL)-1β-mediated pro-inflammatory responses in the degenerating disc.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study utilized two IL-1β induced pro-catabolic culture models; a dog 3D nucleus pulposus (NP) cell pellet culture and a human patient-derived, ex vivo NP tissue culture system. Porcine NC-EVs were generated from NC-conditioned medium by differential centrifugation followed by size exclusion chromatography. Donor matched EV-depleted media were generated by overnight ultracentrifugation, whereafter the EV-depleted NCCM supernatant was subjected to size exclusion chromatography. To investigate whether observed effects were EV-associated, NC-EVs conditions were compared to EV-depleted controls in the absence and presence of IL-1β.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The size and concentration of NC-EVs were quantified by nanoparticle tracking analysis, which showed minimal donor variation and confirmed depletion of EVs in the EV-depleted media. In the IL-1β-induced catabolic cascade, the NC-EVs did not elicit anabolic effects at the matrix level nor did they rescue the pro-catabolic phenotype within dog pellets. Modification of the CCL2 secretion seemed to be context dependent in the human explants: where EVs treatment stimulated CCL2 secretion but in the presence of IL-1β this effect was counteracted. Secretion of IL-6 and C-X-C motif chemokine ligand 1 was significantly decreased in NC-EV + IL-1β vs. control+IL-1β but not compared to EV-depleted human explant controls. Altogether, this data provides evidence for a protective modulatory role of NC-EVs. Considering the homeostatic function EVs exert, inherently encompassing subtle biologic modifications, the current study may have lacked sufficient power to demonstrate statistical significance in a sample set with evident donor variation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;NC-EVs may modulate the production of specific cytokines and chemokines in human degenerate explants when the key pro-i","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E74-like ETS transcription factor 3 expression and regulation in human intervertebral disc","authors":"María González-Rodríguez,&nbsp;Djedjiga Ait Eldjoudi,&nbsp;Alfonso Cordero-Barreal,&nbsp;Mariam Farrag,&nbsp;María Varela-García,&nbsp;Clara Ruiz-Fernández,&nbsp;Carlos Torrijos-Pulpón,&nbsp;Francisca Lago,&nbsp;Lucía García-Caballero,&nbsp;Yousof Farrag,&nbsp;Javier Conde-Aranda,&nbsp;Jesus Pino,&nbsp;Oreste Gualillo","doi":"10.1002/jsp2.70016","DOIUrl":"10.1002/jsp2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intervertebral disc degeneration (IVDD) is one of the main causes of chronic low back pain. The degenerative process is often initiated by an imbalance between catabolic and anabolic pathways. Despite the large socio-economic impact, the initiation and progress of disc degeneration are poorly understood. Although intervertebral disc (IVD) and articular joint are not identical, their degenerative roads are remarkably similar. We, and another authors, previously demonstrated that E-74-like factor 3 (ELF3), a transcription factor induced by inflammatory mediators in various cell types including chondrocytes, is a central contributing factor for cartilage degradation. Thus, we aim to explore, for the first time, the expression, modulation, and the role of ELF3 in human IVD cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The presence of ELF3 in healthy and degenerated IVD tissues was initially determined by immunohistochemistry in annulus fibrosus (AF) and nucleus pulposus (NP). mRNA and protein expression were measured, respectively, by RT-qPCR and Western blot in AF and NP IVD cells harvested from healthy individuals and IVDD patients. Overexpression of ELF3 was performed by transfection of AF IVDD cells with pESE-1: ELF3 expression vector or pCI: empty vector.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our results unveiled, for the first time, the expression of ELF3 in IVD tissues. ELF3 is notably upregulated in degenerated tissues compared to those from healthy patients. In addition, the stimulation of IVDD AF cells with various proinflammatory stimuli, showed marked increase in both mRNA and protein expression of ELF3. ELF3 overexpression in AF IVDD cells resulted in the upregulation of proinflammatory and catabolic genes such as PTGS2, NOS2, LCN2, IL-6, MMP13, and ADAMTS-5; whereas, ELF3 silencing resulted in the opposite results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results support a novel role for ELF3 as a pro-inflammatory and pro-catabolic transcriptional mediator, whose targeting in IVD tissues might be of potential therapeutic relevance in disc degeneration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiome and Metabolome Changes in Chronic Low Back Pain Patients With Vertebral Bone Marrow Lesions","authors":"Wentian Li,&nbsp;Ji Tu,&nbsp;Jinjian Zheng,&nbsp;Abhirup Das,&nbsp;Qi Yan,&nbsp;Xiaotao Jiang,&nbsp;Wenyuan Ding,&nbsp;Xupeng Bai,&nbsp;Kaitao Lai,&nbsp;Sidong Yang,&nbsp;Cao Yang,&nbsp;Jun Zou,&nbsp;Ashish D. Diwan,&nbsp;Zhaomin Zheng","doi":"10.1002/jsp2.70042","DOIUrl":"10.1002/jsp2.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic low back pain (LBP) is a significant global health concern, often linked to vertebral bone marrow lesions (BML), particularly fatty replacement (FR). This study aims to explore the relationship between the gut microbiome, serum metabolome, and FR in chronic LBP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Serum metabolomic profiling and gut microbiome analysis were conducted in chronic LBP patients with and without FR (LBP + FR, <i>n</i> = 40; LBP, <i>n</i> = 40) and Healthy Controls (HC, <i>n</i> = 31). The study investigates alterations in branched-chain amino acids (BCAAs) levels and identifies key microbial species associated with BCAA metabolism. In vitro experiments elucidate the role of BCAAs in adipogenesis of bone marrow mesenchymal stem cells (BM-MSCs) via the SIRT4 pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Chronic LBP patients with FR exhibit depleted BCAA levels in their serum metabolome, along with alterations in the gut microbiome. Specific microbial species, including <i>Ruminococcus gnavus</i>, <i>Roseburia hominis</i>, and <i>Lachnospiraceae bacterium 8 1 57FAA</i>, are identified as influential in BCAA metabolism and BM-MSCs metabolism. In vitro experiments demonstrate the ability of BCAAs to induce BM-MSCs adipogenesis through SIRT4 pathway activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study sheds light on the intricate relationship between the disturbed gut ecosystem, serum metabolites, and FR in chronic LBP. Dysbiosis in the gut microbiome may contribute to altered BCAA degradation, subsequently promoting BM-MSCs adipogenesis and FR. Understanding these interactions provides insights for targeted therapeutic strategies to mitigate chronic LBP associated with FR by restoring gut microbial balance and modulating serum metabolite profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Positive or Negative Correlation Between Cervical Vertebral Bone Quality and Intervertebral Disc Degeneration by Pfirrmann Grading","authors":"Ziye Qiu,&nbsp;Sixue Chen,&nbsp;Ningning Feng,&nbsp;Wenhao Li,&nbsp;Yukun Ma,&nbsp;Shibo Zhou,&nbsp;Guozheng Jiang,&nbsp;Yishu Zhou,&nbsp;Xing Yu,&nbsp;Yang Xiong","doi":"10.1002/jsp2.70038","DOIUrl":"10.1002/jsp2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Cervical degeneration involves many pathophysiological changes. Vertebral bone loss, sclerotic hyperplasia of the vertebral body and intervertebral disc degeneration (IDD) are most common degenerative factors. However, whether there is a correlation between changes in vertebral bone mass and IDD remains unclear. In this study, based on magnetic resonance imaging (MRI), Pfirrmann method was used to grade cervical disc degeneration, and vertebral bone quality (VBQ) was measured. The correlation between VBQ and IDD was analyzed, and its potential mechanism was discussed as well.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From June 2019 to June 2023, clinical data of patients undergoing surgical treatment for cervical degenerative disc diseases (CDDD) in our department were retrospectively analyzed. Preoperative MRI was collected, the degree of IDD was assessed by Pfirrmann grading, and VBQ was measured by T1-weighted image of MRI. With VBQ score = 3.08 as the threshold, Spearman correlation analysis was used to quantified the correlation between IDD grade and VBQ, and multiple ordered Logistic regression analysis was used to evaluate the effect of VBQ on IDD grade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The preoperative MRI data of 94 patients (male, 42; female, 52) with CDDD were collected. Spearman correlation analysis: When VBQ score ≤ 3.08, the IDD grade was negatively correlated with VBQ (<i>p</i> &lt; 0.05, <i>r</i> = −0.153). When VBQ score &gt; 3.08, the IDD grade was positively correlated with VBQ (<i>p</i> &lt; 0.05, <i>r</i> = 0.306). Multiple ordered Logistic regression analysis: When VBQ score ≤ 3.08, the effect of VBQ on IDD was negatively correlated (<i>p</i> &lt; 0.05, <i>β</i> = −0.597). When VBQ score &gt; 3.08, the effect of VBQ on IDD was positively correlated (<i>p</i> &lt; 0.05, <i>β</i> = 0.986).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Either excessive increased or decreased VBQ in the cervical spine may accelerate the progression of IDD. The reason may be that both abnormal interference from the VBQ may imbalance the cervical spinal biomechanics and compromise the absorption of nutrients in the disc, thus accelerating the IDD. Therefore, cervical VBQ may have a bidirectional effect on IDD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary clinical perspectives on chronic low back pain: The biology, mechanics, etc. underpinning clinical and radiological evaluation","authors":"Stone Sima,&nbsp;Ashish Diwan","doi":"10.1002/jsp2.70021","DOIUrl":"10.1002/jsp2.70021","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pain of a chronic nature remains the foremost concern in tertiary spine clinics, yet its elusive nature and quantification challenges persist. Despite extensive research and education on low back pain (LBP), the realm of diagnostic practices lacks a unified approach. Clinically, LBP exhibits a multifaceted character, encompassing conventional assessments of severity and disability, alongside nuanced attributes like pain characterization, duration, and patient expectations. Common instigators of LBP encountered in spine surgical settings comprise degenerated intervertebral discs (IVD), herniated IVD, canal and foraminal stenosis, and spondylolisthesis. However, addressing the root cause necessitates its identification and substantiation through visualization.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This perspective reviews the diagnostic complexities of LBP. Thorough history-taking and physical examinations offer preliminary insights into the underlying source of pain, whether it arises from discogenic origins, neural compression, or sagittal imbalance. The importance of classifying chronic LBP into the underlying pathophysiology is explored. Emphasis is placed on the necessity of aligning clinical observations with imaging findings to guide personalized treatment strategies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Currently, there exists a disparity globally between evidence-based recommendations and actual applications. Recent discoveries behind the pathophysiology of pain phenotypes signify the importance of classifying LBP into its neuropathic or nociceptive origins. The pivotal role of radiological investigations in validating clinical findings for an accurate diagnosis cannot be overstated. However, radiology should not operate in isolation; the disconnect between the clinical and radiological realms ultimately benefits neither the patient nor the surgeon. Additionally, more sensitive measures of IVD prolapse and the corresponding inflammatory pathway triggered are required to provide information on the underlying pathophysiological mechanism of pain generation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This perspective article underscores the imperative fusion of clinical acumen and radiological precision in the intricate landscape of LBP diagnosis. These findings advocate for a paradigm shift towards personalized medicine. By offering a compass for surgeons to navigate this complex terrain and deliver more effective, patient-centered care with targeted interventions this article aims","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Vertebral Bone Marrow Perfusion, Fat/Water Content, and Trabecular Bone Changes Using Multimodal MRI and Micro-CT in a Rat Model of Chronic Kidney Disease","authors":"Guo-Shu Huang,&nbsp;Shih-Wei Chiang,&nbsp;Yi-Jen Peng,&nbsp;Skye Hsin-Hsien Yeh,&nbsp;Yu-Juei Hsu,&nbsp;Yu-Ching Chou,&nbsp;Heng-Han Chang,&nbsp;Herng-Sheng Lee,&nbsp;Ying-Chun Liu,&nbsp;Chao-Ying Wang","doi":"10.1002/jsp2.70039","DOIUrl":"10.1002/jsp2.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Disturbances in calcium and phosphorus homeostasis resulting from chronic kidney disease (CKD) may lead to atherosclerotic changes in blood vessels, potentially altering bone marrow perfusion. Our study aimed to investigate vertebral bone marrow perfusion using dynamic contrast–enhanced (DCE) MRI with a pharmacokinetic model. We also measured possible changes in water and fat content and bony trabeculae using T2* quantification, MR spectroscopy (MRS), and microcomputed tomography (μCT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve rats were randomly separated into a normal control group and a CKD (5/6 nephrectomy) group. Their lumbar spines were imaged, with monitoring of the L5 vertebral body conducted at 0, 8, 16, 30, and 43 weeks. After Week 43, all rats were sacrificed, and histologic changes were correlated with MRI and μCT results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CKD group demonstrated significantly lower <i>A</i> and <i>k</i>_el values (<i>p</i> &lt; 0.05), significantly increased T2* values (<i>p</i> &lt; 0.05), significantly decreased fat content and trabeculation (<i>p</i> &lt; 0.05), sinusoidal dilatation, and decreased adipocytes in the vertebral bone marrow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using quantitative MRI and μCT to assess CKD-related arthropathy of the vertebral body is feasible. Lumbar spine bone marrow perfusion deficiency in experimental CKD may be associated with decreased fat content, increased water content, and sparse trabeculation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Frequency Cyclic Stretch Upregulates the Expression of Nuclear Factor Erythroid 2-Related Factor 2 in Human Nucleus Pulposus Cells to Inhibit the Resistin-Induced Interleukin-20 Expression","authors":"Chia-Kung Yen,&nbsp;Hung-Yu Pan,&nbsp;Hsin-I Chang,&nbsp;Ying-Chen Lu,&nbsp;Yeau-Ren Jeng,&nbsp;Cheng-Nan Chen,&nbsp;Kuo-Yuan Huang","doi":"10.1002/jsp2.70040","DOIUrl":"10.1002/jsp2.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Resistin may connect obesity and intervertebral disc (IVD) degeneration (IDD) and is linked with chronic inflammation. Furthermore, human IDD is characterized by high expression of interleukin-20 (IL-20). The response of human nucleus pulposus (NP) cells to tensile forces depends on both the duration and magnitude of the force applied. Nonetheless, the interactions among resistin, IL-20, and tensile forces in regulating the function of IVD NP cells remain yet to be fully understood. Nuclear factor erythroid 2-related factor 2 (NRF2) has been identified as a pleiotropic protein that enhances cellular resistance to stress stimuli and inflammatory challenges. The role of NRF2 in NP cells is not well defined, and whether tensile force influences NRF2 levels in NP cells is not known.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study investigated the role of NRF2 in human NP cells subjected to low-frequency cyclic stretch stimulation, and the underlying mechanisms involved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Human NP cells were cultured in chambers, serum-starved for 12 h, then subjected to 5% cyclic strain at 0.1 Hz in a bioreactor. Control chambers had no stretching. Cells were lysed for analysis post-loading.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Resistin stimulation induced the expression of IL-20 in human NP cells in a dose- and time-dependent manner. The activation of the p38 mitogen-activated protein kinase, and Akt signaling pathways, as well as the production of toll-like receptor 4, are necessary to render resistin to cause the release of IL-20. In NP cells, transcription factor enzyme-linked immunosorbent assays revealed that resistin led to an increase in nuclear factor (NF)-κB-DNA binding activities. Exposure of NP cells to 5% cyclic stretch at 0.1 Hz inhibited this resistin-induced NF-κB activation and IL-20 expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings elucidate the molecular mechanisms through which resistin induces IL-20 expression in NP cells and also demonstrate that low-frequency cyclic stretch can protect against this induction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intervertebral Disc Degeneration Mediates the Causal Effect of Genetically Predicted Diffuse Idiopathic Skeletal Hyperostosis on Spinal Stenosis: Evidence From a Mendelian Randomization Study","authors":"Yanzhu Shen,&nbsp;Yankun Jiang,&nbsp;Ruichen Jiang,&nbsp;Yanjun Huang,&nbsp;Sizheng Zhan,&nbsp;Yuming Wang,&nbsp;Xiangsheng Tang,&nbsp;Ping Yi","doi":"10.1002/jsp2.70041","DOIUrl":"10.1002/jsp2.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies have noted an association between diffuse idiopathic skeletal hyperostosis (DISH) and spinal stenosis (SS), although causation is unclear. This study used Mendelian randomization (MR) to investigate the causal relationship between the two.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized large GWAS datasets on DISH and SS to perform a two-sample, bidirectional MR analysis, also quantifying the mediating role of intervertebral disc degeneration (IDD). The inverse variance weighting (IVW) method was the primary approach used to estimate the causal effect size. To ensure the reliability of MR results, we conducted heterogeneity tests, horizontal pleiotropy tests, and the MR-PRESSO test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The random-effects IVW method indicated that genetically predicted DISH was associated with an increased risk of SS (OR: 1.432; 95% CI: 1.097–1.868; <i>p</i> = 0.008), and this association remained significant in the validation dataset (OR: 1.444; 95% CI: 1.208–1.725; <i>p</i> &lt; 0.001). Mediation analysis in homogeneous populations showed that IDD partially mediates the causal effect of DISH on SS, with a mediation ratio of 38.39% (95% CI: 2.66–74.13). Sensitivity analyses supported our conclusions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides causal evidence that genetically determined DISH is associated with an increased risk of SS, with IDD acting as a partial mediator. These findings underscore the importance of spine-protective behaviors and early IDD prevention strategies in patients with DISH to mitigate SS risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14876,"journal":{"name":"JOR Spine","volume":"8 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11745897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}