Journal of Spine Practice (JSP)最新文献

{"title":"Causes, Patterns, and Outcomes of Nontraumatic Spinal Cord Injury","authors":"Mutlaq AlMutlaq","doi":"10.18502/jsp.v1i1.9769","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9769","url":null,"abstract":"Introduction: Nontraumatic spinal cord injury (NTSCI), refers to damage to the spinal cord resulting from a cause other than trauma. It is a condition with immense functional implications for individuals involved. The incidence of NTSCI is difficult to estimate due to its heterogeneous cluster of a wide spectrum etiologies with varying pathophysiology. The most described NTSCI causes are degenerative diseases and spinal stenosis, tumors, and inflammatory conditions. In order to avoid delay in diagnosis and time-critical treatment, knowledge of each is important. We aim to fill the gap of knowledge by assessing the causes, patterns, and outcomes of NTSCI. \u0000Methodology: This retrospective cohort study included all patients who had an NTSCI between 2016 and 2020. In addition, patients aged >18 years and treated surgically were included. Demographic and clinical data were collected. Pre- and postoperative American Spinal Injury Association (ASIA) impairment scales and last follow-up outcomes were assessed. \u0000Result: A total of 124 patients were included. The mean age of our population was 62.8 years with an average BMI of 31; 8% of them were smokers. Upon admission, back pain (45%), numbness (43%), and inability to walk (18%) were the highest recorded clinical presentations. Spinal stenosis (45%) followed by degenerative cervical myelopathy (27%) were the most observed pathologies. Lumbar injuries accounted for 45% whereas cervical injuries accounted for 41% and thoracic injuries for 14%. The average length of stay period was 23.2 days, with 48% of patients transferred to inpatient rehabilitation, and the mean follow-up duration was 15 months. \u0000Conclusion: In summary, after assessing the causes, patterns, and outcomes of NTSCI, our study showed that comorbidities were observed in 85% of patients. Spinal stenosis and degenerative cervical myelopathy were the most common etiologies. Patients who presented with urinary incontinence and/or bowel incontinence upon admission had a significantly worse ASIA score at last follow-up. Degenerative pathologies recorded a worse ASIA score, and thoracic injuries recorded the worst ASIA score improvement compared to cervical and lumbar injuries. In total, 57% of the patients showed full recovery at the last follow-up.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122283979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich Plasma for Refractory Coccydynia: A Case Report","authors":"Abdulaziz Hazazi","doi":"10.18502/jsp.v1i1.9802","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9802","url":null,"abstract":"Introduction: Coccydynia is a common syndrome characterized by pain localized to the tailbone that radiates into the lower sacrum and perinium. Coccydynia affects female patients more frequently than male patients. It occurs more commonly after direct trauma from fall directly onto the coccyx. The pain is caused commonly by the strain of sacrococcygeal ligament or fracture of the coccyx and less commonly secondary to arthritis. Conservative treatment of coccydynia include simple analgesics and foam donut to prevent irritation to sacrococcygeal ligament. If pain persist, usually ganglion impar block and radiofrequency are alterative options. There are no strong evidence to support coccygectomy. \u0000Case Report: A 40-year-old presented with coccygeal pain for more than six months. The patient was seen at the pain clinic in Prince Sultan Military Medical City after failure of conservative and multiple steroid injections followed by radiofrequency therapy. We discussed with the patient a trial of a platelet-rich plasma (PRP) injection into the sacrococcygeal ligament under fluoroscopic guidance with full details endorsed to the patient including the risks and benefits of the procedures and informed consent signed before the injection. Pain severity score was taken before and about one month after each injection. The patient received a total of three PRP injections. \u0000Result: The patient reported about 30%, 70%, and 85% pain reduction after the first, second, and third injection, respectively. At six months, the patient continued to experience the same level of reduced pain without the use of regular pain medications. \u0000Conclusion: PRP can be considered as an option for the treatment of patients with refractory coccydynia.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"06 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130482410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nontraumatic Atlantoaxial Rotatory Subluxation: A Rare Complication of COVID-19 in Elderly Patient","authors":"S. Barker","doi":"10.18502/jsp.v1i1.9794","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9794","url":null,"abstract":"Introduction: Nontraumatic Atlantoaxial Rotatory Subluxation (NAAS) or Atlantoaxial Rotatory Subluxation (AARS) without trauma or concomitant bone pathology was first described by Sir Charles Bell in 1830 in a patient with syphilis and pharyngitis, who developed lethal outcome due to spinal compression. The syndrome was named after Grisel who described two cases of pharyngitis and atlantoaxial subluxation in 1951. However, this is an uncommon condition of uncertain etiology characterized by NAAS, usually seen in children secondary to an infection and inflammation in the head and neck region or otolaryngeal procedures. Patients generally complain about neck stiffness and pain, and sometimes dysphagia may occur. Diagnosis is established based on the clinical and radiological findings. The etiopathogenesis and the underlying pathomechanics have not been clearly explained. A hematogenous spread of infection from the posterior pharynx to the cervical spine, according to the recent literature, with hyperemia and abnormal relaxation of the atlantoaxial ligaments is a widely accepted theory. The vascular plexus providing the drainage of poster superior pharyngeal area is responsible. The periodontoid plexus is connected with posterior nasopharyngeal veins via the pharyngovertebral vein. Any infective embolism may spread from superior pharyngeal area to upper cervical joints due to this plexus which does not have any lymph node, thus providing an anatomical explanation for the atlantoaxial hyperemia reported in Grisel's syndrome; however, the clinical picture and complications of COVID-19 are unclear until now and every day new symptoms and findings are reported as early and late complications. \u0000Methodology: An 86-year-old male presented to our clinic in KKT, Jeddah from Yanbu (which is 330 km away) with a complaint of neck stiffness in anterior-lateral position after recovery from COVID-19 six months back. The patient was treated at home without admission in hospital. He had no history of trauma. During the physical examination, the patient's neck was stiff, and there was neck pain with palpation and left-sided torticollis. The patient’s weight was 58 kg, height 160 cm, blood pressure 140/75 mmHg with a pulse rate of 72, SPO2 95, and BMI 22.7. There was no sign of fever or any type of inflammation in his body. The patient had previously consulted neurosurgeons at three different hospitals in Jeddah and was advised a medication with a cervical collar for a clinical follow-up. After three weeks of follow-up, they advised him to start physiotherapy for one month with no benefits seen in clinical finding, the patient then came to us. Direct radiogram of the cervical region showed suspicious findings at the atlantoaxial joint. Anterior view of the cervical radiography revealed tilted position of the head over neck, while the lateral view showed no thickening of the parapharyngeal soft tissue. The distance between the axis and dens was within normal values for","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129592959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective and Observation Study of Selective Nerve Root Block on Patients with PIVD","authors":"V. Singh","doi":"10.18502/jsp.v1i1.9785","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9785","url":null,"abstract":"Introduction: PIVD is the most common cause of lower back pain in old age. The most common site is L4 L5 to L5 S1 in about 95% cases, and about 90% cases are associated with radiculopathy. \u0000Methodology: This prospective study was conducted on 150 patients at the Jawahar Lal Nehru Hospital and Research Center between 2019 and 2021. We used 2–3 ml xylocaine and methylprednisolone. Results were assessed through clinical examination. \u0000Result: Of the 150 patients, 130 experienced excellent results with no pain for more than six months. \u0000Conclusion: We conclude that for mild cases, patients with PIVD have an alternative option of selective nerve root block other than surgery.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127838668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrawound Low-dose Vancomycin (250 mg) Powder has Lower Risk of Wound Dehiscence than Higher Doses in Spine Surgeries","authors":"A. Sonbol","doi":"10.18502/jsp.v1i1.9804","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9804","url":null,"abstract":"Introduction: Surgical site infection post spinal surgery is a known complication which can be serious and may require aggressive intervention. Intrawound vancomycin powder application is an evolving method to prevent such complication. Although it has very low systemic complications, wound dehiscence with negative culture is reported in the literature. The aim of this study was to find the risk of wound dehiscence with low-dose intrawound vancomycin in comparison to 1 gr and its effectiveness in prevention of surgical site infection. \u0000Methodology: A chart review of all patients who underwent posterior thoracic, lumbar or sacral spine surgeries from December 2009 to September 2016 in a single center was done. Patients were categorized into three groups. First, patients who did not receive any intrawound vancomycin; second, patients who received high-dose vancomycin (1 gr); and third, patients who received low-dose vancomycin (250 mg). Additionally, patients’ demographic information, clinical data, and surgical variables were collected. Primary outcome was the presence of wound dehiscence or surgical site infection. \u0000Result: In total, 391 patients were included in this study, of which 56 (14.3%) received high-dose intrawound vancomycin, 126 (32.2%) received low dose, and 209 (53.5%) did not receive any. The overall incidence of wound dehiscence was 6.14% (24 out of 391 patients). Wound dehiscence was statistically and significantly higher (p = 0.039) in the high-dose vancomycin group in comparison to the patients who received low dose. The overall incidence of postoperative infection was 2.05% (eight patients). There was no statistically significant difference between the groups. \u0000Conclusion: The use of intrawound low-dose vancomycin (250 mg) has less wound dehiscence in comparison with other higher standard doses. Further trials are needed to evaluate the effectiveness of this dose in preventing postoperative infections.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115360268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Ageing and Degeneration on Glycosaminoglycan Concentration in the Intervertebral Disc","authors":"D. Taterra","doi":"10.18502/jsp.v1i1.9798","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9798","url":null,"abstract":"Introduction: The correct spatial distribution and high negative charge of glycosaminoglycans (GAGs) within the intervertebral disc (IVD) are responsible for discs water imbibition, proper osmotic pressure, and as such IVD’s physiological swelling behaviors and compressive properties. The aim of this study was to investigate the association of the concentration and distribution of GAG with IVD degeneration as measured by Pfirrmann et al. and Thompson et al. grading systems. \u0000Methodology: Full spinal columns (vertebrae L1-S1 and IVD between them) were harvested from fresh cadavers through an anterior dissection. MRI scans were taken of all spinal columns and were assessed using Pfirrmann grading system. All vertebral columns were cut in the midsagittal plane. The level of degeneration was assessed morphologically using Thompson et al. grading system. Samples from five regions of the L5/S1 IVDs were taken for GAG concentration analyses. Standard curve spectrophotometry was utilized for this purpose. \u0000Result: One hundred lumbar spine columns (L1-S1) were harvested from cadavers. Radiologic assessment using the Pfirrmann grading system and morphological Thompson grading system classified majority of discs as grade 3 and 4. A total of 478 samples from five regions of L5/S1 IVDs were included in the analysis of GAG content. The samples from the nucleus pulposus showed on average the highest concentration of GAG, although the differences were not statistically significant. The one-way analysis of variance (ANOVA) showed no statistically significant differences in the mean GAG mass between different Pfirrmann grades (F = 1.85, p = 0.13) and between different Thompson grades (F = 1.17, p = 0.33). \u0000Conclusion: Our study showed no association between GAG concentration levels and degeneration grade of the IVD as measured by radiological Pfirrmann and morphological Thompson grading systems.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125241699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Lumbar Interbody Fusion with Preservation of Posterior Structures for Management of Lumbar Spondylolisthesis","authors":"T. Aly","doi":"10.18502/jsp.v1i1.9768","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9768","url":null,"abstract":"Introduction: Successful posterior lumbar interbody fusion requires excessive removal of posterior spinal elements and distraction of neural structures. It also requires a large amount of bone graft. The authors have developed this technique to assess results of treatment of degenerative spondylolisthesis by posterior lumbar interbody fusion with preservation of posterior spinal elements and also to examine the safety and efficacy of the recapping  T-saw laminoplasty technique for the management of degenerative lumbar spondylolisthesis using posterior lumbar interbody fusion by interbody cages with preservation of posterior elements. \u0000Methodology: Twenty-five patients with degenerative spondylolisthesis underwent recapping T-saw laminoplasty in the lumbar spine for posterior lumbar interbody fusion with interbody cage. The T-saw was used for the division of the posterior elements. After discectomy and insertion of cages, the excised lamina was replaced exactly in situ to their original anatomic position. Patients were followed neurologically and radiologically. \u0000Result: Only one lamina was excised and replaced again. Primary bone healing was obtained in all patients by four to six months post surgery. No complications such as postoperative spinal canal stenosis, facet arthrosis, or kyphosis were observed. \u0000Conclusion: This technique of posterior lumbar interbody fusion through recapping laminoplasty provide wide space for easier insertion of cages and allow anatomic reconstruction of the vertebral arch preserving its important mechanical roles.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131269456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Often MRI Would Change the Fracture Classification or Decision-making in Thoracolumbar Fractures Compared to CT Alone?","authors":"M. Ali","doi":"10.18502/jsp.v1i1.9797","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9797","url":null,"abstract":"Introduction: This study aimed at analyzing the frequency and predictor of the change in classification of TLFs after performing MRI compared with CT alone. \u0000Methodology: This retrospective review included 235 consecutive patients with acute TLFs (T1-L5) who presented at a single level-1 trauma center between 2014 and 2021 and underwent both CT and MRI. Patients with translation injury, neurologic deficit, or osteoporotic fracture were excluded. Three reviewers independently classified all fractures according to AOSpine and Thoracolumbar Injury classification (TLISS) by CT and then MRI. A fourth reviewer only looked at the MRI images. Posterior ligamentous complex Injury was diagnosed on CT and MRI by two positive CT findings and black stripe discontinuity. Mc-Nemar test was used to evaluate the difference in the proportions of AO type A and B. \u0000Result: The AO classification by CT was type A in 181 patients (77%) and type B in 54 patients (23%). The addition of MRI after CT changed AO classification in 25/235 patients (10.6%, P < 0.0001) due to an 8.5% (20/235) upgrade from type A to type B and 2.1% (5/235) downgrade from type B to type A. When PLC injury in CT was defined by one positive CT finding and in MRI by high signal intensity, it significantly increased the rate of fracture reclassification by MRI compared to default analysis (22% and 33% vs 11%, respectively; P < 0.0001). The best predictor of upgrade from type A to type B and downgrade from type B to type A was a single positive CT finding, and the presence of only two CT signs as opposed to three signs, respectively (reclassification rate 26% vs 4.6%, P < 0.0001 and 17% vs 0%, P = 0.03, respectively). Thoracic and thoracolumbar fractures showed a significantly higher reclassification rate than low lumbar (20% and 10% vs 0%, respectively, P = 0.07). \u0000Conclusion: Using appropriate CT/MRI criteria of PLC injury, the rate of fracture reclassification by MRI can be as low as 10%. The use of alternative CT/MRI criteria or inaccurate image interpretation could significantly increase the rate of fracture reclassification up to 20–30%. The rate of change of fracture classification by MRI could be predicted by the number of positive CT findings on CT or fracture level.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131337204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Spinal Cord Injuries and Their Outcomes: A Study at King Khalid Hospital (KKH), Najran, Saudi Arabia, June 2018–June 2019","authors":"Ahood A Mahjari","doi":"10.18502/jsp.v1i1.9789","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9789","url":null,"abstract":"Introduction: Spinal cord injury (SCI) is a life-changing neurological injury that puts a significant load on the healthcare system. SCI can be caused by several reasons such as road traffic accident (RTA), motor traffic accident (MTA), fall, gunshots, or bomb blast. There is not much national data concerning the etiology of SCI in Saudi Arabia. Therefore, we conducted this study to quantify the number of SCI incidence at King Khalid Hospital (KKH), Najran between June 2018 and June 2019. The study aimed at reviewing the rate and epidemiology of SCI at KKH for all patients admitted to the hospital during the study period and examining the causes of SCI for suggesting prevention strategies. \u0000Methodology: This retrospective study included all patients with SCI admitted to KKH during the mentioned period. Several factors for each patient were recorded including their age, gender, nationality, cause of SCI, and the outcomes of neurological injury. \u0000Result: In total, 182 SCI patients were admitted during the study period: 53% of them were male, and those aged 16–30 years were most vulnerable to SCI. RTA was the most common cause of SCI for males (59%), followed by bomb blasts (15%). While fall was ranked as the second cause of SCI in males (15.4%), it was the main reason for SCI in females 13%, followed by RTA. The majority of admitted cases in younger age was stable and improved, however, after RTA four patients had quadriplegia and six cases had paraplegia. \u0000Conclusion: RTA is the most common cause of SCI followed by fall and bomb blast. Younger patients are more likely to improve after SCI compared to elderly patients.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125993048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disc Degeneration in Direct Injury or Instability Models Share Common Metabolic Pathways","authors":"Matthew Goodwin","doi":"10.18502/jsp.v1i1.9807","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9807","url":null,"abstract":"Introduction: Disc degeneration is the central component involved in numerous common spinal pathologies. Degenerative disc disease affects millions of people every year, yet the mechanisms driving degeneration remain poorly understood. Previous work to date has shown that high levels of intracellular lactate seem to be involved in driving this pathology once thought to be purely mechanical. Here, we present a series of studies utilizing mouse models of mechanical injuring or loading of the intervertebral disc (IVD), with a goal of better defining the role of lactate and lactate transport in degenerative disc disease. \u0000Methodology: Four models of disc degeneration were studied: (i) lumbar disc poke, (ii) tail disc poke, (iii) spinal instability, and (iv) sham. Female mice (C57BL/6J, n = 30) were randomly assigned to one group. In group 1, a retroperitoneal approach exposed the IVD of the lumbar spine, and a 27G needle was used to injure the disc. In group 2, the needle was inserted in the tail IVD. In group 3, lumbar instability was induced by resection of bilateral facet joints and supraspinous/interspinous ligaments. In group 4, a sham was used for each. The mice were euthanized at two, four, and eight weeks. IVD was evaluated by histological and immunofluorescence analysis. RNA extraction from disc tissue was analyzed with QPCR. \u0000Result: Sham mice did not have significant disc degeneration. In groups 1 and 2, the degenerative process at two, four, and eight weeks was characterized by loss of nucleus pulposus (NP) cells and the gradual increase in matrix components in NP. The distinction between NP and annulus fibroids (AF) or endplate cartilage is lost. There was increased expression of collagen X and MMP13 in the NP, and MCT4 was decreased, while MCT3 was increased. In group 3, disorder of the AF was evident in the first two weeks post surgery, the collapsed disc space and the NP area gradually lessened. The proteoglycan detected in the inner layer of AF and the periphery of NP decreased after eight weeks. There was increase in type X collagen and MMP13 in the inner AF and NP. \u0000Conclusion: Our results demonstrate a common molecular pathway whereby discs degenerate after direct injury or becoming unstable. In our model, there was a rapid degeneration of the IVD in mice who exhibit up- and downregulation of several important markers. Importantly, MCT4 was downregulated, while MCT3 was upregulated. While MCT4 was associated with lactate exportation, and its loss resulted in elevated intracellular lactate and disc degradation, MCT3 is rarely expressed and may be acting as a rescue lactate transporter.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128962987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}