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Li T, Li Y, Wang W. Association between cup orientation and low back pain after total hip arthroplasty in patients with osteonecrosis of the femoral head. BMC Musculoskelet Disord 2024; 25:10. [PMID: 38167127 PMCID: PMC10759751 DOI: 10.1186/s12891-023-07139-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Postoperative low back pain (LBP) following total hip arthroplasty (THA) is classified as secondary hip-spine syndrome. The purpose of this study was to explore the correlations between cup orientation of THA and postoperative LBP in patients with osteonecrosis of the femoral head (ONFH). METHODS A retrospective cohort study included 364 ONFH patients who underwent bilateral THA between January 2011 and December 2020. Among them, 53 patients (14.6%) experienced postoperative LBP at the end of follow-up and were designated as pain group (PG). A control group (CG) consisting of 106 patients with similar age, sex, and body mass index (BMI) to those in the PG was selected. Postoperative LBP in the PG was assessed using the visual analogue scale (VAS). Demographic data, clinical information, and radiographic criteria were evaluated as potential predictors of LBP. RESULTS Patients in PG (mean age, 47.3 years [range, 27 to 75 years]; 42 [79%] male) had a mean VAS score of 4.6 (range, 1 to 9) compared with 0 for the patients in CG (mean age, 47.6 years [range, 19 to 77 years]; 84 [79%] male). There were no significant differences in clinical data between the two groups (p > 0.05). Preoperative radiographic variables also showed no significant differences between the PG and CG (p > 0.05). However, the postoperative inclination, anteversion, and standing ante-inclination (AI) were significantly lower in the PG compared to the CG, whereas the sitting and standing sacral slope (SS) were significantly higher (p < 0.05). Moreover, the variations in standing AI, standing and sitting pelvic tilt (PT) were significantly lower in the PG compared to the CG, while the variations in standing and sitting SS and lumbar lordosis (LL) were significantly higher (p < 0.05). The variation in standing AI in the PG showed a significantly correlation with the variation of standing SS, standing PT, and LL (p < 0.05). CONCLUSION Postoperative LBP in ONFH patients after bilateral THA is significantly associated with the intraoperative cup orientation. The variation in standing AI is correlated with the variations in standing SS, standing PT, and LL, potentially contributing to the development of postoperative LBP.
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Affiliation(s)
- Tong Li
- Department of Orthopedics, China-Japan Friendship Hospital, Beijing, China
| | - Yifei Li
- 15th Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weiguo Wang
- Department of Orthopedics, China-Japan Friendship Hospital, Beijing, China.
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Huang Y, Lei L, Zhao Z, Li Z, Wang H, Chen S, Zheng J, Jiang G, Guo X, Li J, Wang J, Zheng Z, Chen F. Acetylshikonin promoting PI3K/Akt pathway and inhibiting SOX4 expression to delay intervertebral disc degeneration and low back pain. J Orthop Res 2024; 42:172-182. [PMID: 37377113 DOI: 10.1002/jor.25653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023]
Abstract
This study investigated the molecular mechanism by which acetylshikonin inhibits SOX4 expression via the PI3K/Akt pathway to delay intervertebral disc degeneration (IVDD) and low back pain (LBP). Bulk RNA-seq, RT-qPCR, Western blot analysis, immunohistochemical staining, small interfering RNA (siSOX4), lentivirus (lentiv-SOX4hi ), and imaging techniques were used to assess SOX4 expression and validate its upstream regulatory pathway. Acetylshikonin and siSOX4 were injected into the IVD to measure IVDD. SOX4 expression significantly increased in degenerated IVD tissues. TNF-α increased SOX4 expression and apoptosis-related proteins in nucleus pulposus cells (NPCs). siSOX4 reduced TNF-α-induced NPCs apoptosis, while Lentiv-SOX4hi increased it. The PI3K/Akt pathway was significantly correlated with SOX4, and acetylshikonin upregulated PI3K/Akt pathway while inhibiting SOX4 expression. In the anterior puncture IVDD mouse model, SOX4 expression was upregulated, and acetylshikonin and siSOX4 delayed IVDD-induced LBP. Acetylshikonin delays IVDD-induced LBP by inhibiting SOX4 expression through the PI3K/Akt pathway. These findings offer potential therapeutic targets for future treatments.
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Affiliation(s)
- Yuming Huang
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Linchuan Lei
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
- Laboratory of General Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhuoyang Zhao
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
- Laboratory of General Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zemin Li
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Hua Wang
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Shunlun Chen
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Jinjian Zheng
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Guowei Jiang
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Xingyu Guo
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Jiamin Li
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Jianru Wang
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Zhaomin Zheng
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
| | - Fan Chen
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Guangdong Province Key Laboratory of Orthopaedics and Traumatology, Guangzhou, People's Republic of China
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Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
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Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
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Okuzu Y, Goto K, Kuroda Y, Kawai T, Matsuda S. How Do Spinal Parameters Change in Patients Who Have Improvement of Low Back Pain After Total Hip Arthroplasty? A Propensity Score-Matched Cohort Study. J Arthroplasty 2024; 39:132-137. [PMID: 37331437 DOI: 10.1016/j.arth.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Many studies have demonstrated that low back pain (LBP) improves after total hip arthroplasty (THA). However, the mechanism underlying this improvement remains unclear. We aimed to investigate changes in the spinal parameters of patients who had LBP improvement after THA to elucidate the mechanism of LBP improvement. METHODS We included 261 patients who underwent primary THA between December 2015 and June 2021 and had a preoperative visual analog scale score of ≥ 2 for LBP. The patients were classified into the LBP-improved or LBP-continued groups based on the visual analog scale for LBP at 1 year after THA. Preoperative and postoperative changes in the coronal and sagittal spinal parameters were compared between the 2 groups after propensity score matching for age, sex, body mass index, and preoperative spinal parameters. RESULTS A total of 161 patients (61.7%) were classified into the LBP-improved group. After 85 patients in both groups were matched, the LBP-improved group showed significant differences in spinal parameter changes, which were a higher lumbar lordosis (LL) (P = .04) and lower sagittal vertical axis (SVA) (P = .02) and pelvic incidence (PI) minus LL (PI-LL) (P = .01) postoperatively, whereas the LBP-continued group showed worsened changes in LL and SVA and PI-LL mismatch. CONCLUSION Patients who had LBP improvement after THA had significant differences in spinal parameter changes in LL, SVA, and PI-LL. These spinal parameters may be the key factors in the mechanism of LBP improvement after THA.
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Affiliation(s)
- Yaichiro Okuzu
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Toshiyuki Kawai
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Sakyo-ku, Kyoto, Japan
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155
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Kjærgaard C, Schmidt AM, Larsen JB, Laurberg TB, Mechlenburg I. Which patients with chronic low back pain respond favorably to multidisciplinary rehabilitation? A secondary analysis of a randomized controlled trial. Scand J Pain 2024; 24:sjpain-2023-0139. [PMID: 38733320 DOI: 10.1515/sjpain-2023-0139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES The aim of this study was to identify prognostic variables at baseline associated with being responding favorably to multidisciplinary rehabilitation in patients with chronic low back pain (CLBP). METHODS A responder analysis was conducted based on data from a randomized controlled trial with 26-week follow-up including 165 patients with CLBP treated at a Danish multidisciplinary rehabilitation center. Patients were dichotomized into responders and non-responders based on the outcome of a minimal clinically important difference of six points on the Oswestry Disability Index. The associations between prognostic variables and responders were analyzed using logistic regression. RESULTS A total of 139 patients completed the study, of which 42% were classified as responders. Sex and employment status were statistically significant, with a decreased odds ratio (OR) of being a responder found for males compared to females (OR = 0.09, 95% CI = 0.02-0.48) and for being on temporary or permanent social benefits (OR = 0.28, 95% CI = 0.10-0.75) compared to being self-supporting or receiving retirement benefits. Statistically significant interaction (OR = 8.84, 95% CI = 1.11-70.12) was found between males and being on temporary or permanent social benefits. CONCLUSIONS In patients with CLBP, female patients as well as patients who were self-supporting or receiving retirement benefits were significantly more likely than male patients or patients on temporary or permanent social benefits to be a responder to multidisciplinary rehabilitation.
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Affiliation(s)
- Claus Kjærgaard
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Aarhus, Denmark
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Anne Mette Schmidt
- Medical Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Josefine Beck Larsen
- Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Aarhus, Denmark
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Trine Bay Laurberg
- Department of Rheumatology, Aarhus University Hospital, Sano Aarhus, Aarhus, Denmark
| | - Inger Mechlenburg
- Department of Orthopedic Surgery, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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156
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Zhou D, Liu H, Zheng Z, Wu D. Design principles in mechanically adaptable biomaterials for repairing annulus fibrosus rupture: A review. Bioact Mater 2024; 31:422-439. [PMID: 37692911 PMCID: PMC10485601 DOI: 10.1016/j.bioactmat.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/25/2023] [Accepted: 08/12/2023] [Indexed: 09/12/2023] Open
Abstract
Annulus fibrosus (AF) plays a crucial role in the biomechanical loading of intervertebral disc (IVD). AF is difficult to self-heal when the annulus tears develop, because AF has a unique intricate structure and biologic milieu in vivo. Tissue engineering is promising for repairing AF rupture, but construction of suitable mechanical matching devices or scaffolds is still a grand challenge. To deeply know the varied forces involved in the movement of the native annulus is highly beneficial for designing biomimetic scaffolds to recreate the AF function. In this review, we overview six freedom degrees of forces and adhesion strength on AF tissue. Then, we summarize the mechanical modalities to simulate related forces on AF and to assess the characteristics of biomaterials. We finally outline some current advanced techniques to develop mechanically adaptable biomaterials for AF rupture repair.
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Affiliation(s)
- Dan Zhou
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Hongmei Liu
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Zhaomin Zheng
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, China
- Pain Research Center, Sun Yat-Sen University, Guangzhou 510080, China
| | - Decheng Wu
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
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157
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Meng Q, Xie E, Sun H, Wang H, Li J, Liu Z, Li K, Hu J, Chen Q, Liu C, Li B, Han F. High-Strength Smart Microneedles with "Offensive and Defensive" Effects for Intervertebral Disc Repair. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2305468. [PMID: 37681640 DOI: 10.1002/adma.202305468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/05/2023] [Indexed: 09/09/2023]
Abstract
Intervertebral disc degeneration (IVDD) is a global public health issue. The injury of annulus fibrosus (AF) caused by acupuncture or discectomy can trigger IVDD again. However, there is currently no suitable method for treating AF injury. In this study, the high-strength smart microneedles (MNs) which can penetrate the AF tissue through a local and minimally invasive method, and achieve remote control of speeded-up release of the drug and hyperthermia by the Near Infrared is developed. The PDA/GelMA composite MNs loaded with diclofenac sodium are designed to extracellularly "offend" the inflammatory microenvironment and mitigate damage to cells, and intracellularly increase the level of cytoprotective heat shock proteins to enhance the defense against the hostile microenvironment, achieving "offensive and defensive" effects. In vitro experiments demonstrate that the synergistic treatment of photothermal therapy and anti-inflammation effectively reduces inflammation, inhibits cell apoptosis, and promotes the synthesis of the extracellular matrix (ECM). In vivo experiments show that the MNs mitigate the inflammatory response, promote ECM deposition, reduce the level of apoptosis, and restore the biomechanical properties of the intervertebral disc (IVD) in rats. Overall, this high-strength smart MNs display promising "offensive and defensive" effects that can provide a new strategy for IVD repair.
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Affiliation(s)
- Qingchen Meng
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - En Xie
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Heng Sun
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Huan Wang
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Jiaying Li
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Zhao Liu
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Kexin Li
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Jie Hu
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Qianglong Chen
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Chaoyong Liu
- Beijing Advanced Innovation Center for Soft Matter Science and Engineering, College of Life Science and Technology, Beijing University of Chemical Technology, Beijing, 100029, China
| | - Bin Li
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
| | - Fengxuan Han
- Medical 3D Printing Center, Orthopedic Institute, Department of Orthopedic Surgery, The First Affiliated Hospital, School of Biology and Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, 215000, China
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158
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Yang S, Zhang Y, Peng Q, Meng B, Wang J, Sun H, Chen L, Dai R, Zhang L. Regulating pyroptosis by mesenchymal stem cells and extracellular vesicles: A promising strategy to alleviate intervertebral disc degeneration. Biomed Pharmacother 2024; 170:116001. [PMID: 38128182 DOI: 10.1016/j.biopha.2023.116001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Intervertebral disc degeneration (IVDD) is a main cause of low back pain (LBP), which can lead to disability and thus generate a heavy burden on society. IVDD is characterized by a decrease in nucleus pulposus cells (NPCs) and endogenous mesenchymal stem cells (MSCs), degradation of the extracellular matrix, macrophage infiltration, and blood vessel and nerve ingrowth. To date, the therapeutic approaches regarding IVDD mainly include conservative treatment and surgical intervention. However, both can only relieve symptoms rather than stop or revert the progression of IVDD, since the pathogenesis of IVDD is not yet clear. Pyroptosis, which is characterized by Caspase family dependence and conducted by the Gasdermin family, is a newly discovered mode of programmed cell death. Pyroptosis has been observed in NPCs, annulus fibrosus cells (AFCs), chondrocytes, MSCs, macrophages, vascular endothelial cells and neurons and may contribute to IVDD. MSCs are a kind of pluripotent stem cell that can be found in almost all tissues. MSCs have a strong ability to secrete extracellular vesicles (EVs), which contain exosomes, microvesicles and apoptotic bodies. EVs derived from MSCs play an important role in pyroptosis regulation and could be beneficial for alleviating IVDD. This review focuses on clarifying the regulation of pyroptosis to improve IVDD by MSCs and EVs derived from MSCs.
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Affiliation(s)
- Sheng Yang
- Department of Orthopedics, Graduate School of Dalian Medical University, Dalian 116044, China
| | - Yongbo Zhang
- Department of Orthopedics, Graduate School of Dalian Medical University, Dalian 116044, China
| | - Qing Peng
- Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - Bo Meng
- Department of Orthopedics, Graduate School of Dalian Medical University, Dalian 116044, China
| | - Jiabo Wang
- Department of Orthopedics, Huai'an 82 Hospital, Huai'an 223003, China
| | - Hua Sun
- Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - Liuyang Chen
- Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - Rui Dai
- Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, China
| | - Liang Zhang
- Department of Orthopedics, Clinical Medical College, Yangzhou University, Yangzhou 225001, China.
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159
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Kong Q, Li T, Reddy S, Hodges S, Kong J. Brain stimulation targets for chronic pain: Insights from meta-analysis, functional connectivity and literature review. Neurotherapeutics 2024; 21:e00297. [PMID: 38237403 PMCID: PMC10903102 DOI: 10.1016/j.neurot.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 02/16/2024] Open
Abstract
Noninvasive brain stimulation (NIBS) techniques have demonstrated their potential for chronic pain management, yet their efficacy exhibits variability across studies. Refining stimulation targets and exploring additional targets offer a possible solution to this challenge. This study aimed to identify potential brain surface targets for NIBS in treating chronic pain disorders by integrating literature review, neuroimaging meta-analysis, and functional connectivity analysis on 90 chronic low back pain patients. Our results showed that the primary motor cortex (M1) (C3/C4, 10-20 EEG system) and prefrontal cortex (F3/F4/Fz) were the most used brain stimulation targets for chronic pain treatment according to the literature review. The bilateral precentral gyrus (M1), supplementary motor area, Rolandic operculum, and temporoparietal junction, were all identified as common potential NIBS targets through both a meta-analysis sourced from Neurosynth and functional connectivity analysis. This study presents a comprehensive summary of the current literature and refines the existing NIBS targets through a combination of imaging meta-analysis and functional connectivity analysis for chronic pain conditions. The derived coordinates (with integration of the international electroencephalography (EEG) 10/20 electrode placement system) within the above brain regions may further facilitate the localization of these targets for NIBS application. Our findings may have the potential to expand NIBS target selection beyond current clinical trials and improve chronic pain treatment.
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Affiliation(s)
- Qiao Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Tingting Li
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Sveta Reddy
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Sierra Hodges
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA.
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160
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Hernandez-Lucas P, Leirós-Rodríguez R, Lopez-Barreiro J, García-Soidán JL. Prevention of non-specific back pain through exercise and education: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2024; 37:585-598. [PMID: 38217578 DOI: 10.3233/bmr-230252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Clinical practice guidelines stress the importance of prevention and treatment of non-specific back pain through exercise therapy. However, it has not yet been confirmed whether the combination of exercise plus education is more effective than such interventions taken separately. OBJECTIVE To determine if the combination of exercise plus education is more effective for the prevention of non-specific back pain than exercise or education alone. METHOD A systematic search of studies whose sample consisted of participants without non-specific back pain (primary prevention) and participants with non-specific back pain (secondary and tertiary prevention) was conducted in the following databases in March 2023: PubMed, Scopus, Web of Science and Medline. RESULTS A total of 16 articles were selected. Statistically significant results were found in the pain variable with SMD =-2.02 (95% CI =-2.71 to -1.33; p< 0.001), the disability variable with SMD =-1.14 (95% CI =-1.63 to -0.65; p< 0.001), and the kinesiophobia variable with SMD =-1.8 (95% CI =-2.54 to -1.05; p< 0.001). CONCLUSION Interventions that combine exercise and education seem to have a greater preventive effect on non-specific back pain, disability and kinesiophobia than those that include exercise or education in an isolated manner.
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Affiliation(s)
- Pablo Hernandez-Lucas
- Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of León, Ponferrada, Spain
| | - Juan Lopez-Barreiro
- Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain
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He JY, Tu XY, Yin ZF, Mu H, Luo MJ, Chen XY, Cai WB, Zhao X, Peng C, Fang FF, Lü C, Li B. Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain: A prospective, multicenter randomized trial. JOURNAL OF INTEGRATIVE MEDICINE 2024; 22:39-45. [PMID: 38311541 DOI: 10.1016/j.joim.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/04/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND As one of the most common musculoskeletal ailments, chronic nonspecific low-back pain (CNLBP) causes persistent disability and substantial medical expenses. Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising. Recent guidelines indicate a reduced role for medicines in the management of CNLBP. OBJECTIVE The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm, compared to nonsteroidal anti-inflammatory drug (NSAID) with a capsaicin plaster, in the treatment of CNLBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS We designed a prospective multicenter randomized clinical trial enrolling patients from January 1, 2022 to December 31, 2022. A total of 156 patients with CNLBP were randomized into two parallel groups. Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally. Patients in the test group were treated with cupping and scraping using a medical device and medicated balm. MAIN OUTCOME MEASURES Primary outcome was pain recorded using the visual analogue scale (VAS). Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale (JOA) and the traditional Chinese medicine (TCM) syndrome integral scale (TCMS) as assessment tools. RESULTS Between baseline and postintervention, all changes in outcome metric scales were statistically significant (P < 0.001). Compared to the control group, patients in the test group had a significantly greater treatment effect in all outcome variables, as indicated by lower VAS and TCMS scores and higher JOA scores, after the one-week intervention period (P < 0.001). Further, according to the findings of multivariate linear regression analysis, the participants' pain (VAS score) was related to their marital status, age, smoking habits and body mass index. No adverse reactions were reported for any participants in this trial. CONCLUSION The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters, regarding to pain intensity, TCM symptoms and quality of life. The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects. TRIAL REGISTRATION This study was registered at Chinese Clinical Trial Registry (ChiCTR2200055655). Please cite this article as: He JY, Tu XY, Yin ZF, Mu H, Luo MJ, Chen XY, Cai WB, Zhao X, Peng C, Fang FF, Lü C, Li B. Short-term effects of cupping and scraping therapy for chronic nonspecific low-back pain: A prospective, multicenter randomized trial. J Integr Med. 2024; 22(1): 39-45.
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Affiliation(s)
- Jun-Yan He
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Xiao-Yu Tu
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Zi-Fei Yin
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China
| | - Hui Mu
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Ming-Jun Luo
- Department of Rehabilitation Medicine and Training, PLA 458 Hospital, Guangzhou 510602, Guangdong Province, China
| | - Xing-Yu Chen
- Department of Rehabilitation Medicine and Training, PLA 458 Hospital, Guangzhou 510602, Guangdong Province, China
| | - Wei-Bin Cai
- No.3 Ward of Acupuncture Rehabilitation Department, Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou 510095, Guangdong Province, China
| | - Xue Zhao
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China
| | - Can Peng
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China
| | - Fan-Fu Fang
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.
| | - Can Lü
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.
| | - Bai Li
- School of Traditional Chinese Medicine, Naval Medical University, Shanghai 200433, China; Department of Rehabilitation Medicine and Physiotherapy, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.
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Li XC, Wang W, Jiang C, Chen YL, Chen JH, Zhang ZW, Luo SJ, Chen RC, Mo PF, Zhong ML, Shi JY, Huang CM, Chen Q, Wu YH. CD206 + M2-like macrophages protect against intervertebral disc degeneration partially by targeting R-spondin-2. Osteoarthritis Cartilage 2024; 32:66-81. [PMID: 37802465 DOI: 10.1016/j.joca.2023.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/31/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE This study aimed to explore the specific function of M2 macrophages in intervertebral disc degeneration (IDD). METHODS Intervertebral disc (IVD) samples from normal (n = 4) and IDD (n = 6) patients were collected, and the expression of M2-polarized macrophage marker, CD206, was investigated using immunohistochemical staining. Nucleus pulposus cells (NPCs) in a TNF-α environment were obtained, and a mouse caudal IVD puncture model was established. Mice with Rheb deletions, specifically in the myeloid lineage, were generated and subjected to surgery-induced IDD. IDD-induced damage and cell apoptosis were measured using histological scoring, X-ray imaging, immunohistochemical staining, and TdT-mediated dUTP nick end labeling (TUNEL) assay. Finally, mice and NPCs were treated with R-spondin-2 (Rspo2) or anti-Rspo2 to investigate the role of Rspo2 in IDD. RESULTS Accumulation of CD206 in human and mouse IDD tissues was detected. Rheb deletion in the myeloid lineage (RheBcKO) increased the number of CD206+ M2-like macrophages (mean difference 18.6% [15.7-21.6%], P < 0.001), decreased cell apoptosis (mean difference -15.6% [-8.9 to 22.2%], P = 0.001) and attenuated the IDD process in the mouse IDD model. NPCs treated with Rspo2 displayed increased extracellular matrix catabolism and apoptosis; co-culture with a conditioned medium derived from RheBcKO mice inhibited these changes. Anti-Rspo2 treatment in the mouse caudal IVD puncture model exerted protective effects against IDD. CONCLUSIONS Promoting CD206+ M2-like macrophages could reduce Rspo2 secretion, thereby alleviating experimental IDD. Rheb deletion may help M2-polarized macrophages accumulate and attenuate experimental IDD partially by inhibiting Rspo2 production. Hence, M2-polarized macrophages and Rspo2 may serve as therapeutic targets for IDD.
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Affiliation(s)
- Xiao-Chuan Li
- Department of Orthopedic Surgery, Gaozhou People's Hospital, No.89 XiGuan Rd, Gaozhou 525200, Guangdong, China; Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Postdoctoral Innovation Practice Base of Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China
| | - Wei Wang
- Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Graduate School of Guangdong Medical University, No. 2, Wenming East Road, Zhanjiang 524023, Guangdong, China
| | - Cheng Jiang
- Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Graduate School of Guangdong Medical University, No. 2, Wenming East Road, Zhanjiang 524023, Guangdong, China
| | - Yong-Long Chen
- Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Graduate School of Guangdong Medical University, No. 2, Wenming East Road, Zhanjiang 524023, Guangdong, China
| | - Jiong-Hui Chen
- Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Graduate School of Guangdong Medical University, No. 2, Wenming East Road, Zhanjiang 524023, Guangdong, China
| | - Zhen-Wu Zhang
- Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China; Graduate School of Guangdong Medical University, No. 2, Wenming East Road, Zhanjiang 524023, Guangdong, China
| | - Shao-Jian Luo
- Department of Orthopedic Surgery, Gaozhou People's Hospital, No.89 XiGuan Rd, Gaozhou 525200, Guangdong, China
| | - Rong-Chun Chen
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China
| | - Ping-Fan Mo
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China
| | - Ming-Liang Zhong
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China
| | - Jiang-You Shi
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China
| | - Chun-Ming Huang
- Department of Orthopedic Surgery, Gaozhou People's Hospital, No.89 XiGuan Rd, Gaozhou 525200, Guangdong, China; Central Laboratory of Orthopedics, Gaozhou People's Hospital, XiGuan Rd, Gaozhou 525200, China.
| | - Qin Chen
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China.
| | - Yao-Hong Wu
- Department of Spinal Surgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Ganzhou 341000, Jiangxi, China.
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Bastiaens F, van de Wijgert IH, Bronkhorst EM, van Roosendaal BKWP, van Heteren EPZ, Gilligan C, Staats P, Wegener JT, van Hooff ML, Vissers KCP. Factors Predicting Clinically Relevant Pain Relief After Spinal Cord Stimulation for Patients With Chronic Low Back and/or Leg Pain: A Systematic Review With Meta-Analysis and Meta-Regression. Neuromodulation 2024; 27:70-82. [PMID: 38184342 DOI: 10.1016/j.neurom.2023.10.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 01/08/2024]
Abstract
RATIONALE To optimize results with spinal cord stimulation (SCS) for chronic low back pain (CLBP) and/or leg pain, including persistent spinal pain syndrome (PSPS), careful patient selection based on proved predictive factors is essential. Unfortunately, the necessary selection process required to optimize outcomes of SCS remains challenging. OBJECTIVE This review aimed to evaluate predictive factors of clinically relevant pain relief after SCS for patients with CLBP and/or radicular leg pain, including PSPS. MATERIALS AND METHODS In August 2023, PubMed, Cinahl, Cochrane, and EMBASE were searched to identify studies published between January 2010 and August 2023. Studies reporting the percentage of patients with ≥50% pain relief after SCS in patients with CLBP and leg pain, including PSPS at 12 or 24 months, were included. Meta-analysis was conducted to pool results for back, leg, and general pain relief. Predictive factors for pain relief after 12 months were examined using univariable and multivariable meta-regression. RESULTS A total of 27 studies (2220 patients) were included for further analysis. The mean percentages of patients with substantial pain relief were 68% for leg pain, 63% for back pain, and 73% for general pain at 12 months follow-up, and 63% for leg pain, 59% for back pain, and 71% for general pain at 24 months follow-up assessment. The implantation method and baseline Oswestry Disability Index made the multivariable meta-regression model for ≥50% back pain relief. Sex and pain duration made the final model for ≥50% leg pain relief. Variable stimulation and implantation method made the final model for general pain relief. CONCLUSIONS This review supports SCS as an effective pain-relieving treatment for CLBP and/or leg pain, and models were developed to predict substantial back and leg pain relief. To provide high-grade evidence for predictive factors, SCS studies of high quality are needed in which standardized factors predictive of SCS success, based on in-patient improvements, are monitored and reported.
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Affiliation(s)
- Ferdinand Bastiaens
- Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Anesthesiology and Pain Medicine, Sint Maartenskliniek, Nijmegen, The Netherlands.
| | - Ilse H van de Wijgert
- Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Esther P Z van Heteren
- Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christopher Gilligan
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA, USA
| | - Peter Staats
- National Spine and Pain, ElectroCore, Inc, Jacksonville, FL, USA
| | - Jessica T Wegener
- Department of Anesthesiology and Pain Medicine, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Miranda L van Hooff
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kris C P Vissers
- Department of Anesthesiology, Pain, and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Anesthesiology and Pain Medicine, Sint Maartenskliniek, Nijmegen, The Netherlands
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Nielsen LM, Getz EN, Young JL, Rhon DI. Preoperative conservative treatment is insufficiently described in clinical trials of lumbar fusion: a scoping review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:264-273. [PMID: 37803158 DOI: 10.1007/s00586-023-07926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE To identify how pre-surgical conservative care is characterized and reported in randomized controlled trials of adults undergoing elective lumbar fusion, including duration and type of treatment. METHODS The study design is a scoping review. Data sources include PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Ovid Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). All randomized controlled trials published in English between January 1, 2005, and February 15, 2022, assessing lumbar fusion as the intervention were included in this review. RESULTS Of 166 studies, 62.0% reported a failure in conservative care prior to lumbar fusion, but only 15.1% detailed the type of specific conservative care received. None of the trials provided sufficient details to understand the nature of the pre-surgical conservative treatment, such as frequency, recency/timing, or dosage of conservative interventions. CONCLUSION Although roughly two-thirds of trials reported that patients failed conservative care prior to receiving a lumbar fusion, few studies named the conservative intervention provided and no studies provided any details regarding dosing or recency of care. This lack of information creates ambiguity in the surgical decision-making process, setting the assumption that all patients received adequate conservative care prior to surgery. Details about pre-surgical conservative care should be disclosed to allow for appropriate clinical application, decision-making, and interpretation of treatment effects.
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Affiliation(s)
- Lauren M Nielsen
- Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA.
| | - Emily N Getz
- Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA
| | - Jodi L Young
- Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA
| | - Daniel I Rhon
- Doctor of Science in Physical Therapy Program, Bellin College, Eaton Road, Green Bay, WI, 54311, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Sun H, Xiao D, Liu W, Li X, Lin Z, Li Y, Ding Y. Well-known polypeptides of deer antler velvet with key actives: modern pharmacological advances. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:15-31. [PMID: 37555852 DOI: 10.1007/s00210-023-02642-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023]
Abstract
Deer antler velvet, with kidney tonifying, promoting the production of essence and blood, strengthening tendons and bones, not only has a thousand-year medicinal history but also its modern pharmacology mainly focuses on its active polypeptides on motor, nerve, and immune systems. The purpose of this report is to fill the gap in the comprehensive, systematic, and detailed review of polypeptides during the recent 30 years (1992-2023). The research method was to review 53 pharmacological articles from the Public Medicine, Web of science, ACS, and Science Direct database sources by searching the keywords "pilose antler," "deer velvet," "Pilose Antler Peptide (PAP) and Velvet Antler Polypeptide (VAP)." The results showed that deer antler polypeptides (DAPs), by regulating EGF, EGFR, MAPK, P38, ERK, NF-κB, Wnt, PI3K, Akt, MMP, AMPK, Stir1, NLRP3, HO-1, Nrf, Rho, TLR, TGF-β, Smad, Ang II, etc., revealed their effects on seven system-related diseases and their mechanisms, including osteoarthritis, intervertebral disc degeneration, osteoporosis, Alzheimer's, Parkinson's, triple-negative breast cancer, liver injury, liver fibrosis, cardiovascular disease, acute lung injury, and late-onset hypogonadism. In conclusion, DAPs have good effects on motor and other system-related diseases, but the secondary and tertiary structures of DAPs (0.5-1800 KDa) need to be further elucidated, and the structure-activity relationship study is still unavailable and needs to be covered. It is expected that this review may provide the necessary literature support for further research. The activities and mechanisms of polypeptides from the past 30 years (1992-2023) are summarized covering seven systems, related diseases, and its regulatory genes and proteins.
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Affiliation(s)
- He Sun
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Dandan Xiao
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Wei Liu
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Xue Li
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Zhe Lin
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China
| | - Yong Li
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China.
| | - Yuling Ding
- School of Pharmaceutical Sciences, Changchun University of Chinese Medicine, Changchun, 130117, Jilin, China.
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Van den Heuvel SAS, Cohen SPC, de Andrès Ares J, Van Boxem K, Kallewaard JW, Van Zundert J. 3. Pain originating from the lumbar facet joints. Pain Pract 2024; 24:160-176. [PMID: 37640913 DOI: 10.1111/papr.13287] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/19/2023] [Accepted: 08/04/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Pain originating from the lumbar facets can be defined as pain that arises from the innervated structures comprising the joint: the subchondral bone, synovium, synovial folds, and joint capsule. Reported prevalence rates range from 4.8% to over 50% among patients with mechanical low back pain, with diagnosis heavily dependent on the criteria employed. In well-designed studies, the prevalence is generally between 10% and 20%, increasing with age. METHODS The literature on the diagnosis and treatment of lumbar facet joint pain was retrieved and summarized. RESULTS There are no pathognomic signs or symptoms of pain originating from the lumbar facet joints. The most common reported symptom is uni- or bilateral (in more advanced cases) axial low back pain, which often radiates into the upper legs in a non-dermatomal distribution. Most patients report an aching type of pain exacerbated by activity, sometimes with morning stiffness. The diagnostic value of abnormal radiologic findings is poor owing to the low specificity. SPECT can accurately identify joint inflammation and has a predictive value for diagnostic lumbar facet injections. After "red flags" are ruled out, conservatives should be considered. In those unresponsive to conservative therapy with symptoms and physical examination suggesting lumbar facet joint pain, a diagnostic/prognostic medial branch block can be performed which remains the most reliable way to select patients for radiofrequency ablation. CONCLUSIONS Well-selected individuals with chronic low back originating from the facet joints may benefit from lumbar medial branch radiofrequency ablation.
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Affiliation(s)
- Sandra A S Van den Heuvel
- Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Steven P C Cohen
- Anesthesiology, Pain Medicine Division, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | - Koen Van Boxem
- Anesthesiology, Critical Care and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk, Belgium
- Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jan Willem Kallewaard
- Anesthesiology and Pain Medicine, Rijnstate Ziekenhuis, Velp, The Netherlands
- Anesthesiology and Pain Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan Van Zundert
- Anesthesiology, Critical Care and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk, Belgium
- Anesthesiology and Pain Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
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Pickering ME, Javier RM, Malochet S, Pickering G, Desmeules J. Osteoporosis treatment and pain relief: A scoping review. Eur J Pain 2024; 28:3-20. [PMID: 37403555 DOI: 10.1002/ejp.2156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 05/11/2023] [Accepted: 06/17/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Anti-osteoporosis (OP) drugs have been suggested to contribute to pain reduction during OP management. This scoping review aimed at mapping the literature on pain relief with anti-OP drugs in OP treatment. DATABASES AND DATA TREATMENT Medline, Pubmed and Cochrane databases were searched by two reviewers with keywords combinations. Randomized controlled and real-life English studies, pain as an endpoint, antiosteoporosis drugs were inclusion criteria. Case reports, surveys, comment letters, conference abstracts, animal studies and grey literature were excluded. Predetermined data were extracted by two reviewers and disagreement solved through discussion. RESULTS A total of 130 articles were identified, 31 publications were included, 12 randomized clinical trials and 19 observational studies. Pain reduction was assessed by different tools: Visual Analogue Scale, Verbal Rating Scale, Facial Scale or as a domain of quality of life questionnaires including Short form 8, 36, mini-OP, Japanese OP, Qualeffo, Roland Morris Disability questionnaires. Collective data show that anti-OP drugs may display an analgesic effect that may be linked to the local mode of action of drugs on bone and consecutive modulation of pain sensitization. The methodology of the studies showed a heterogeneity of endpoints, comparators, statistical approaches and follow-up duration. CONCLUSION Considering the limitations of the literature, there is a need for more rigorous trials and larger real-life studies taking into account the recommendations published for research in rheumatology and in pain medicine. The identification of responders, patient subtypes, and of analgesic-effect doses would allow optimization and individualization for pain relief in patients with OP. SIGNIFICANCE STATEMENT This scoping review shows that anti-OP drugs may improve pain and quality of life of patients with OP. The heterogeneity in design, choice of endpoints, methodology, comparators and follow-up duration of included randomized clinical trials and real-life studies does not allow so far to identify a predominant antiosteoporosis drug or an optimal dosage for pain relief. These gaps need to be addressed and warrant further research in the future for optimizing pain improvement in the course of OP drug treatment.
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Affiliation(s)
| | - Rose-Marie Javier
- Centre d'Evaluation et de Traitement de la Douleur et Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sandrine Malochet
- Rheumatology Department, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Gisele Pickering
- Clinical Investigation Center, PIC/CIC, University Hospital, CHU, Clermont-Ferrand, France
| | - Jules Desmeules
- Service de Pharmacologie et Toxicologie Cliniques, Centre multidisciplinaire de la douleur, Hôpitaux Universitaires de Genève, Geneva, Switzerland
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Wu Z, Zhou T, Ai S. Extracorporeal shock wave therapy for low back pain: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e36596. [PMID: 38206739 PMCID: PMC10754595 DOI: 10.1097/md.0000000000036596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND To provide high-quality evidence for extracorporeal shock wave therapy (ESWT) for low back pain (LBP). METHODS A computerized search screened trials of ESWT for LBP, and the time range was from the establishment of databases to August 2023, including CNKI, CBMdisc, Wanfang Data, VIP, PubMed, Web of Science, Embase, and Cochrane databases. The outcomes were extracted, including patients' pain, physical and psychological conditions, and adverse reactions. Meta-analysis was completed using Revman 5.4 and Stata 15 software, and GRADEpro software quantitated rate the evidence and assigned a recommendation strength. RESULTS This meta-analysis included 22 studies involving 1749 patients. After treatment, patients in the ESWT group had lower scores in the visual analog scale (VAS) (mean difference [MD] = -1.14, 95% confidence interval [CI] (-1.47, -0.80), P < .00001), Oswestry disability index (ODI) [MD = -6.01, 95%CI (-7.97, -4.05), P < .00001], and Beck depression inventory [MD = -3.89, 95%CI (-6.59, -1.20), P = .005]; finger-floor distance [MD = -3.71, 95%CI (-5.26, -2.17), P < .00001] was shorter; Japanese orthopedic association scores [MD = 3.20, 95%CI (1.56, 4.85), P = .0001] were higher; at the 3-month follow-up, the VAS [MD = -1.29, 95%CI (-2.39, -0.19), P = .02] and ODI [MD = -5.95, 95%CI (-10.06, -1.84), P = .005] remained lower; adverse reactions [odds ratio = 0.19, 95%CI (0.07, 0.52), P = .001] were less, and the valid cases [odds ratio = 3.84, 95%CI (2.47, 5.96), P < .00001] were more. Sensitivity analyses revealed that the results were stable; Egger test found no publication bias in VAS (P = .270) and valid cases (P = .747); the trim and fill analysis tested the robustness of ODI scores due to the publication bias (P = .029), and the effect sizes before and after the trim and fill were consistent, which means the result was robust. CONCLUSION ESWT for LBP has efficacy and safety in improving pain, dysfunction, and psychological conditions compared to other therapies. ESWT has shown advantages in terms of long-term efficacy. Randomized controlled trials with larger sample sizes and more objective outcomes are required.
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Affiliation(s)
- Zhuorao Wu
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianqi Zhou
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuangchun Ai
- College of Health and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Rehabilitation Medicine, Mianyang Hospital, Chengdu University of Traditional Chinese Medicine, Mianyang, China
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169
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Espin A, Núñez-Cortés R, Irazusta J, Rodriguez-Larrad A, Torres-Unda J, Vinstrup J, Jakobsen MD, Andersen LL. Mental health and vitality predict spinal pain in healthcare workers. Occup Med (Lond) 2023; 73:464-469. [PMID: 37665779 DOI: 10.1093/occmed/kqad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Despite extensive investigation of ergonomic risk factors for spinal pain in healthcare workers, limited knowledge of psychological risk factors exists. AIMS To assess the prospective association of mental health and vitality with development of spinal pain in healthcare workers. METHODS A prospective cohort study was carried out involving 1950 healthcare workers from 19 hospitals in Denmark. Assessments were done at baseline and at 1-year follow-up. Mental health and vitality were measured using the Short Form-36 Health Survey, while spinal pain intensity was measured using a 0-10 scale in the low-back, upper-back and neck, respectively. Cumulative logistic regressions adjusted for several confounding factors were applied, reporting risk estimates as odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Using good mental health as reference, moderate (but not poor) mental health at baseline was associated with increased pain intensity in the low-back (OR: 1.41 [95% CI: 1.21-1.77]), upper-back (OR: 1.63 [95% CI: 1.31-2.02]) and neck (OR: 1.31 [95% CI: 1.07-1.61]) at 1-year follow-up. Likewise, using high vitality as reference, both moderate and low vitality at baseline were associated with increased pain intensity in the low-back (OR: 1.54 [95% CI: 1.22-1.94] and OR: 2.34 [95% CI: 1.75-3.12], respectively), upper-back (OR: 1.72 [95% CI: 1.34-2.23] and OR: 2.46 [95% CI: 1.86-3.25], respectively) and neck (OR: 1.66 [95% CI: 1.34-2.06] and OR: 2.06 [95% CI: 1.61-2.63], respectively) at 1-year follow-up. CONCLUSIONS Compared to healthcare workers with good mental health and high vitality, those with moderate mental health and low/moderate vitality, respectively, were more likely to increase spinal pain intensity at 1-year follow-up. These components should also be considered in the prevention of spinal pain in healthcare workers.
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Affiliation(s)
- A Espin
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - R Núñez-Cortés
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Department of Physical Therapy, Faculty of Medicine, University of Chile, 8380000 Santiago, Chile
| | - J Irazusta
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - A Rodriguez-Larrad
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Clinical Nursing and Community Health Research Group, Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
| | - J Torres-Unda
- Ageing on Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - J Vinstrup
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - M D Jakobsen
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
| | - L L Andersen
- Department of Musculoskeletal Disorders, National Research Centre for the Working Environment, 2100 Copenhagen, Denmark
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170
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Belluzzi E, Pozzuoli A, Ruggieri P. Musculoskeletal Diseases: From Molecular Basis to Therapy. Biomedicines 2023; 12:32. [PMID: 38255139 PMCID: PMC10813464 DOI: 10.3390/biomedicines12010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Musculoskeletal diseases (MSDs) comprise a plethora of different disorders (more than 150 conditions) affecting the locomotor system [...].
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Affiliation(s)
- Elisa Belluzzi
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 3, 35128 Padova, Italy;
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 3, 35128 Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy
| | - Assunta Pozzuoli
- Musculoskeletal Pathology and Oncology Laboratory, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 3, 35128 Padova, Italy;
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 3, 35128 Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy
| | - Pietro Ruggieri
- Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padova, Via Giustiniani 3, 35128 Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, 35131 Padova, Italy
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171
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Zhou L, Feng X, Zheng R, Wang Y, Sun M, Liu Y. The correlation between pregnancy-related low back pain and physical fitness evaluated by an index system of maternal physical fitness test. PLoS One 2023; 18:e0294781. [PMID: 38127938 PMCID: PMC10734947 DOI: 10.1371/journal.pone.0294781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
To investigate incidence of pregnancy-related low back pain (LBP), evaluate physical fitness objectively during pregnancy and analyze the correlation between LBP and physical fitness of pregnant women, 180 pregnant women including 101 in mid-gestation (14-28 gestational weeks) and 79 in late-gestation (28-37 gestational weeks) were recruited and self-reported their LBP. The aerobic ability such as cardiorespiratory fitness and anaerobic ability including strength, endurance, speed, flexibility, and balance were evaluated by a novel materal physical fitness test system. The correlation between LBP and each component in physical fitness test system was analyzed in SPSS. As the results, 135 out of 180 participants (75% of total) had pregnancy-related LBP. Physical fitness of participants in late-gestation was significantly weaker including weaker back strength (p<0.05), less resistance band pullbacks in 30s (p<0.01), less stretching in sit-and-reach test (p<0.001), shorter duration in left legged blind balance test (p<0.05) and weaker bird dog balance(p<0.05) than those in mid-gestation. Correlation analysis indicated that LBP was negatively associated with standing heel raises in 20s (p<0.01) and standing glute kickbacks in 30s (left p<0.01, right p<0.05). Thus, it is concluded that LBP is in high prevalence throughout the entire pregnant course. The pregnant women are prone to have weakened strength of core muscle groups and poorer flexibility and balance along the pregnancy. In addition, their LBP was negatively correlated to strength of back muscle groups of lower limbs.
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Affiliation(s)
- Longfeng Zhou
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Xiaoyi Feng
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Ruimin Zheng
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuhan Wang
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Mengyun Sun
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Liu
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
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172
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Allen S, Rashid A, Adjani A, Akram M, Khan FS, Sherwani R, Khalil MT. Efficacy and safety of thermobalancing therapy with Dr Allen's Device for chronic low back pain: A randomised controlled trial. World J Orthop 2023; 14:878-888. [PMID: 38173805 PMCID: PMC10758594 DOI: 10.5312/wjo.v14.i12.878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/12/2023] [Accepted: 11/08/2023] [Indexed: 12/15/2023] Open
Abstract
BACKGROUND Lumbar disc herniation and non-specific low back pain are common conditions that seriously affect patients' health-related quality of life (HRQoL). Although empirical evidence has demonstrated that novel Thermobalancing therapy and Dr Allen's Device can relieve chronic low back pain, there have been no randomised controlled trials for these indications. AIM To evaluate the efficacy of Dr Allen's Device in lumbar disc herniation (LDH) and non-specific low back pain (NSLBP). METHODS A randomised clinical trial was conducted investigating 55 patients with chronic low back pain due to LDH (n = 28) or NSLBP (n = 27), out of which 15 were randomly assigned to the control group and 40 were assigned to the treatment group. The intervention was treatment with Dr Allen's Device for 3 mo. Changes in HRQoL were assessed using the Numerical Pain Rating Scale and the Japanese Orthopedic Association Back Pain Questionnaire. RESULTS Thermobalancing therapy with Dr Allen's Device showed a significant reduction in pain in the treatment group (P < 0.001), with no recorded adverse effects. Both pain assessment scales showed a significant improvement in patients' perception of pain indicating improvement in HRQoL. CONCLUSION The out-of-hospital use of Thermobalancing therapy with Dr Allen's Device for Low Back Treatment relieves chronic low back pain significantly and without adverse effects, improves the level of activity and HRQoL among patients with LDH and NSLBP. This study demonstrates the importance of this safe first-line therapy that can be used for effective at-home management of chronic low back pain.
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Affiliation(s)
- Simon Allen
- Director and Head of Medical Research, Fine Treatment, Oxford OX2 7SL, United Kingdom
| | - Abid Rashid
- Director of Faculty of Medical Sciences, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Ariana Adjani
- Senior Researcher, Fine Treatment, Oxford OX2 7SL, United Kingdom
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad 38000, Pakistan
| | - Fahad Said Khan
- Faculty of Medical and Health Sciences, University of Poonch Rawalakot, Rawalakot 12350, Pakistan
| | - Rehan Sherwani
- College of Statistical and Actuarial Science, University of the Punjab, Lahore 54000, Pakistan
| | - Muhammad Talha Khalil
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad 38000, Pakistan
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173
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Ślusarczyk WT, Nejman TJ, Laskowski M, Koperczak A, Stanuszek A, Ciekalski M. Evaluation of Patient's Quality of Life before and after Implantation of Abbott's Proclaim™ XR Spinal Cord Stimulator with BurstDR™ Stimulation in Chronic Pain Syndrome. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2192. [PMID: 38138295 PMCID: PMC10744504 DOI: 10.3390/medicina59122192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: In case of the ineffectiveness of pharmacological and non-pharmacological treatments in managing chronic neuropathic pain, spinal cord stimulation (SCS) with BurstDR™ stimulation may reduce pain and increase the quality of life. The term "burst" refers to a series of stimulation impulses that are compressed into small packets and separated by intervals of latency. Materials and Methods: A group of 30 consecutive patients who received the BurstDR™ stimulator using the minimally invasive percutaneous method was selected. Patients selected for our study underwent numerous spinal surgeries before SCS implantation. In the study, analgesics and co-analgesics and their doses used by patients before and 6 months after SCS implantation were examined and compared. Using the visual analogue scale (VAS), pain was compared before and after the procedure. Patients` quality of life was assessed using the Oswestry Disability Index (ODI). Results: We observed a significant reduction in opioid daily doses by an average of 32.4% (±36.1%) and a reduction in paracetamol daily doses by an average of 40% (±33.4%). There was a reduction in pregabalin doses as well. Ketoprofen daily dose reduction was 85.4 mg. The mean VAS difference before and after procedure was 3.9 (±2.3), and the mean difference in ODI was 12.9 (±9), which benefits operative treatment. The VAS and ODI results were statistically significant as well. Conclusions: According to our research, BurstDR™ stimulation improves the quality of life by reducing doses of analgesics and the level of pain.
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Affiliation(s)
- Wojciech Tomasz Ślusarczyk
- Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; (T.J.N.)
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174
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Ratajczak M, Waszak M, Śliwicka E, Wendt M, Skrypnik D, Zieliński J, Krutki P. In search of biomarkers for low back pain: can traction therapy effectiveness be prognosed by surface electromyography or blood parameters? Front Physiol 2023; 14:1290409. [PMID: 38143914 PMCID: PMC10739392 DOI: 10.3389/fphys.2023.1290409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Background: Lumbar traction therapy is a common method to reduce low back pain (LBP) but is not always effective. The search for biomarkers that would prognose the effectiveness of LBP management is one priority for improving patients' quality of life. Objectives: 1) To determine the phenotype of patients benefiting most from lumbar traction therapy. 2) To correlate systemic and electromyographic biomarkers with pain and pain-related disability. Methods: Data on muscle bioelectrical activity (surface electromyography [SEMG]) in the flexion-extension task, the concentrations of twelve systemic biochemical factors, LBP intensity (Visual Analog Scale), the Oswestry Disability Index, and the Roland-Morris Disability Questionnaire (RMDQ) were collected before and 72 h after 20 sessions of lumbar traction therapy. Patients were divided into responders and nonresponders based on the criterion of a 50% reduction in maximal pain. Results: The responders had lower maximal muscle bioactivity in the extension phase on the left side (p < 0.01) and higher flexion-extension ratios on both sides of the body in the SEMG (left: p < 0.05; right: p < 0.01), and higher adipsin, interleukin-2, interleukin-4, and interleukin-10 concentrations (p < 0.05) than nonresponders. Patients with higher interleukin-4 concentrations before therapy achieved greater reductions in maximal pain in the sitting position, bioelectrical muscle activity in flexion, and flexion-relaxation ratio on the left side of the body. Changes in adipsin and interleukin-4 concentrations correlated with changes in LBP intensity (r = 0.68; r = -0.77). Changes in stem cell growth factor and interleukin-17A correlated with changes in RMDQ (R = 0.53) and bioelectrical muscle activity in extension (left: R = -0.67; right: R = -0.76), respectively. Conclusion: Responders to traction therapy had SEMG indices of less favorable muscle activity in the flexion-extension task and elevated indices of inflammation before the study. For the first time, interleukin-4 was indicated as a potential biomarker for prognosing post-therapy changes in pain intensity and muscle activity.
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Affiliation(s)
- Marzena Ratajczak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Małgorzata Waszak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Ewa Śliwicka
- Department of Physiology and Biochemistry, Poznan University of Physical Education, Poznan, Poland
| | - Michał Wendt
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Zieliński
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Piotr Krutki
- Department of Medical Biology, Poznan University of Physical Education, Poznan, Poland
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175
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Jiang W, Glaeser JD, Kaneda G, Sheyn J, Wechsler JT, Stephan S, Salehi K, Chan JL, Tawackoli W, Avalos P, Johnson C, Castaneda C, Kanim LEA, Tanasansomboon T, Burda JE, Shelest O, Yameen H, Perry TG, Kropf M, Cuellar JM, Seliktar D, Bae HW, Stone LS, Sheyn D. Intervertebral disc human nucleus pulposus cells associated with back pain trigger neurite outgrowth in vitro and pain behaviors in rats. Sci Transl Med 2023; 15:eadg7020. [PMID: 38055799 DOI: 10.1126/scitranslmed.adg7020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/06/2023] [Indexed: 12/08/2023]
Abstract
Low back pain (LBP) is often associated with the degeneration of human intervertebral discs (IVDs). However, the pain-inducing mechanism in degenerating discs remains to be elucidated. Here, we identified a subtype of locally residing human nucleus pulposus cells (NPCs), generated by certain conditions in degenerating discs, that was associated with the onset of discogenic back pain. Single-cell transcriptomic analysis of human tissues showed a strong correlation between a specific cell subtype and the pain condition associated with the human degenerated disc, suggesting that they are pain-triggering. The application of IVD degeneration-associated exogenous stimuli to healthy NPCs in vitro recreated a pain-associated phenotype. These stimulated NPCs activated functional human iPSC-derived sensory neuron responses in an in vitro organ-chip model. Injection of stimulated NPCs into the healthy rat IVD induced local inflammatory responses and increased cold sensitivity and mechanical hypersensitivity. Our findings reveal a previously uncharacterized pain-inducing mechanism mediated by NPCs in degenerating IVDs. These findings could aid in the development of NPC-targeted therapeutic strategies for the clinically unmet need to attenuate discogenic LBP.
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Affiliation(s)
- Wensen Jiang
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Juliane D Glaeser
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Giselle Kaneda
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julia Sheyn
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jacob T Wechsler
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stephen Stephan
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Khosrowdad Salehi
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Julie L Chan
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Wafa Tawackoli
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Pablo Avalos
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Christopher Johnson
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Chloe Castaneda
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Linda E A Kanim
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Teerachat Tanasansomboon
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Joshua E Burda
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Oksana Shelest
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Haneen Yameen
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Tiffany G Perry
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Michael Kropf
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Jason M Cuellar
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Dror Seliktar
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Hyun W Bae
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Laura S Stone
- Department of Biomedical Engineering, Israeli Institute of Technology Technion, Haifa 3200003, Israel
| | - Dmitriy Sheyn
- Orthopaedic Stem Cell Research Laboratory, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Board of Governors Regenerative Medicine Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Orthopedics, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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176
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Song C, Xu Y, Peng Q, Chen R, Zhou D, Cheng K, Cai W, Liu T, Huang C, Fu Z, Wei C, Liu Z. Mitochondrial dysfunction: a new molecular mechanism of intervertebral disc degeneration. Inflamm Res 2023; 72:2249-2260. [PMID: 37925665 DOI: 10.1007/s00011-023-01813-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE Intervertebral disc degeneration (IVDD) is a chronic degenerative orthopedic illness that causes lower back pain as a typical clinical symptom, severely reducing patients' quality of life and work efficiency, and imposing a significant economic burden on society. IVDD is defined by rapid extracellular matrix breakdown, nucleus pulposus cell loss, and an inflammatory response. It is intimately related to the malfunction or loss of myeloid cells among them. Many mechanisms have been implicated in the development of IVDD, including inflammatory factors, oxidative stress, apoptosis, cellular autophagy, and mitochondrial dysfunction. In recent years, mitochondrial dysfunction has become a hot research topic in age-related diseases. As the main source of adenosine triphosphate (ATP) in myeloid cells, mitochondria are essential for maintaining myeloid cell survival and physiological functions. METHODS We searched the PUBMED database with the search term "intervertebral disc degeneration and mitochondrial dysfunction" and obtained 82 articles, and after reading the abstracts and eliminating 30 irrelevant articles, we finally obtained 52 usable articles. RESULTS Through a review of the literature, it was discovered that IVDD and cellular mitochondrial dysfunction are also linked. Mitochondrial dysfunction contributes to the advancement of IVDD by influencing a number of pathophysiologic processes such as mitochondrial fission/fusion, mitochondrial autophagy, cellular senescence, and cell death. CONCLUSION We examine the molecular mechanisms of IVDD-associated mitochondrial dysfunction and present novel directions for quality management of mitochondrial dysfunction as a treatment approach to IVDD.
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Affiliation(s)
- Chao Song
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Yulin Xu
- Department of Orthopedics, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Qinghua Peng
- College of Integrative Chinese and Western Medicine, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Rui Chen
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Daqian Zhou
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Kang Cheng
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Weiye Cai
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Tao Liu
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China
| | - Chenyi Huang
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China.
| | - Zhijiang Fu
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China.
| | - Cong Wei
- Department of Clinical Laboratory, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
| | - Zongchao Liu
- Department of Orthopedics and Traumatology (Trauma and Bone-setting), Laboratory of Integrated Chinese and Western Medicine for Orthopedic and Traumatic Diseases Prevention and Treatment, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Longmatan District, No.182, Chunhui Road, Luzhou, 646000, Sichuan Province, China.
- Luzhou Longmatan District People's Hospital, Luzhou, 646000, Sichuan Province, China.
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Hu X, Tian X, Yang C, Ling F, Liu H, Zhu X, Pei M, Yang H, Liu T, Xu Y, He F. Melatonin-loaded self-healing hydrogel targets mitochondrial energy metabolism and promotes annulus fibrosus regeneration. Mater Today Bio 2023; 23:100811. [PMID: 37810753 PMCID: PMC10550778 DOI: 10.1016/j.mtbio.2023.100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/21/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023] Open
Abstract
Intervertebral disc (IVD) herniation is a major cause of chronic low back pain and disability. The current nucleus pulposus (NP) discectomy effectively relieves pain symptoms, but the annulus fibrosus (AF) defects are left unrepaired. Tissue engineering approaches show promise in treating AF injury and IVD degeneration; however, the presence of an inflammatory milieu at the injury site hinders the mitochondrial energy metabolism of AF cells, resulting in a lack of AF regeneration. In this study, we fabricated a dynamic self-healing hydrogel loaded with melatonin (an endocrine hormone well-known for its antioxidant and anti-inflammatory properties) and investigate whether melatonin-loaded hydrogel could promote AF defect repair by rescuing the matrix synthesis and energy metabolism of AF cells. The protective effects of melatonin on matrix components (e.g. type I and II collagen and aggrecan) in AF cells were observed in the presence of interleukin (IL)-1β. Additionally, melatonin was found to activate the nuclear factor erythroid 2-related factor signaling pathway, thereby safeguarding the mitochondrial function of AF cells from IL-1β, as evidenced by the increased level of adenosine triphosphate, mitochondrial membrane potential, and respiratory chain factor expression. The incorporation of melatonin into a self-healing hydrogel based on thiolated gelatin and β-cyclodextrin was proposed as a means of promoting AF regeneration. The successful implantation of melatonin-loaded hydrogel has been shown to facilitate in situ regeneration of AF tissue, thereby impeding IVD degeneration by preserving the hydration of nucleus pulposus in a rat box-cut IVD defect model. These findings offer compelling evidence that the development of a melatonin-loaded dynamic self-healing hydrogel can promote the mitochondrial functions of AF cells and represents a promising strategy for IVD regeneration.
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Affiliation(s)
- Xiayu Hu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
| | - Xin Tian
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
| | - Chunju Yang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
- Suzhou Medical College of Soochow University, Suzhou, 215123, China
| | - Feng Ling
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
- Department of Orthopaedics,the Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, 225300, China
| | - Hao Liu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
| | - Xuesong Zhu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
| | - Ming Pei
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics and Division of Exercise Physiology, West Virginia University, Morgantown, WV 26506, USA
| | - Huilin Yang
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
| | - Tao Liu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
| | - Yong Xu
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
| | - Fan He
- Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China
- Orthopaedic Institute, Suzhou Medical College, Soochow University, Suzhou 215000, China
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Liao Z, Tong B, Zhang X, Zhang W, Ke W, Liang H, Lei M, Hua W, Li S, Song Y, Wu X, Yang C. Selective cargo sorting in stem cell-derived small extracellular vesicles: impact on therapeutic efficacy for intervertebral disc degeneration. Clin Transl Med 2023; 13:e1494. [PMID: 38037469 PMCID: PMC10689973 DOI: 10.1002/ctm2.1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Growing evidence has suggested the role of stem cell-derived small extracellular vesicles (sEVs) in intervertebral disc degeneration (IVDD). The cargo sorting of sEVs, particularly miRNAs, may be influenced when the donor cell is subjected to oxidative stress. Here, we discovered that miRNAs containing specific motifs are selectively sorted into intraluminal vesicles within mesenchymal stem cells (MSCs) in response to oxidative stress. METHODS Analysis of miRNA cargoes in sEVs derived from normal MSCs (C-sEVs) or stressed MSCs (T-sEVs) was conducted using miRNA sequencing. Differential expressed miRNAs in sEVs and the identification of motifs were evaluated through bioinformatics analysis. Protein binding was assessed using immunofluorescent staining and immunoprecipitation analysis. Additionally, RNA pull down and RNA immunoprecipitation (RIP) immunoprecipitation were employed to determine the binding between miRNAs and proteins. The effects of C-sEVs and T-sEVs on IVDD were compared by detecting the expression levels of phenotypic genes in vitro or histological evaluation in vivo. RESULTS The sorting process of miRNAs is mediated by the nucleocytoplasmic transport of heterogeneous nuclear ribonucleoproteins, which in turn facilitates the phosphorylation of SNAP25 and promotes the transport and secretion of sEVs. Additionally, CHMP1B plays a role in membrane repair and protects against cell ferroptosis upon oxidative stress, concurrently affecting the release of sEVs. Notably, stem cell-derived sEVs associated with ferroptosis impair the therapeutic efficacy for IVDD. However, the application of engineered sEVs containing a specific miRNA inhibitor exhibits the potential to reinstate the therapeutic efficacy for IVDD both in vitro and in vivo. CONCLUSIONS Taken together, our findings shed light on the mechanism of miRNAs sorting into sEVs and offer new insights for the optimization of sEV-based treatments during intervertebral disc regeneration. regeneration.
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Affiliation(s)
- Zhiwei Liao
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Bide Tong
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xiaoguang Zhang
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Weifeng Zhang
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Wencan Ke
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Huaizhen Liang
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Ming Lei
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Wenbin Hua
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Shuai Li
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yu Song
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Xinghuo Wu
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Cao Yang
- Department of OrthopaedicsUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Yuk FJ, Carr MT, Schupper AJ, Lin J, Tadros R, Wiklund P, Sfakianos J, Steinberger J. Da Vinci Meets Globus Excelsius GPS: A Totally Robotic Minimally Invasive Anterior and Posterior Lumbar Fusion. World Neurosurg 2023; 180:29-35. [PMID: 37708971 DOI: 10.1016/j.wneu.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Minimally invasive approaches to the spine via anterior and posterior approaches have been increasing in popularity, culminating in the development of robot-assisted spinal fusions. The da Vinci surgical robot has been used for anterior lumbar interbody fusion (ALIF), with promising results. Similarly, multiple spinal robots have been developed to assist placement of posterior pedicle screws. However, no previous cases have reported on using robots for both anterior and posterior fixation in a single surgery. We present a technical note on the first reported case of a totally robotic minimally invasive anterior and posterior lumbar fusion and instrumentation. METHODS A 65-year-old man with chronic low back pain and left greater than right lower extremity radiculopathy was found to have grade 1 spondylolisthesis at L5/S1 that worsened on standing upright. He underwent ALIF using a da Vinci robotic approach, followed by percutaneous posterior instrumented fusion with the Globus Excelsius GPS robot. RESULTS The patient did well postoperatively, with improvement of back and leg pain at 3 months follow-up. Radiography confirmed appropriate placement of the interbody cage and pedicle screws. CONCLUSIONS All-robotic placement of both ALIF and posterior lumbar pedicle fixation may be safe, feasible, and efficacious.
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Affiliation(s)
- Frank J Yuk
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Matthew T Carr
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alexander J Schupper
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - James Lin
- Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rami Tadros
- Department of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jeremy Steinberger
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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180
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Guillemin PC, Salomir R, Lauper N, Lorton O, Maturana E, Stöckli A, Poletti PA, Dominguez DE, Boudabbous S, Scheffler M. Clinical outcomes of 3T magnetic resonance imaging-guided lumbar and sacral foraminal injections. Neuroradiology 2023; 65:1793-1802. [PMID: 37848741 PMCID: PMC10654205 DOI: 10.1007/s00234-023-03234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023]
Abstract
PURPOSE This article evaluates the feasibility, safety, and efficacy of MRI-guided lumbar or sacral nerve root infiltration for chronic back pain. We compared the outcomes of our MRI-guided infiltrations with data from CT-guided infiltrations reported in the literature and explored the potential advantages of MRI guidance. METHOD Forty-eight MRI-guided nerve root infiltrations were performed using a 3 T MRI machine. The optimal needle path was determined using breathhold T2-weighted sequences, and the needle was advanced under interleaved guidance based on breathhold PD-weighted images. Pain levels were assessed using a numeric rating scale (NRS) before the procedure and up to 5 months after, during follow-up. Procedure success was evaluated by comparing patients' pain levels before and after the infiltration. RESULTS The MRI-guided infiltrations yielded pain reduction 1 week after the infiltration in 92% of cases, with an average NRS substantial change of 3.9 points. Pain reduction persisted after 5 months for 51% of procedures. No procedure-related complications occurred. The use of a 22G needle and reconstructed subtraction images from T2 FatSat sequences improved the workflow. CONCLUSION Our study showed that MRI-guided nerve root infiltration is a feasible, safe, and effective treatment option for chronic back pain. Precise positioning of the needle tip and accurate distribution of the injected solution contributed to the effectiveness of MRI-guided infiltration, which appeared to be as accurate as CT-guided procedures. Further research is needed to explore the potential benefits of metal artifact reduction sequences to optimize chronic back pain management.
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Affiliation(s)
| | - Rares Salomir
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Nicolas Lauper
- Division of Orthopedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Orane Lorton
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Enrique Maturana
- Division of Radiology, Geneva University Hospitals, Thônex, Switzerland
| | - Alex Stöckli
- Division of Radiology, Geneva University Hospitals, Thônex, Switzerland
| | | | - Dennis E Dominguez
- Division of Orthopedic Surgery and Traumatology, Geneva University Hospitals, Geneva, Switzerland
| | - Sana Boudabbous
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Geneva University Hospitals, Thônex, Switzerland
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Watson M, Coughlan D, Clement ND, Murray IR, Murray AD, Miller SC. Biomechanical parameters of the golf swing associated with lower back pain: A systematic review. J Sports Sci 2023; 41:2236-2250. [PMID: 38446499 DOI: 10.1080/02640414.2024.2319443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
Low back pain (LBP) is the most common injury in golfers of all abilities. The primary aim of this review was to improve understanding of human golf swing biomechanics associated with LBP. A systematic review using the PRISMA guidelines was performed. Nine studies satisfying inclusion criteria and dually reporting golf swing biomechanics and LBP were identified. Human golf swing biomechanics potentially associated with LBP include: reduced lumbar flexion velocity; reduced transition phase length; reduced lumbar torsional load; earlier onset of erector spinae contraction; increased lumbar lateral flexion velocity; reduced or greater erector spinae activity; and earlier onset of external oblique contraction. These potential associations were undermined by a very limited and conflicting quality of evidence, study designs which introduced a severe potential for bias and a lack of prospective study design. There is no conclusive evidence to support the commonly held belief that LBP is associated with "poor" golf swing technique. The potential associations identified should be further investigated by prospective studies of robust design, recruiting participants of both sexes and dexterities. Once firm associations have been identified, further research is required to establish how this knowledge can be best integrated into injury prevention and rehabilitation.
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Affiliation(s)
- M Watson
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
| | - D Coughlan
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
- London Sport Institute, Middlesex University, London, UK
| | - N D Clement
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Orthopaedics, University of Edinburgh, Edinburgh, UK
| | - I R Murray
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
- Department of Orthopaedics, University of Edinburgh, Edinburgh, UK
| | - A D Murray
- European Tour Health and Performance Institute, European Tour Group, Virginia Water, UK
- Medical and Scientific Department, The R&A, St Andrews, UK
- Department of Sports and Exercise/Physical Activity for Health, University of Edinburgh, Edinburgh, UK
| | - S C Miller
- Department of Sports and Exercise Medicine, Queen Mary University of London, London, UK
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Kimura R, Yamamoto N, Watanabe J, Ono Y, Hongo M, Miyakoshi N. Comparative efficacy of ultrasound guidance and fluoroscopy or computed tomography guidance in spinal nerve injections: a systematic review and meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:4101-4110. [PMID: 37798592 DOI: 10.1007/s00586-023-07968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 08/16/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE Spinal nerve injections have traditionally been performed under fluoroscopic (FL) and computed tomography (CT) guidance. Recently, ultrasound (US)-guided procedures have provided an alternative guidance approach that does not expose the patient and operator to radiation. The aim of this study was to compare the efficacy and safety of US-guided spinal nerve injections compared with FL- or CT-guided spinal nerve injections. METHODS MEDLINE, Cochrane Library, EMBASE, international clinical trials registry platform (ICTRP) and ClinicalTrials.gov database searches for inclusion until February 2023 were independently performed by two authors using predefined criteria. Randomized controlled trials (RCTs) were included. Primary outcomes were change in pain score (numeric rating scale or visual analogue scale) and major adverse events. Secondary outcomes were procedure time, change in functional disability score and minor adverse events. Meta-analysis was performed using random-effect model. We evaluated the certainty of evidence based on the Grading of Recommendations, Assessment and Development (GRADE) approach. RESULTS Eight RCTs involving 962 patients were included. There might be little to no difference in the mean score of the pain change between the US-guided methods and the FL- or CT-guided injections (standard mean difference -0.06; 95% confidence interval [CI] -0.26 to 0.15). US guidance probably reduced major adverse events (0.7% [3/433] and 6.5% [28/433], respectively), reduced procedure time (mean difference -4.19 min; 95% CI -5.09 to -3.30), and probably reduced minor adverse events (2.1% [9/433] and 4.2% [18/433], respectively) compared with FL or CT guidance. There was probably little to no difference in the change in functional disability score with either method. CONCLUSION US-guided spinal nerve injections remained effective and reduced adverse events compared with conventional FL- or CT-guided spinal nerve injections. Further RCTs are required to verify our results. STUDY REGISTRATION Open Science Forum (Available from: https://osf.io/vt92w/ ).
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Affiliation(s)
- Ryota Kimura
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan.
| | - Norio Yamamoto
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Jun Watanabe
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University, Yakushiji Shimotsuke City, Tochigi, Japan
- Center for Community Medicine, Ichi Medical University, Yakushiji Shimotsuke City, Tochigi, Japan
| | - Yuichi Ono
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Michio Hongo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
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Shi J, Liu Z, Zhou X, Jin F, Chen X, Wang X, Lv L. Effects of breathing exercises on low back pain in clinical: A systematic review and meta-analysis. Complement Ther Med 2023; 79:102993. [PMID: 37827444 DOI: 10.1016/j.ctim.2023.102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE This study aims to systematically evaluate the effect of breathing exercises on the low back pain (LBP). METHODS The studies of relevant randomized controlled trials (RCTs) testing the effect of breathing exercises on LBP were selected after strict screening from the establishment of PubMed, EMBASE, Cochrane Library, Web of Science, CBM, and CNKI databases until September 2022. The studies included were then independently assessed for risk bias by two investigators. The PRISMA 2020 statement was followed in this study. RESULTS 11 RCTs involving 383 patients were included in this analysis. Results showed that the effective rate of LBP patients after breathing exercises was significantly higher than those in the control group, and the VAS (Visual Analogue Score) and ODI (Oswestry Disability Index) scores of LBP patients were significantly lower than those in the control group [VAS: MD = -0.50, 95% CI (-0.88, -0.11), I2 = 76%, p = 0.0009; ODI: MD = -2.46, 95% CI (-3.41, -1.52), I2 = 20%, p = 0.28]. The results of subgroup showed that the duration of treatment had little effect on the effect of breathing exercises, and breathing exercises alone could also have a positive effect on LBP. However, there were methodological limitations in the included studies, future studies should ensure blinded outcome assessors and full reporting to reduce bias risks. Because this review is a study of breathing exercises as an intervention without any adverse events, all studies did not involve safety assessments. CONCLUSIONS The results indicated that breathing exercises have a positive effect on alleviating LBP, but due to the lack of methodological rigor and some limitations of the included studies, more critical RCTs are still needed in the future to verify the precision of this conclusion. The protocol was registered in PROSPERO (No. CRD42022345561).
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Affiliation(s)
- Jiao Shi
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Zhen Liu
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Xingchen Zhou
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Fanyuan Jin
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Xiaojie Chen
- 72nd Group Army Hospital of Chinese People's Liberation Army
| | - Xiaodong Wang
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
| | - Lijiang Lv
- The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.
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Tieppo Francio V, Westerhaus BD, Carayannopoulos AG, Sayed D. Multifidus dysfunction and restorative neurostimulation: a scoping review. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1341-1354. [PMID: 37439698 PMCID: PMC10690869 DOI: 10.1093/pm/pnad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/14/2023] [Accepted: 07/10/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Chronic low back pain (CLBP) is multifactorial in nature, with recent research highlighting the role of multifidus dysfunction in a subset of nonspecific CLBP. This review aimed to provide a foundational reference that elucidates the pathophysiological cascade of multifidus dysfunction, how it contrasts with other CLBP etiologies and the role of restorative neurostimulation. METHODS A scoping review of the literature. RESULTS In total, 194 articles were included, and findings were presented to highlight emerging principles related to multifidus dysfunction and restorative neurostimulation. Multifidus dysfunction is diagnosed by a history of mechanical, axial, nociceptive CLBP and exam demonstrating functional lumbar instability, which differs from other structural etiologies. Diagnostic images may be used to grade multifidus atrophy and assess other structural pathologies. While various treatments exist for CLBP, restorative neurostimulation distinguishes itself from traditional neurostimulation in a way that treats a different etiology, targets a different anatomical site, and has a distinctive mechanism of action. CONCLUSIONS Multifidus dysfunction has been proposed to result from loss of neuromuscular control, which may manifest clinically as muscle inhibition resulting in altered movement patterns. Over time, this cycle may result in potential atrophy, degeneration and CLBP. Restorative neurostimulation, a novel implantable neurostimulator system, stimulates the efferent lumbar medial branch nerve to elicit repetitive multifidus contractions. This intervention aims to interrupt the cycle of dysfunction and normalize multifidus activity incrementally, potentially restoring neuromuscular control. Restorative neurostimulation has been shown to reduce pain and disability in CLBP, improve quality of life and reduce health care expenditures.
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Affiliation(s)
- Vinicius Tieppo Francio
- Department of Physical Medicine & Rehabilitation, The University of Kansas Medical Center, Kansas City, KS 66160, United States
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Benjamin D Westerhaus
- Cantor Spine Institute at the Paley Orthopedic & Spine Institute, West Palm Beach, FL 33407, United States
| | - Alexios G Carayannopoulos
- Department of Neurosurgery and Neurology, Warren Alpert Medical School of Brown University, Providence, RI 02903, United States
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, United States
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Lotz JC, Ropella G, Anderson P, Yang Q, Hedderich MA, Bailey J, Hunt CA. An exploration of knowledge-organizing technologies to advance transdisciplinary back pain research. JOR Spine 2023; 6:e1300. [PMID: 38156063 PMCID: PMC10751978 DOI: 10.1002/jsp2.1300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 10/02/2023] [Accepted: 10/29/2023] [Indexed: 12/30/2023] Open
Abstract
Chronic low back pain (LBP) is influenced by a broad spectrum of patient-specific factors as codified in domains of the biopsychosocial model (BSM). Operationalizing the BSM into research and clinical care is challenging because most investigators work in silos that concentrate on only one or two BSM domains. Furthermore, the expanding, multidisciplinary nature of BSM research creates practical limitations as to how individual investigators integrate current data into their processes of generating impactful hypotheses. The rapidly advancing field of artificial intelligence (AI) is providing new tools for organizing knowledge, but the practical aspects for how AI may advance LBP research and clinical are beginning to be explored. The goals of the work presented here are to: (1) explore the current capabilities of knowledge integration technologies (large language models (LLM), similarity graphs (SGs), and knowledge graphs (KGs)) to synthesize biomedical literature and depict multimodal relationships reflected in the BSM, and; (2) highlight limitations, implementation details, and future areas of research to improve performance. We demonstrate preliminary evidence that LLMs, like GPT-3, may be useful in helping scientists analyze and distinguish cLBP publications across multiple BSM domains and determine the degree to which the literature supports or contradicts emergent hypotheses. We show that SG representations and KGs enable exploring LBP's literature in novel ways, possibly providing, trans-disciplinary perspectives or insights that are currently difficult, if not infeasible to achieve. The SG approach is automated, simple, and inexpensive to execute, and thereby may be useful for early-phase literature and narrative explorations beyond one's areas of expertise. Likewise, we show that KGs can be constructed using automated pipelines, queried to provide semantic information, and analyzed to explore trans-domain linkages. The examples presented support the feasibility for LBP-tailored AI protocols to organize knowledge and support developing and refining trans-domain hypotheses.
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Affiliation(s)
- Jeffrey C. Lotz
- Department of Orthopaedic SurgeryUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
| | | | - Paul Anderson
- Department of Computer Science & Software EngineeringCalifornia Polytechnic State UniversitySan Luis ObispoCaliforniaUSA
| | - Qian Yang
- Department of Information ScienceCornell UniversityIthacaNew YorkUSA
| | | | - Jeannie Bailey
- Department of Orthopaedic SurgeryUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
| | - C. Anthony Hunt
- Department of Bioengineering & Therapeutic SciencesUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
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Zhao W, Li Y, Cheng X, Wei H, Li P, Fan L, Liu K, Zhang S, Wang H. The antioxidant Glycitin protects against intervertebral disc degeneration through antagonizing inflammation and oxidative stress in nucleus pulposus cells. Aging (Albany NY) 2023; 15:13693-13709. [PMID: 38019477 PMCID: PMC10756108 DOI: 10.18632/aging.205251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Intervertebral disc degeneration (IVDD) is a kind of typical degenerative disorder of the skeletal muscle system caused by many factors including aging, abnormal mechanical stress and inflammatory responses. Glycitin is a natural isoflavone extracted from legumes. Previous studies have found that it is anti-inflammatory and promotes wound repair. However, the role of Glycitin in IVDD has not been elucidated. In the present research, we were surprised that Glycitin antagonized the NF-κB pathway activity. In addition, we also found that Glycitin alleviated TNF-α-induced metabolic disorders, extracellular matrix degradation, oxidative stress, inflammation responses, and mitochondrial damage. Furthermore, in in vivo experimental study, we discovered Glycitin attenuated IVDD. The results revealed that Glycitin alleviated the degenerative phenotype of IVDD. According to this research, Glycitin has anti-inflammatory properties that might exert a protective function in IVDD, suggesting a prospective therapeutic approach for IVDD.
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Affiliation(s)
- Wei Zhao
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Yanpei Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Xiang Cheng
- Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
| | - Hui Wei
- Rehabilitation Center, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Peng Li
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Lixia Fan
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Kaiwen Liu
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Shuai Zhang
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
| | - Hao Wang
- Department of Trauma Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
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187
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Tang Y, Zhang K, Zhou H, Zhang C, Liu Z, Chen H, Li H, Chen K. Transplantation of active nucleus pulposus cells with a keep-charging hydrogel microsphere system to rescue intervertebral disc degeneration. J Nanobiotechnology 2023; 21:453. [PMID: 38017517 PMCID: PMC10683266 DOI: 10.1186/s12951-023-02226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Cell transplantation has been demonstrated as a promising approach in tissue regeneration. However, the reactive oxygen species (ROS) accumulation and inflammation condition establish a harsh microenvironment in degenerated tissue, which makes the transplanted cells difficult to survive. METHODS In this study, we constructed a keep-charging hydrogel microsphere system to enable cells actively proliferate and function in the degenerated intervertebral disc. Specifically, we combined Mg2+ to histidine-functionalized hyaluronic acid (HA-His-Mg2+) through coordination reaction, which was further intercrossed with GelMA to construct a double-network hydrogel microsphere (GelMA/HA-His-Mg2+, GHHM) with microfluidic methods. In vitro, the GHHM loaded with nucleus pulposus cells (GHHM@NPCs) was further tested for its ability to promote NPCs proliferation and anti-inflammatory properties. In vivo, the ability of GHHM@NPCs to promote regeneration of NP tissue and rescue intervertebral disc degeneration (IVDD) was evaluated by the rat intervertebral disc acupuncture model. RESULTS The GHHM significantly enhanced NPCs adhesion and proliferation, providing an ideal platform for the NPCs to grow on. The loaded NPCs were kept active in the degenerative intervertebral disc microenvironment as charged by the Mg2+ in GHHM microspheres to effectively support the loaded NPCs to reply against the ROS-induced inflammation and senescence. Moreover, we observed that GHHM@NPCs effectively alleviated nucleus pulposus degeneration and promoted its regeneration in the rat IVDD model. CONCLUSION In conclusion, we constructed a keep charging system with a double-network hydrogel microsphere as a framework and Mg2+ as a cell activity enhancer, which effectively maintains NPCs active to fight against the harsh microenvironment in the degenerative intervertebral disc. The GHHM@NPCs system provides a promising approach for IVDD management.
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Affiliation(s)
- Yingchuang Tang
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Kai Zhang
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Hongyou Zhou
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Chenchen Zhang
- Department of Radiology, Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Zixiang Liu
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Hao Chen
- Department of Orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou, People's Republic of China.
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, People's Republic of China.
| | - Hanwen Li
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
| | - Kangwu Chen
- Department of Orthopedic, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China.
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188
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Yao D, Li M, Wang K, Jin S, Zeng W, Liao Z, Chen E, Liang Y, Xing T, Wen G, Liang C, Su K, Lu S, Che Z, Li Y, Huang L. Emodin ameliorates matrix degradation and apoptosis in nucleus pulposus cells and attenuates intervertebral disc degeneration through LRP1 in vitro and in vivo. Exp Cell Res 2023; 432:113794. [PMID: 37741491 DOI: 10.1016/j.yexcr.2023.113794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
Low back pain (LBP) is the leading cause of disability worldwide, with a strong correlation to intervertebral disc degeneration (IDD). Inflammation-induced extracellular matrix (ECM) degradation plays a major role in IDD's progression. Emodin, known for its anti-inflammatory effects and ability to inhibit ECM degradation in osteoarthritis, but its role in IDD is unclear. Our study aimed to explore emodin's role and mechanisms on IDD both in vivo and in vitro. We discovered that emodin positively regulated anabolic markers (COL2A1, aggrecan) and negatively impacted catabolic markers (MMP3, MMP13) in nucleus pulposus cells, while also inhibiting cell apoptosis under inflammation environment. We revealed that emodin inhibits inflammation-induced NF-ĸB activation by suppressing the degradation of LRP1 via the proteasome pathway. Additionally, LRP1 was validated as essential to emodin's regulation of ECM metabolism and apoptosis, both in vitro and in vivo. Ultimately, we demonstrated that emodin effectively alleviates IDD in a rat model. Our findings uncover the novel pathway of emodin inhibiting ECM degradation and apoptosis through the inhibition of NF-κB via LRP1, thus alleviating IDD. This study not only broadens our understanding of emodin's role and mechanism in IDD treatment but also guides future therapeutic interventions.
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Affiliation(s)
- Dengbo Yao
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Ming Li
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Kun Wang
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Song Jin
- Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Weike Zeng
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Zhuangyao Liao
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Enming Chen
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yuwei Liang
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Tong Xing
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Guoming Wen
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Changchun Liang
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Kaihui Su
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Shixin Lu
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China; Department of Orthopedics Surgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Zhen Che
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yuxi Li
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
| | - Lin Huang
- Department of Orthopedics Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
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189
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Yurube T, Han I, Sakai D. Concepts of Regeneration for Spinal Diseases in 2023. Int J Mol Sci 2023; 24:16335. [PMID: 38003526 PMCID: PMC10671128 DOI: 10.3390/ijms242216335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
It is our pleasure to announce the publication of the Special Issue "Regeneration for Spinal Diseases 3.0" in the International Journal of Molecular Sciences (ISSN 1422-0067) [...].
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Affiliation(s)
- Takashi Yurube
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Inbo Han
- Department of Neurosurgery, CHA University School of Medicine, CHA Bundang Medical Center, Seongnam-si 13496, Republic of Korea;
| | - Daisuke Sakai
- Department of Orthopedic Surgery, School of Medicine, Tokai University, 143 Shimokasuya, Isehara 259-1193, Japan;
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190
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Tsatsaraki E, Bouloukaki I, Kontakis G, Vakis AF, Basta M. Associations between Combined Psychological and Lifestyle Factors with Pain Intensity and/or Disability in Patients with Chronic Low Back Pain: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2928. [PMID: 37998420 PMCID: PMC10671559 DOI: 10.3390/healthcare11222928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Chronic low back pain (CLBP) is common in primary care, causing disability and economic burden globally. We aimed to compare socio-demographic, health, lifestyle, and psychological factors in people with and without CLBP and correlate them with clinical outcomes in people with CLBP. A total of 253 volunteers with and 116 without CLBP provided sociodemographic information, daily habits, medical history, subjective sleep complaints (Penn State Sleep Questionnaire), low back pain intensity, and disability (Quebec Back Pain Disability Scale), as well as the Zung Self-Rating Scale for self-assessment of depression and Self-Rating Anxiety Scale. CLBP diagnosis was linked with female gender and older age, as well as a higher level of sleep complaints such as sleepiness, OSA and insomnia symptoms, and a higher prevalence of moderate to severe depressive symptoms. The combination of moderate to severe depressive symptoms with obstructive sleep apnea or insomnia symptoms was the most important predictive factor for functional disability in CBLP patients (OR 13.686, 95% CI 4.581-40.885; p < 0.001). In conclusion, depressive symptoms and subjective sleep complaints appear to relate to greater CLBP intensity and/or CLBP-related disability in people with CLBP. A holistic approach is crucial for treating chronic CLBP patients, including psychological and sleep issue assessment and management, to improve their quality of life.
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Affiliation(s)
- Eirini Tsatsaraki
- Nursing Department, University Hospital of Heraklion, University of Crete, 70013 Heraklion, Greece;
| | - Izolde Bouloukaki
- Department of Social and Family Medicine, University of Crete, 70013 Heraklion, Greece;
| | - Georgios Kontakis
- Department of Orthopaedics and Traumatology, University Hospital of Heraklion, University of Crete, 71110 Heraklion, Greece
| | - Antonis F. Vakis
- Department of Neurosurgery, School of Medicine, University of Crete, 70013 Heraklion, Greece
| | - Maria Basta
- Division of Psychiatry and Behavioral Science, School of Medicine, University of Crete, 70013 Heraklion, Greece
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191
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Guan X, Zhang D, Zhang F, Zong Y, Wang H, Shen Z, Yin F. Causal association of physical activity with low back pain, intervertebral disc degeneration and sciatica: a two-sample mendelian randomization analysis study. Front Cell Dev Biol 2023; 11:1260001. [PMID: 38020887 PMCID: PMC10665496 DOI: 10.3389/fcell.2023.1260001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objective: Previous studies are insufficient to confirm a causal association between physical activity (PA) and low back pain (LBP), intervertebral disc degeneration (IDD), and sciatica. The present study used a two-sample Mendelian randomization (MR) analysis method to demonstrate whether or not there was a causal connection. Methods: First, four PA phenotypes were selected [accelerometer-based PA (average acceleration), accelerometer-based PA (acceleration fraction >425 mg), self-reported moderate-to-vigorous PA, and self-reported vigorous PA], setting thresholds for single nucleotide polymorphisms (SNPs) significantly concerned with PA p < 5 × 10-8, linkage disequilibrium (LD) r 2 < 0.01, genetic distance >5,000 kb, and F-value >10. SNPs associated with the outcome and confounding factors were then excluded using the PhenoScanncer database. Finally, after coordinating the genetic instruments from genome-wide association studies (GWAS) effect alleles for exposure and outcomes, multiplicative random effects inverse variance weighting (IVW), MR-Egger, weighted median method (WMM), and weighted mode method were used to assess exposure-outcome causality and perform sensitivity analysis on the estimated results. Results: The current study's IVW findings revealed proof of a causal connection between PA and LBP. While there was a positive causal tie between accelerometer-based PA (acceleration fraction >425 mg) and LBP [OR: 1.818, 95% CI:1.129-2.926, p = 0.012], there was a negative causal link between accelerometer-based PA (average acceleration) and LBP [OR: 0.945, 95% CI: 0.909-0.984, p = 0.005]. However causal relationship between PA and IDD or sciatica was not found. Conclusion: Increasing average PA but needing to avoid high-intensity PA may be an effective means of preventing low back pain. Although PA is not directly causally related to disc degeneration and sciatica, it can act through indirect pathways.
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Affiliation(s)
| | | | | | | | | | | | - Fei Yin
- Departments of Orthopedics Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
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192
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Zhang W, Wang G, Xie R, Zhan J, Zhu L, Wan C, Xie H, Cai C, Du Y. Traditional Chinese exercises on pain and disability in middle-aged and elderly patients with lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2023; 10:1265040. [PMID: 38020108 PMCID: PMC10663407 DOI: 10.3389/fmed.2023.1265040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Traditional Chinese exercises (TCEs) have played a significant role in treating various diseases. However, there is limited research assessing the efficacy of TCEs in treating Lumbar disc herniation (LDH). This study aimed to systematically evaluate the effects of four commonly used TCEs (Baduanjin, Yijinjing, Taichi, and Wuqinxi) on pain and disability in elderly patients with LDH. Objectives To assess the quality of relevant randomized controlled trials (RCTs) to provide evidence support for the treatment of LDH. Methods RCTs were identified through eight databases. Meta-analysis and trial sequence analysis (TSA) were conducted using RevMan 5.4, Stata 17.0, and TSA 0.9. Results A total of 22 RCTs, involving 1931 patients, were included in the analysis. TCEs exhibited a superior effectiveness in treating LDH compared to the control group. However, the TSA analysis suggested the possibility of false positives, indicating the need for more high-quality RCT evidence. Nevertheless, TCEs showed reliable results in significantly improving the VAS score and JOA score of LDH patients. Conclusion Current evidence indicates that the four TCEs have advantages in treating LDH in middle-aged and elderly individuals. However, considering the limitations of this study, we need to exercise caution in drawing conclusions, and further research is required to validate these findings. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023431633].
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Affiliation(s)
- Weiye Zhang
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Gewen Wang
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rong Xie
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiawen Zhan
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, China
| | - Liguo Zhu
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, China
- Second Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunyou Wan
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Hualong Xie
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chuhao Cai
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuxuan Du
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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193
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Wei B, Wu H. Study of the Distribution of Lumbar Modic Changes in Patients with Low Back Pain and Correlation with Lumbar Degeneration Diseases. J Pain Res 2023; 16:3725-3733. [PMID: 37954474 PMCID: PMC10637215 DOI: 10.2147/jpr.s430792] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose To study the distribution of lumbar Modic changes (MC) in low back pain patients, and to explore the relationship between Modic changes and age, gender, segment and lumbar degeneration diseases (disc degeneration, spinal stenosis, lumbar spondylolisthesis). Patients and Methods Modic changes were counted and analysed in 500 randomly selected patients who visited the outpatient clinic for lumbar spine MRI for low back pain from 2019 to 2022. The relationship between Modic changes and bulging disc, protrusion, extrusion, sequestration, Schmorl's node, spinal stenosis, and lumbar spondylolisthesis was studied. Data correlations were compared using the chi-square test, P<0.05 was considered a statistically significant difference. Results Modic changes were present in 184 segments. 58 were type I, 119 were type II, and 7 were type III. The number of Modic changes segments in L1-2, L2-3, L3-4, L4-5, and L5-S1 was 10, 22, 22, 58, and 72, respectively. Modic changes by gender occurred in 44 males and 82 females, and by age grouping were 0 cases in 10-19 years, 3 cases in 20-29 years, 6 cases in 30-39 years, 41 cases in 40-49 years, 64 cases in 50-59 years, 38 cases in 60-69 years, 15 cases in 70-79 years, and 5 cases in 80-89 years, respectively. Modic changes occurred in 56 with bulging disc, 45 with Protrusion, 57 with Extrusion and Sequestration, 32 with Schmorl's node, 32 with spondylolisthesis, and 56 with stenosis. Modic changes correlated with all of the above factors except bulging disc, and all differences were statistically significant (P<0.05). Conclusion The most common type of Modic changes is type II; Modic changes have correlation with age, gender, segment, lumbar disc herniation, lumbar spondylolisthesis, and lumbar spinal stenosis, and are a very important factor in low back pain.
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Affiliation(s)
- Baixing Wei
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
| | - Han Wu
- Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of China
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194
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Davidovic K, Cotofana S, Heisinger S, Savic S, Alfertshofer M, Antonić T, Jovanović S, Ercegovac M, Muto M, Jeremić D, Janićijević A, Rasulić L, Janošević V, Šarić L, Chua D, Masulovic D, Maksimović R. Percutaneous Computed Tomography-Guided Oxygen-Ozone (O 2O 3) Injection Therapy in Patients with Lower Back Pain-An Interventional Two-Year Follow-Up Study of 321 Patients. Diagnostics (Basel) 2023; 13:3370. [PMID: 37958266 PMCID: PMC10650810 DOI: 10.3390/diagnostics13213370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVES To assess the effect of oxygen-ozone therapy guided by percutaneous Computed Tomography (CT) compared to corticosteroids in individuals experiencing lower back pain (LBP) not attributed to underlying bone-related issues. METHODS A total of 321 patients (192 males and 129 females, mean age: 51.5 ± 15.1 years) with LBP were assigned to three treatment groups: group A) oxygen-ozone only, group B) corticosteroids only, group C) oxygen-ozone and corticosteroids. Treatment was administered via CT-guided injections to the intervertebral disc (i.e., intradiscal location). Clinical improvement of pain and functionality was assessed via self-reported pain scales and magnetic resonance (MR) and CT imaging. RESULTS At all follow-up times, the mean score of the numeric rating scale and the total global pain scale (GPS) of study groups receiving oxygen-ozone (groups A and C) were statistically significantly lower than the study group receiving corticosteroids only (group B), with p < 0.001. There was a statistically significant difference between groups A and C at 30 days for the numeric rating scale. CONCLUSIONS The percutaneous application of oxygen-ozone in patients with LBP due to degeneration of the lumbosacral spine showed long-lasting significant pain reduction of up to two years post-treatment when compared to corticosteroids alone. Combination therapy of oxygen-ozone and corticosteroids can be useful as corticosteroids showed statistically significant improvement in LBP earlier than the oxygen-ozone-only treatment.
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Affiliation(s)
- Kristina Davidovic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (K.D.)
| | - Sebastian Cotofana
- Department of Dermatology, Erasmus Medical Centre, 3015 GD Rotterdam, The Netherlands
- Centre for Cutaneous Research, Blizard Institute, Queen Mary University of London, London E1 4NS, UK
- Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Stephan Heisinger
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria
| | - Slavica Savic
- Medical Faculty, University of Belgrade, 11120 Belgrade, Serbia
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, LMU University Hospital, 80336 Munich, Germany
| | - Tatjana Antonić
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (K.D.)
| | | | - Marko Ercegovac
- Clinic of Neurology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Mario Muto
- Neuroradiology Department, Ospedale Cardarelli Napoli, 80131 Napoli, Italy
| | - Danilo Jeremić
- Institute for Orthopedic Surgery “Banjica”, 11000 Belgrade, Serbia
| | | | - Lukas Rasulić
- Clinic of Neurosurgery, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Vesna Janošević
- Clinic of Neurosurgery, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | - Lidija Šarić
- Clinic of Neurosurgery, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | | | - Dragan Masulovic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (K.D.)
| | - Ružica Maksimović
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (K.D.)
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195
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Baroni F, Schleip R, Arcuri L, Consorti G, D’Alessandro G, Zegarra-Parodi R, Vitali AM, Tramontano M, Lunghi C. Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care-An Osteopathic Perspective. Healthcare (Basel) 2023; 11:2886. [PMID: 37958030 PMCID: PMC10667998 DOI: 10.3390/healthcare11212886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients' adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients' unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework.
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Affiliation(s)
- Francesca Baroni
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
| | - Robert Schleip
- Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, 80333 Munich, Germany;
| | - Lorenzo Arcuri
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
| | - Giacomo Consorti
- Education Department of Osteopathy, Istituto Superiore di Osteopatia, 20126 Milan, Italy
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Foundation COME Collaboration, 65121 Pescara, Italy
- Centre pour l’Etude, la Recherche et la Diffusion Ostéopathiques “C.E.R.D.O.”, 00199 Rome, Italy
| | | | | | - Marco Tramontano
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy
| | - Christian Lunghi
- BMS Formation, 75116 Paris, France; (F.B.); (C.L.)
- Osteopatia Lunghi-Baroni Private Practice, 00146 Rome, Italy
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196
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Li Y, Zhang K, Ai X, Zhang Q, Jiang L, Long J, Xu H, Feng C, Zhang Y, Tang G, Chong F, Wang L, Huang B. A Biomimetic Peptide Functions as Specific Extracellular Matrix for Quiescence of Stem Cells against Intervertebral Disc Degeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2300578. [PMID: 37423970 DOI: 10.1002/smll.202300578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 05/03/2023] [Indexed: 07/11/2023]
Abstract
Maintaining quiescence of stem cells is a potential way to decrease cell nutrition demand for restoring the organization. Herein, a biomimetic peptide to maintain quiescence of stem cells through C-X-C motif chemokine ligand 8 (CXCL8)-C-X-C motif chemokine receptor 1 (CXCR1) pathway against intervertebral disc degeneration (IVDD) is developed. First, it is confirmed that quiescence can be induced via inhibiting phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway in nucleus pulposus stem cells (NPSCs). Meanwhile, it is well known that CXCR1, a chemokine receptor, can be targeted by CXCL8, resulting in cell proliferation via activating PI3K/Akt/mTOR pathway. Second, a biomimetic peptide (OAFF) that can bind to CXCR1 and form fibrous networks on NPSCs, mimicking extracellular matrix formation is developed. The multivalent effect and long-term binding to CXCR1 on NPSCs of OAFF fibers offer forcefully competitive inhibition with natural CXCL8, which induces NPSCs quiescence and ultimately overcomes obstacle in intradiscal injection therapy. In rat caudal disc puncture model, OAFF nanofibers still maintain at 5 weeks after operation and inhibit degeneration process of intervertebral disc in terms of histopathology and imageology. In situ fibrillogenesis of biomimetic peptide on NPSCs provides promising stem cells for intradiscal injection therapy against IVDD.
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Affiliation(s)
- Yuan Li
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Kuo Zhang
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, P. R. China
| | - Xuezheng Ai
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Qingshi Zhang
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, P. R. China
| | - Lu Jiang
- Clinical Medicine Research Center, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Jiang Long
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Huange Xu
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, P. R. China
| | - Chencheng Feng
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Yaqing Zhang
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Guoke Tang
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, P. R. China
| | - Fanli Chong
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
| | - Lei Wang
- CAS Center for Excellence in Nanoscience, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, National Center for Nanoscience and Technology (NCNST), Beijing, 100190, P. R. China
| | - Bo Huang
- Department of Orthopedics, Xinqiao Hospital, Army Medical University, Chongqing, 400037, P. R. China
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197
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Huang ZN, Wang ZY, Cheng XF, Huang ZZ, Han YL, Cui YZ, Liu B, Tian W. Melatonin alleviates oxidative stress-induced injury to nucleus pulposus-derived mesenchymal stem cells through activating PI3K/Akt pathway. J Orthop Translat 2023; 43:66-84. [PMID: 38089645 PMCID: PMC10711395 DOI: 10.1016/j.jot.2023.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/23/2023] [Accepted: 10/10/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The changes in the microenvironment of degenerative intervertebral discs cause oxidative stress injury and excessive apoptosis of intervertebral disc endogenous stem cells. The purpose of this study was to explore the possible mechanism of the protective effect of melatonin on oxidative stress injury in NPMSCs induced by H2O2. METHODS The Cell Counting Kit-8 assay was used to evaluate the cytotoxicity of hydrogen peroxide and the protective effects of melatonin. ROS content was detected by 2'7'-dichlorofluorescin diacetate (DCFH-DA). Mitochondrial membrane potential (MMP) was detected by the JC-1assay. Transferase mediated d-UTP Nick end labeling (TUNEL) and Annexin V/PI double staining were used to determine the apoptosis rate. Additionally, apoptosis-associated proteins and PI3K/Akt signaling pathway-related proteins were evaluated by immunofluorescence, immunoblotting and PCR. ECMs were evaluated by RT‒PCR and immunofluorescence. In vivo, X-ray, Magnetic resonance imaging (MRI) and Histological analyses were used to evaluate the protective effect of melatonin. RESULTS Melatonin had an obvious protective effect on NPMSCs treated with 0-10 μM melatonin for 24 h. In addition, melatonin also had obvious protective effects on mitochondrial dysfunction, decreased membrane potential and cell senescence induced by H2O2. More importantly, melatonin could significantly reduce the apoptosis of nucleus pulposus mesenchymal stem cells induced by H2O2 by regulating the expression of apoptosis-related proteins and decreasing the rate of apoptosis. After treatment with melatonin, the PI3K/Akt pathway was significantly activated in nucleus pulposus mesenchymal stem cells, while the protective effect was significantly weakened after PI3K-IN-1 treatment. In vivo, the results of X-ray, MRI and histological analyses showed that therapy with melatonin could partially reduce the degree of intervertebral disc degeneration. CONCLUSION Our research demonstrated that melatonin can effectively alleviate the excessive apoptosis and mitochondrial dysfunction of nucleus pulposus mesenchymal stem cells induced by oxidative stress via the PI3K/Akt pathway, which provides a novel idea for the therapy of intervertebral disc degeneration. THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE This study indicates that melatonin can effectively alleviate the excessive apoptosis and mitochondrial dysfunction of NPMSCs through activating the PI3K/Akt pathway. Melatonin might serve as a promising candidate for the prevention and treatment of Intervertebral disc degeneration disease (IVDD) in the future.
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Affiliation(s)
- Ze-Nan Huang
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Science, Shandong, 200072, China
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
| | - Ze-Yu Wang
- Department of Orthopedics, The Affiliated BenQ Hospital of Nanjing Medical University, 210019, Nanjing, Jiangsu Province, China
| | - Xiao-Fei Cheng
- Department of Orthopedic Surgery, Shanghai Key Laboratory of Orthopedics Implants, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China
| | - Zhao-Zhang Huang
- Taixing Medical Center, Taixing People's Hospital, Taixing, 225400, Jiangsu Province, China
| | - Yan-Ling Han
- Medical Experimental Research Center, Yangzhou University, Yangzhou, 225001, China
| | - Ya-Zhou Cui
- Department of Orthopedics, Shandong First Medical University & Shandong Academy of Medical Science, Shandong, 200072, China
| | - Bo Liu
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
| | - Wei Tian
- Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Hospital Affiliated to Peking University, No. 37 Xinjiekou East, Road, Beijing, 100035, China
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198
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Iwasaki T, Akeda K, Kawaguchi K, Yamada J, Hasegawa T, Takegami N, Fujiwara T, Sudo A. Expression of Glial-Cell-Line-Derived Neurotrophic Factor Family Ligands in Human Intervertebral Discs. Int J Mol Sci 2023; 24:15874. [PMID: 37958856 PMCID: PMC10649213 DOI: 10.3390/ijms242115874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Glial-cell-line-derived neurotrophic factor (GDNF) family ligands (GFLs) contribute to the sensitization of primary afferents and are involved in the pathogenesis of inflammatory pain. The purpose of this preliminary study was to examine the expression of other GFLs (neurturin (NRTN), artemin (ARTN), persephin (PSPN)) and receptors in human IVD cells and tissues exhibiting early and advanced stages of degeneration. Human IVD cells were cultured as a monolayer after isolation from the nucleus pulposus (NP) and anulus fibrosus (AF) tissues. The mRNA expression of NRTN, ARTN, PSPN, and their receptors (GFRA2-GFRA4) was quantified using real-time PCR. Protein expression was evaluated using immunohistochemistry and Western blotting. The expression of NRTN, ARTN, PSPN, and their co-receptors (GFRA2-GFRA4) was identified in human IVD cells at both mRNA and protein levels. A trend was noted wherein the mRNA expression of ARTN, PSPN, and GFRA2 was upregulated by IL-1β treatment in a dose-dependent manner. The percentages of immunopositive cells in the advanced degenerate stage of ARTN, PSPN, and GFRA2 were significantly higher than those in the early degenerate stage. Their expression was enhanced in advanced tissue degeneration, which suggests that GFLs (ARTN and PSPN) may be involved in the pathogenesis of discogenic pain.
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Affiliation(s)
| | - Koji Akeda
- Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City 514-8507, Mie, Japan; (T.I.); (K.K.); (J.Y.); (T.H.); (N.T.); (T.F.); (A.S.)
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199
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Wang D, Treede RD, Köhr G. Electrophysiological evidence that TRPM3 is a candidate in latent spinal sensitization of chronic low back pain. Neurosci Lett 2023; 816:137509. [PMID: 37802417 DOI: 10.1016/j.neulet.2023.137509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/19/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
Latent spinal sensitization is one key mechanism developing at the early stage of chronic low back pain (LBP). TRPM3-mediated calcium transients of dorsal root ganglia (DRG) neurons are considered critical presynaptic signals involved in this latent sensitization. However, postsynaptic consequences in input laminae of the spinal cord have not been addressed so far. Here, by electrophysiological recordings in acute spinal cord slices from adult rats, we show that perfusion of the TRPM3 agonist pregnenolone sulfate (PregS) induced a significant increase in the frequency but not amplitude of spontaneous postsynaptic currents in lamina I and II neurons. This frequency increase started slowly during PregS perfusion but was reversible following washout. This result is consistent with a presynaptic action of the neurosteroid PregS, indicating the presynaptic expression of functional TRPM3 in the superficial dorsal horn of adult rats. Thus, PregS-induced TRPM3 activation enhances spinal synaptic strength, implying a mediating role of TRPM3 between neuroendocrine and nociceptive signaling, which might as well exist in chronic LBP primed by chronic stress that promotes the biosynthesis of PregS.
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Affiliation(s)
- Dan Wang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China; Department of Neurophysiology, Mannheim Center for Translational Neurosciences, Heidelberg University, Mannheim, Germany
| | - Rolf-Detlef Treede
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences, Heidelberg University, Mannheim, Germany; Deptartment of Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Georg Köhr
- Department of Neurophysiology, Mannheim Center for Translational Neurosciences, Heidelberg University, Mannheim, Germany; Physiology of Neural Networks, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany.
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200
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Peace J, Pooleri A, Frech A, Tumin D. Socioeconomic Characteristics Associated With the Development of Chronic Pain After Pain Interference Experienced in Early Adulthood. Clin J Pain 2023; 39:628-633. [PMID: 37440352 DOI: 10.1097/ajp.0000000000001149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Predictors of pain persistence have been identified among patients undergoing treatment for chronic pain or related conditions, but correlates of pain persistence in the general population remain underexplored. We identify socioeconomic variables associated with pain onset or persistence over a 6 to 10 year period in a nationally representative cohort. METHODS Using panel data from the National Longitudinal Survey of Youth-1997, we examined the presence of pain interference at age 29 and chronic pain at ages 35 to 39. Persistent pain was defined as pain present at both interview time points; new-onset pain was defined as pain not reported at age 29, but present at ages 35 to 39; and transient pain was defined as experiencing pain interference at age 29 with no report of chronic pain at ages 35 to 39. RESULTS Based on a sample of 6188 participants, we estimated that 4% experienced persistent pain, 11% experienced transient pain, and 7% experienced new-onset pain. Pain persistence was less likely among non-Hispanic Black respondents but more likely among formerly married respondents and those with poor health, health-related work limitation, or greater pain interference at the age 29 baseline. New-onset pain was most likely among female respondents, respondents with some college education, and respondents with poor self-rated health or obesity at baseline. DISCUSSION Development of chronic pain by the mid-late 30s was common among young adults experiencing pain interference at age 29. Race/ethnicity, gender, and educational attainment exhibited different associations with persistence as compared with new onset of pain problems.
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Affiliation(s)
- Jordan Peace
- Brody School of Medicine at East Carolina University
| | - Anand Pooleri
- ECU Health
- Department of Physical Medicine and Rehabilitation, Brody School of Medicine at East Carolina University
| | | | - Dmitry Tumin
- Department of Academic Affairs Brody School of Medicine at East Carolina University, Greenville NC
- Department of Social Medicine, Heritage College of Medicine at Ohio University-Cleveland campus, Cleveland OH
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