Influência genética na degeneração do disco intervertebral

PROSPECTIVE CONTROLLED STUDY OF SPINAL SURGERY VERSUS PHYSICAL CAPACITY

Objectives

Assess whether the spine surgical approach for degenerative diseases can influence the physical capacity of patients and its correlation with cardiorespiratory function.

Methods

A prospective study was conducted on 9 patients of both genders, aged between eighteen and sixty, scheduled for spinal surgery for degenerative disease in the lumbar segment. Patients underwent treadmill stress test two times, fifteen days before and sixty days after the surgery. A cardiologist performed the test according to the Bruce protocol with a progressive increase in incline and speed.

Results

There were no statistically significant differences between pre- and postoperative assessments for the parameters evaluated in the treadmill stress test. Forty-four percent of patients needed to interrupt the test postoperatively due to dyspnea (p=0.023).

Conclusion

The improvement obtained with spinal surgery does not have statistically significant relevance in tiredness, pain, and fatigue in the lower limbs and low back pain. Some patients could not complete the examination after surgery due to poor physical conditioning, and it was necessary to interrupt the examination due to dyspnea. Level of Evidence II; Lesser quality RCT (eg, < 80% followup, no blinding, or improper randomization).

MRI Phenotyping of COL9A2/Trp2 and COL9A3/Trp3 Alleles in Lumbar Disc Disease: A Case-control Study in South-Western Iranian Population Reveals a Significant Trp3-Disease Association in Males

STUDY DESIGN

A case-control study of the Trp2/3 alleles of COL9A2/3 genes and their correlation with occurrence of Lumbar disc disease (DDD) as phenotyped by magnetic resonance imaging.

OBJECTIVE

To establish a better understanding of relationship between presence of said alleles and occurrence of DDD in South-Western Iranian population.

SUMMARY OF BACKGROUND DATA

A number of genetic predisposing factors have been identified in elevating the risk of developing DDD. Specifically, the Trp2 and Trp3 alleles of COL9A2 and COL9A3 genes have been suggested as DDD risk variants.

METHODS

A total of 108 patients (mean age = 41±11.8 yrs, range = 20-66 yrs) with 57 controls (mean age = 35±10.0 yrs, range = 20-58 yrs) participated in the study. The frequency of G/A polymorphism in COL9A2 gene on location 326 on chromosome 1 and G/A/C/ or T polymorphism in 103 location of COL9A3 gene on chromosome 20 was assessed using a PCR short-primer technique. Outcome measure was defined as presence of DDD on MRI. Odds ratios (OR) and 95% confidence intervals (CI) were used to assess the likelihood of DDD given occurrence of Trp2(3).

RESULTS

Each allele was present in both patients and controls. The Trp2 allele was positive in 28.5% of individuals (31.5% of patients; 22.8% of controls), OR 1.55 (0.71-3.56). The Trp3 allele, the frequency was 23.6% in all patients (26.9% patients; 17.5% controls), OR 1.72 (0.73-4.33). We observed a 5.8-fold increase in the odds of DDD in males when the Trp3 allele was present, OR 5.83 (1.09-9.98), P = 0.0273.

CONCLUSION

Both Trp2 and Trp3 alleles occurred more frequently compared with other studied ethnicities. The sampled Iranian population exhibited a similar Trp2 frequency to a Southern Chinese population, and Trp3 occurrence to Finnish and Greek population. We found that male patient were much more likely to develop DDD when Trp 3 was present.

LEVEL OF EVIDENCE

N/A.