bluuebunny/crossref_metadata_2025_split huggingface dataset:
MRI-Based Classification of the Morphology and Pathology of the Annulus Fibrosus of the Intervertebral Disc
Authors: Benneker L. , Bonel H. , Weisstanner C. , Aghayev E. , Hoppe S. 
Published: May 2014

Introduction The high rate of recurrent disc herniation after discectomy is a prevalent problem. An effective biological annular repair could improve the surgical outcome in patients with contained disc herniation but otherwise minor degenerative changes. To estimate the integrity of the annulus fibrosus (AF) and judge different repair options a better understanding of disc morphology and pathology is crucial.1 Axial- and sagittal T2*-mapping are effective to detect early stages of degenerative disc disease and are especially suited to evaluate the interface between the proton-rich nucleus pulposus and the fibers of the annulus fibrosus.2,3 So far there is no classification of AF morphology or pathology as current classifications only describe localization and extend of the hernia itself. Materials and Methods Prospective consecutive case study of 100 patients requiring MRI diagnostic for suspected lumbar disc herniation. Beside the clinical standard MRI protocol with sagittal T1- and T2-weighted images, axial and sagittal T2*-mapping sequences of the affected and adjacent discs were performed using 3T MRI. Three observers used established classification schemes to assess the grade of degeneration (Pfirrmann, Benneker, Watanabe) and herniation (Carragee, Rajaserakan) and also developed a new classification protocol specific for the annulus fibrosus. Results In the preliminary data four types of annulus morphology/pathology could be found: type 1: healthy, uniform thickness of AF, clear demarcation between nucleus pulposus (NP) and AF. Type 2: concentric thinning with bulge, concentric tears, demarcation between NP and AF unclear. Type 3: nonconcentric thinning, ±radial fissures, ±protrusion, and type 4: herniations with further subgroups. Conclusion Based on preliminary axial and sagittal T2* images a new classification system for AF morphology and pathology could be established. Inter- and intraobserver liability is high. Disclosure of Interest None declared References Guterl CC, See EY, Blanquer SB, et al. Challenges and strategies in the repair of ruptured annulus fibrosus. Eur Cell Mater 2013;25:1–21 Stelzeneder D, Welsch GH, Kovács BK, et al. Quantitative T2 evaluation at 3.0T compared to morphological grading of the lumbar intervertebral disc: a standardized evaluation approach in patients with low back pain. Eur J Radiol 2012;81(2):324–330 Hoppe S, Quirbach S, Mamisch TC, Krause FG, Werlen S, Benneker LM. Axial T2 mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration. Eur Radiol 2012;22(9):2013–2019
Study to Determine the Presence of Progenitor Cells in the Degenerated Human Cartilage Endplates
Authors: Huang B. , Liu L. , Li C. , Zhuang Y. , Luo G. , Hu H. , Zhou Y. 
Published: May 2014

Introduction Cartilage endplate (CEP) degeneration is usually accompanied by loss of cellularity, and this loss may be a crucial key factor in initiation and development of degenerative disc disease. The study of cell types in degenerated CEP could help in understanding CEP etiopathogenesis, and may help in devising new treatments, especially if the presence of progenitor cells could be demonstrated. The aim of this study, was to determine if progenitor cells existed in degenerated human CEP. Materials and Methods Cells isolated from CEP were cultured in a three-dimensional agarose suspension to screen for proliferative cell clusters. Cell clusters were then expanded in vitro and the populations were analyzed for colony forming unit (CFU), immunophenotype, multilineage induction, and expression of stem cell-related genes. Results The presence of progenitor cells in degenerated human CEP is indicated by the results of CFU, immunophenotype, multilineage induction, and expression of stem cell-related genes. Conclusion We believe that this is the first study, which has conclusively shown the presence of progenitor cells in degenerated CEP. The finding of this study may influence the clinical management of degenerative disc disorder. Disclosure of Interest None declared
Human Degenerate Discs Show Increased Activation of Intracellular Signalling Pathways of IL-1
Authors: Daniels J. , Binch A. LA. , Dunn S. , Phillips K. L. , Chiverton N. , Cole A. , Michael A. R. , Breakwell L. , Le Maitre C. L. 
Published: May 2014

Introduction Intervertebral disc degeneration is implicated in 40% of low back pain cases. Interleukin 1 (IL-1) is known to be important in the pathogenesis of intervertebral disc (IVD) degeneration, here we investigated the intracellular signaling pathways activated by IL-1 and determined the activation status of these pathways in native IVD tissues highlighting potential pathways for new therapies. Materials and Methods Human nucleus pulposus cells (NP) removed during discetomy for nerve root pain were stimulated with IL-1 for 30 minutes. The activation of ERK1/2, p38, c-jun, and IκB were determined using cell-based enzyme-linked immunosorbent assays, in addition pNFκB localisation in stimulated cells was determined using immunohistochemistry. Localisation of phosphorylated c-jun, p38, ERK1/2, and NFκB together with IL-1 was investigated within paraffin embedded sections of human IVD to investigate the presence of active pathways in vivo . Pretreatment with inhibitors of p38, c-jun, and NFκB for 30 minutes before stimulation with IL-1 (10 ng/mL) for 48 hours was investigated to determine the ability of individual signaling inhibitors to block the catabolic responses induced by IL-1. Results IL-1-induced activation of p38, MAPK, ERK ½, JNK/c-jun, and NFκB signaling pathways in human NP cells. IVD tissue samples displayed immunopositive staining for phosphorylated c-jun, ERK1/2, NFκB, and p38, immunopositivity was significantly increased within degenerate discs, particularly in those discs which also expressed high levels of IL-1. Inhibition of individual signaling pathways demonstrated differential regulation of the pleathora of IL-1-induced catabolic events, with different signaling molecules shown to regulate matrix metalloproteases, cytokines, and factors involved in innervation and angiogenesis of the disc. Conclusion Here, we have shown that the signaling pathways activated by IL-1 in vitro display increased activation in vivo during disc degeneration. Inhibitors of these pathways demonstrated multiple signaling pathways were involved in the pleathora of IL-1 actions. Thus, inhibition of signaling pathways could be a novel mechanism to inhibit catabolic processes which could hold promise to inhibit degeneration at early stages of disease but also create the correct tissue niche to promote regeneration of the disc. Disclosure of Interest None declared
A New Experimental Animal Model of Chronic Cervical Compressive Myelopathy
Authors: Zihe L. , Zhongjun L. , Gengding D. , Feng W. 
Published: May 2014

Introduction Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction among adults over the age of 55?In China the morbidity of CSM is 10%. However, the pathobiology of CSM is still unclear which limits therapeutic advances for this common cause of neurological dysfunction. The clinical course of the disease remains unpredictable. The lack of reliable animal models of CSM has been a restriction to advancing the field. Up to now, various animal model of CSM have been made. Although some of these studies have impressive progress, they also have significant defects. Many of these models fail to model the chronic and progressive nature of the disease since they do not accurately reproduce the main human neuropathological and clinical features of CSM, In this study we report a new model of CSM in sheep. It is more accurate and stable than previous models. Moreover, the entire course of compression is digitized. Materials and Methods A Silicone sealed compression device is assembled with a stepping motor, gear reducer and a push rod. The compression device is connected to a circuit board which contains a bluetooth module and a control chip. Power supply is a lithium battery. Circuit board is also well sealed with silicone. It is controlled via an Android cellphone in vitro. Six male small tailed han sheep were divided into two groups randomly, four in experimental group and two in control group. The compression device was implanted into intervertebral space of C4/C5 and fixed. Circuit board was implanted subcutaneously. The control group ran no compression after surgery. Animals of each group were carried on a routine CT inspection right after the surgery. The front end of the push rod was adjusted to the posterior edge of the cervical vertebral. The experimental group pushed 0.4 mm each week while awake. Tarlov scores were assessed in each group before and after push. Results In the course of the experiment, one sheep of the experimental group appeared malfunction of the circuit board subskin. The dysfunctional board was replaced during an extra operation. The Tarlov sores of the experimental group didn't change before and after each time of push. No behavioral changes were noted in control group. While sheep in the experimental group showed gradually changes of gait. The final Tarlov score was four in three sheep and three in one sheep of the experimental group and the final radiological findings showed that the average spinal canal encroachment rate was 60.6% in the experimental group after 18 weeks’ observation. Conclusion This animal model can be used to generate controllable compression to spine operated by a digitized system. No invasive procedures were applied during the experiment. In next stage of experiment we could get specimens and run pathological tests. Disclosure of Interest None declared
Intervertebral Disc Degenerative Changes after Intradiscal Injection of TNFα in a Porcine Model
Authors: Kang R. , Li H. , Ringgaard S. , Rickers K. , Xie L. , Bünger C. 
Published: May 2014

Introduction Tumor necrosis factor (TNF) has higher expression in degenerated disc tissues, thus be proposed as one of the initiators of causing disc degeneration. However, whether direct induction by TNFα leads to disc degeneration in vivo that has not been studied yet. Materials and Methods Two lumbar intervertebral discs in seven pigs were injected by 50 or 100 ng TNFα predisc, and with a third disc remaining intact as a normal control. Magnetic resonance imaging (MRI) including T1-, T2-weighted, T2-weighted 3D, sagittal-T2 mapping, was performed pre- and 3 months postintervention. Serial postcontrast T1-weighted MRI and histology study also performed at the end. Results After 3 months, these TNFα injected discs showed degenerative changes, with the percentage of disc height index, nucleus pulposus (NP) area, and NP T2 value lower than the normal controls. Serial postcontrast T1-weighted MRI showed increase diffusion in annulus and nucleus in TNFα injected discs compared with the normal controls. Histology confirmed these intervertebral disc degeneration changes, and found capillaries formation in annulus of TNFα injected discs. No significent difference was found between discs with different dose of TNF. Conclusion Intradiscal injection of TNFα lead to disc degeneration, and induce capillary ingrowth to disc in a pocine model. Disclosure of Interest None declared
Surgery in Pott Disease—Experience of 115 Cases
Authors: Alam M. Shah 
Published: May 2014

Introduction Tuberculosis (TB) of the spine is the most common and dangerous form of TB infection accounting 50 to 60% of osseous TB. Although, uncommon spinal TB still occurs even in both developed and developing countries. The diagnosis of spinal TB is difficult and it commonly presents at an advanced stage. Delay in establishing diagnosis and management cause spinal cord compression and spinal deformity. Materials and Methods A total of 30 patients who had TB of the thoracic and lumbar spine with moderate to severe cord compression was studied. Variable degrees of neurological deficit with deformity were treated at NITOR and PGHL, DHAKA during the period from 2008 to 2010. Anterolateral decompression and autogenous strut bone grafting with simultaneous fixation by screws and rod were done. Posterior decompression, posterior interbody, and posterolateral fusion by bone graft with stabilization by transpediculer screws and rods. Appropriate antituberculous drugs was given to all patients for 18 to 24 months. The postoperative follow-up period was 12 months (range 3-21 months). Results Ovearll 20 cases with neurological deficits recovered totally or partially. No neurological improvement had occurred in five cases with paraplegia. Five cases were lost from follow-up. X-ray shows bony fusion was achieved in all cases for mean of 6 months(range 4-8 months). There were no recurrences. Two cases had bed sores postoperatively and there was no neurological improvement. Conclusion For patients with thoracolumbar spinal TB anterior debridement, auto graft bone fusion, anterior or posterior fixation appears to be effective in arresting disease, correcting kyphotic deformity and maintaining correction until solid spinal fusion. Disclosure of Interest None declared
Characteristics of Spinopelvic Sagittal Alignment in Patients with Lumbar Disc Degenerative Diseases
Authors: Yang X. , Kong Q. 
Published: May 2014

Introduction A comparative study of the spinopelvic sagittal alignment in patients with lumbar disc degeneration or herniation (LDD/LDH) with normal population was designed to analyze roles of sagittal anatomical parameter (pelvic incidence, PI) and positional parameters in the pathogenesis and development of LDD/LDH. Several comparative studies of these patients with asymptomatic controls have been done. However, in previous studies without lumbar MRI, a certain number of asymptomatic LDD patients should have been included in the control group and then impacted on the results. Materials and Methods Total 60 LDD or LDH patients and 110 asymptomatic volunteers were included. Based on MRI, the normal group (NG) and degeneration group (DG) were divided. In DG, the symptomatic (SDG) and asymptomatic (ADG) subgroups were divided according to patients’ symptoms. Standing full-spine radiographs were used to measure sagittal parameters, including PI, sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK), sagittal vertical axis (SVA), and sacrum-bicoxofemoral distance (SFD). Results PI, SS, and LL in DG were significantly lower than NG while the SVA and SFD were significantly greater ( p < 0.05). PI correlated well with the SS and LL in all subjects; however the trend lines of SS or LL over PI were down-shifted in DG. Comparing SDG to ADG, PI was similar ( p = 0.716) but SS and LL were significantly lower and SVA was significantly greater ( p < 0.05). Conclusion PI may play a predisposing role in the pathogenesis of lumbar disc degenerative diseases. Moreover, the secondary structural and compensatory factors would lead to a straighter spine after disc degenerative change. Disclosure of Interest None declared References Barrey C, Jund J, Noseda O, Roussouly P. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases. Eur Spine J 2007;16(9):1459–1467 Rajnics P, Templier A, Skalli W, Lavaste F, Illes T. The importance of spinopelvic parameters in patients with lumbar disc lesions. Int Orthop 2002;26(2):104–108 Endo K, Suzuki H, Tanaka H, Kang Y, Yamamoto K. Sagittal spinal alignment in patients with lumbar disc herniation. Eur Spine J 2010;19(3):435–438
Mechanical Far Lateral Disc Herniation Reproduction in Ovine Model for Intervertebral Disc Repair
Authors: Friedmann A. , Goehre F. , Schwan S. , Wiesner I. , Meisel H. J. 
Published: May 2014

Introduction Until today, the therapy of intervertebral disc disease is mainly based on the surgical removal of the cartilage tissue that protrudes between the vertebras, as well as the fixation of the vertebral bodies. Thus, the development of regenerative therapies for intervertebral disc degeneration presents a particular research area, which includes both material research and tissue engineering subjects. From a clinical point of view, it is assumed that a self-regenerative implant-based adipose mesenchymal stem cells, combined with an injectable scaffold material, represents a crucial improvement of the mechanical long-term stability of damaged intervertebral disc segments. The objective of the development, evaluation, and testing of the research is to examine various new materials in significant large animal model at several time stages. Materials and Methods Because of the similarity in anatomy and biomechanics of the ovine intervertebral disc in comparison to human discs, the sheep animal model was selected. The disc herniation reproduction was performed through a minimal invasive surgery under X-ray control by penetration of the annulus fibrosis with subsequent removal of nucleus pulposus tissue with a Rongeur instrument. After 6 weeks, the induced degeneration of the disc could be observed. This represents the starting point for investigations of suitable materials for intervertebral disc implants. Our study is focused on the development of injectable hydrogels loaded with autologous adipose stem cells. Results This model has been used successfully in 33 sheep for injectable scaffold material tests. The procedure and its implication will be presented based on X-ray and micro computed tomography imaging as well as analysis of the disc height. Conclusion In cooperation with the BG Hospital Bergmannstrost Halle and Translational Centre for Regenerative Medicine (TRM) Leipzig we developed a suitable sheep animal model with a mechanically induced far lateral disc lesion. Disclosure of Interest None declared
Extended Duration of Torsional Loading Reduces the Survival of Nucleus Pulposus Cells in the Intact Disc
Authors: Chan S. , Walser J. , Ferguson S. J , Gantenbein-Ritter B. 
Published: May 2014

Introduction Previous studies on the influence of torsion and combined torsion-compression loading revealed a positive effect on the cell viability when a repetitive short-term torsion was applied at a physiological magnitude to intervertebral disc organ culture.1 However, after an extended period (8 hours) of combined torsion-compression loading, substantial cell death was detected in the nucleus pulposus (NP).2 In this follow-up study, we aimed to investigate the relationship, if any, between the duration of torsion applied to the intervertebral disc (IVD) and the level of NP cell viability. Materials and Methods Bovine caudal discs were harvested and cultured in a custom-built multiaxis dynamic loading bioreactor.2 Torsion (± 2 degrees) was applied to the samples at a frequency of 0.2 Hz. Torsion was applied for durations of 0, 1, 4, and 8 h/d, repeated over 7 days. After the last day of loading, disc tissue was dissected for analysis of cell viability and gene expression. Results Disc NP cell viability remained above 85% after torsional loading for 0, 1, or 4 h/d. Viability was statistical significantly reduced to below 70% when torsion was applied for 8 h/d ( p = 0.03) ( Table 1 ). The daily duration of torsional loading did not affect the AF cell viability (> 80% for all loading durations). The trend of collagen 2 gene upregulation and matrix metalloproteases 13 downregulation with an increasing duration of torsion was observed in both NP and AF (Fig. 1). [Table: see text] Conclusion We have demonstrated that an extended duration of torsion could inhibit the survival of NP cells within the IVD in organ culture. Acknowledgments Funds from the Orthopedic Department of the Insel University Hospital of Bern and a private donation from Prof. Dr. Paul Heini, Spine Surgeon, Sonnenhof Clinic Bern were received to support this work. Disclosure of Interest None declared References Chan SC, Ferguson SJ, Wuertz K, Gantenbein-Ritter B. Biological response of the intervertebral disc to repetitive short-term cyclic torsion. Spine 2011;36(24):2021–2030 Chan SC, Walser J, Käppeli P, Shamsollahi MJ, Ferguson SJ, Gantenbein-Ritter B. Region specific response of intervertebral disc cells to complex dynamic loading: an organ culture study using a dynamic torsion-compression bioreactor. PLoS ONE 2013;8(8):e72489
17β-Estradiol Protects against Apoptosis Induced by Levofloxacin in Rat Nucleus Pulposus Cells by Upregulating Integrin Alpha2beta1
Authors: Ding W. , Yang S. , Ma L. , Yang D. 
Published: May 2014

Introduction Levofloxacin has been reported to have cytotoxicity to chondrocytes in vitro. 17β-estradiol has been widely studied for its protective effects against cell apoptosis. Based on apoptotic cell model induced by levofloxacin, the purpose of this study was to explore the underlying mechanism by which 17β-estradiol protects rat nucleus pulposus cells from apoptosis. Materials and Methods Inverted phase-contrast microscopy, flow cytometry, and caspase-3 activity assay were used to determine apoptosis incidence induced by levofloxacin. Moreover, western blot and real-time quantitative polymerase chain reaction were used to explore the expression of integrins. Results Levofloxacin-induced marked apoptosis, which was abolished by 17β-estradiol. Estrogen receptor antagonist, ICI182780, and functional blocking antibody to α2beta1 integrin, both prohibited the effect of 17β-estradiol. Simultaneously, levofloxacin decreased cellular binding ability to type II collagen, which was also reversed by 17β-estradiol. Integrin α2beta1 was responsible for estrogen-dependent anti-apoptosis, which was time- and dose-response effect. Conclusion 17β-Estradiol was proved for the first time to protect rat nucleus pulposus cells against levofloxacin-induced apoptosis by upregulating integrin α2beta1 signal pathway. Disclosure of Interest None declared