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Morimoto T, Kobayashi T, Ito H, Tsukamoto M, Yoshihara T, Hirata H, Otani K, Izuhara K, Nunomura S, Mawatari M. Serum periostin levels correlate with severity of intervertebral disc degeneration. 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; 33:2007-2013. [PMID: 38340176 DOI: 10.1007/s00586-024-08162-4] [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: 10/16/2023] [Revised: 12/14/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Periostin, an extracellular matrix protein closely related to mechanical stress, inflammation, and ageing, has been implicated in intervertebral disc degeneration (IVDD) in basic research. However, it has not been examined in clinical cases. This study aimed to evaluate the association between IVDD severity and serum periostin concentration as well as to analyse potential associations between IVDD and clinical and demographic factors. METHODS This retrospective cohort study included 198 patients who underwent lumbar disc herniation and lumbar canal stenosis between January 2020 and December 2022. The severity of IVDD was evaluated using the Pfirrmann grading, whereas serum periostin levels were measured using ELISA kits. Clinical demographics, including age, sex, body mass index, comorbidities, psoas muscle index, and spinal disease, were also recorded. RESULTS This study demonstrated a significant correlation between high serum periostin levels and IVDD severity, as indicated by a high cumulative Pfirrmann score. Serum periostin levels were identified as an independent risk factor for IVDD in a multivariate regression model. Correlation analysis showed a correlation between periostin levels and Pfirrmann grade at each lumbar level (ρ = 0.458-0.550, p < 0.001) and a strong correlation with cumulative Pfirrmann score (ρ = 0.690, p < 0.001). CONCLUSION The higher the serum periostin level, the higher the cumulative Pfirrmann score. Multivariate analysis showed that serum periostin was an independent risk factor for IVDD. Periostin levels may be a clinically suitable and useful biomarker for diagnosing IVDD, estimating disease progression and activity, providing prognostic information, and evaluating treatment options.
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Affiliation(s)
- Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan.
| | - Takaomi Kobayashi
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Hayato Ito
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Masatsugu Tsukamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Tomohito Yoshihara
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Hirohito Hirata
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
| | - Koji Otani
- Department of Orthopaedic Surgery, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Kenji Izuhara
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga University, Saga, Japan
| | - Satoshi Nunomura
- Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga University, Saga, Japan
| | - Masaaki Mawatari
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, Japan
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Huang S, Lu K, Shi HJ, Shi Q, Gong YQ, Wang JL, Li C. Association between lumbar endplate damage and bone mineral density in patients with degenerative disc disease. BMC Musculoskelet Disord 2023; 24:762. [PMID: 37759236 PMCID: PMC10523726 DOI: 10.1186/s12891-023-06812-0] [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: 05/30/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND To explore the independent association between lumbar endplate damage and bone mineral density (BMD) in patients with degenerative disc disease (DDD). METHODS This retrospective investigation was based out of a prospectively collected database from the Affiliated Kunshan Hospital of Jiangsu University. Data from 192 DDD patients, collected between December 2018 and January 2022, were chosen for the final analysis. The average total endplate score (TEPS) of lumbar(L) 1-L4 was assessed by magnetic resonance imaging (MRI), and represents the extent of endplate damage. Osteoporosis severity was assessed via the L1-L4 BMD evidenced by dual-energy x-ray absorptiometry (DXA). Other analyzed information included gender, age, body mass index (BMI), and osteophyte score (OSTS). Uni- and multivariate linear regression analyses were employed to evaluate the association between average TEPS and BMD of L1-L4. Moreover, the generalized additive model (GAM) was employed for non-linear association analysis. RESULTS Upon gender, age, BMI, and OSTS adjustments, a strong independent inverse relationship was observed between average TEPS and BMD (β, -0.021; 95% CI, -0.035 to -0.007, P-value = 0.00449). In addition, the gender stratification analysis revealed a linear relationship in males, and a non-linear relationship in females. Specifically, there was a significantly stronger negative relationship between average TEPS and BMD in females, when the average TEPS was < 3.75 (β, -0.063; 95% CI, -0.114 to -0.013; P-value = 0.0157). However, at an average TEPS > 3.75, the relationship did not reach significance (β, 0.007; 95% CI, -0.012 to 0.027; P-value = 0.4592). CONCLUSIONS This study demonstrated the independent negative association between average TEPS and BMD values of L1-L4. Upon gender stratification, a linear relationship was observed in males, and a non-linear association in females. The findings reveal that patients with osteoporosis or endplate damage require more detailed examinations and treatment regimen.
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Affiliation(s)
- Shan Huang
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300 Jiangsu China
| | - Ke Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300 Jiangsu China
| | - Hui-juan Shi
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300 Jiangsu China
| | - Qin Shi
- Department of Orthopedics, the First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University, Suzhou, 215031 Jiangsu China
| | - Ya-qin Gong
- Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, 215300 Jiangsu China
| | - Jian-liang Wang
- Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300 Jiangsu China
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Kunshan, Suzhou, 215300 Jiangsu China
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Zheng H, Li B, Song S, Jiang L, Zheng X, Jiang S. High Endplate Hounsfield Units Value Indicate Intervertebral Disc Degeneration Following Transforaminal Lumbar Interbody Fusion Surgery. Orthop Surg 2023; 15:2291-2299. [PMID: 37526120 PMCID: PMC10475678 DOI: 10.1111/os.13793] [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: 12/20/2022] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE Lumbar disc degeneration (LDD) is a common cause of low back pain and disability, and its prevalence increases with age. The aim of this study is to investigate whether endplate Hounsfield unit (HU) values have an effect on lumbar disc degeneration (LDD) after transforaminal lumbar interbody fusion (TLIF) surgery in patients with degenerative lumbar stenosis. METHODS This study was a retrospective analysis of patients who underwent TLIF surgery in January 2016 to October 2019. One hundred and fifty-seven patients who underwent TLIF surgery for degenerative lumbar stenosis were enrolled in this study. Demographic data was recorded. VAS and ODI values were compared to assess the surgical outcomes in patients with or without process of LDD after TLIF surgery. Correlation analysis was performed to investigate associations between LDD and endplate HU value. Binary logistic regression analysis was carried out to study relationships between the DDD and the multiple risk factors. RESULTS There was a statistically significant correlation between LDD, body mass index (BMI), age, paraspinal muscle atrophy, and total endplate scores (TEPS). Also, a strong and independent association between endplate HU value and LDD was found at every lumbar disc level (p < 0.01). After conditioning on matching factors, multivariate logistic regression analysis showed that higher endplate HU (odds ratio [OR]: 1.003, p = 0.003), higher TEPS (OR: 1.264, p = 0.002), higher BMI (odds ratio [OR]: 1.202, p = 0.002), a smaller cross-sectional area (CSA) of the paraspinal muscle preoperatively (OR: 0.096, p < 0.001) were significant predictors of LDD development after TLIF surgery. CONCLUSIONS There is a significant association between LDD and endplate HU value after TLIF surgery in patients with degenerative lumbar stenosis. Beyond that, results from this study provide a mechanism by which high endplate HU value predisposes to LDD after TLIF surgery.
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Affiliation(s)
- Huo‐Liang Zheng
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Bo Li
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Shao‐Kuan Song
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Lei‐Sheng Jiang
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Xin‐Feng Zheng
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
| | - Sheng‐Dan Jiang
- Department of Clinic of Spine Center, Xinhua HospitalShanghai Jiaotong University School of MedicineShanghaiChina
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Çelen ZE, Onay T. The Relationship Between Bone Mineral Density and Lumbar Disc Herniation in Postmenopausal Women. Cureus 2023; 15:e44156. [PMID: 37753050 PMCID: PMC10519149 DOI: 10.7759/cureus.44156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION In previous studies, the relationship between BMD (bone mineral density) and LDH (lumbar disc herniation) has been investigated in young people, except for postmenopausal women. The aim of this study was to evaluate this association in postmenopausal women. METHODS A cross-sectional analysis of 545 consecutive postmenopausal women was performed at a single center. The study included patients aged 45 to 85 with low back pain. Age, weight, height, L1-L4 BMD, L1-L4 T-score, L1-L4 Z-score, femoral neck BMD, femoral neck T-score, and femoral neck Z-score of patients were collected. MRI scans were assessed for the diagnosis of LDH. To explore the impact of the number of herniated segments, patients with LDH were further divided into single-level and multi-level LDH groups. RESULTS Five hundred and thirteen postmenopausal women were included in the final analysis. The mean age of the patients was 61.3±8.6 years in the LDH group and 58.4±7.8 years in the non-LDH group (p=0.001). The LDH group had higher lumbar (p<0.001) and femoral neck (p<0.05) BMD, T, and Z-scores than the non-LDH group. In binary logistic regression analysis, age, lumbar, and femoral neck BMD were significantly associated with LDH (p<0.001, p=0.03, and p=0.040, respectively). Patients with multi-level herniation had significantly higher rates of obesity (BMI ≥30) compared to patients with single-level herniation (58.0% vs. 47.0%; p=0.031). However, in terms of obesity rates, the LDH group and the non-LDH group were statistically similar (53.9% vs. 54.2%; p=0.961). There was no association between the single and multi-level herniation groups in terms of L1-4 and femoral neck BMD (p=0.760 and 0.435, respectively). CONCLUSION Higher lumbar bone mineral density and higher femoral neck bone mineral densities were found to be associated with lumber disc herniation in postmenopausal women with low back pain. These results suggest that bone mineral density assessment may be useful in clinical practice to determine which patients are at higher risk of lumbar disc herniation.
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Affiliation(s)
- Zekeriya Ersin Çelen
- Department of Orthopaedic Surgery and Traumatology, Yalova Training and Research Hospital, Yalova, TUR
| | - Tolga Onay
- Department of Orthopaedic Surgery and Traumatology, Göztepe Training and Research Hospital, İstanbul, TUR
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Zhang Y, Patiman, Liu B, Zhang R, Ma X, Guo H. Correlation between intervertebral disc degeneration and bone mineral density difference: a retrospective study of postmenopausal women using an eight-level MRI-based disc degeneration grading system. BMC Musculoskelet Disord 2022; 23:833. [PMID: 36057596 PMCID: PMC9440522 DOI: 10.1186/s12891-022-05793-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/30/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose To explore the correlation between intervertebral disc degeneration (IDD) and bone mineral density (BMD) difference between adjacent vertebrae. Methods A retrospective analysis of 114 postmenopausal women who were treated in our hospital from January 2021 to December 2021. The degree of lumbar(L)1–5 IDD was scored according to an 8-grade scoring system. The lumbar vertebrae BMD was detected, and the BMD difference was calculated. The subjects were grouped according to age and whether the disc was severe IDD. Data were collected for statistical analysis. Results The prevalence of osteoporosis in the 51–60-year-old group was lower than that in the other groups, while the prevalence of modic changes in the 71–80-year-old group was higher than that in the 51–70-year-old group (P < 0.05). At the L1/2 level, the prevalence of severe IDD in the 81-90y group was higher than that in the 51-70y group (P < 0.05). At the L2/3 level, the prevalence of severe IDD in the 71-90y group was higher than that in the 51-60y group, and the prevalence of severe IDD in the 71-80y group was higher than that in the 61-70y group (P < 0.05). The L2/3 disc score was positively correlated with the L3-L2 BMD difference (P < 0.05). At the level of L1-2, the BMD difference in the non-severe IDD group was smaller than that in the severe IDD group (P < 0.05). Conclusion For postmenopausal women, an increase in BMD difference is correlated with IDD. Osteoporosis is more common in people over 60 years old, and the possibility of modic change in 71-80y is higher than in other age groups. The incidence of severe IDD also increases with aging, especially for the L1/2 and L2/3 discs.
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