Spine research highlights
A meta-analysis showed that those over 50 with disc bulge, disc herniation, modic type 1 and disc degeneration more likely to be painful than asymptomatic controls.
Complex loading conditions revealed that flexion was the most unsafe for the intervertebral disc causing annulus fibrosus disruption.
Understanding how the neural arch stress shields the interverterbal disc and how the annulus delaminates as progressive loads induces disc degeneration.
Lying down has a significant influence on the thoracic and cervical discs of the spine. In this research they looked at the changes with the simple act of lying down for 27 minutes.
Medial branch abalation is a common treatment for low back pain. The intent is to deaden the nerves that are providing sensory input from the facet joints. In this study, they found that doing so causes further degeneration.
Depression and low back pain appear to be connected somehow. These researchers used a longitudinal twin study to determine if the depression and low back pain were causal. They found they were not.
Much attention has been devoted to the topic of lifting mechanics. In this study, researchers looked at the mechanics of lifting and found that the spine angles were more important as the hip and knees. Maintaining lordosis within the lumbar spine is the important factor in lifting.
Movement of synovial joints can be noisy. These subtle sounds cannot always be heard or felt in the lumbar spine because they are such distance from one’s ears. These researchers looked to measure the vibrations and sounds of the z joints of the lumbar spine before and after manipulation. Our models, can show this crepitus.
How discs move and what is optimal for convection transport of nutrients? This is what these researchers looked at. They looked at low rate loading and high rate loading of intervertebral discs in New Zealand rabbits. Low rate loading increased net transport of nutrients into the nucleus where high rate loading reduced it.
The seated slump position was found to have over 17 degrees more range of motion when compared to normal flexion conventional movement in the assessment of spinal instability and other abnormal motion patterns.
Pain often presents in the load bearing state. That is, patients often clinically complain of back and/or leg and/or arm pain when they are vertically oriented. Even in the act of sitting when the spine is under a static load the intervertebral discs must support hydraulically to resist compression. Here, these researchers looked closely at the spinal tissues using upright MRI.
There are over 150 diseases of the musculoskeletal frame related to pain. These researchers reviewed the current research and concluded that the subchondrial and hyaline interface is where the problems begin. They call it the osteoarticular junction. This is also why we placed this anatomical detail in our models.
Disc herniation can cause a multitude of biomechanical scenarios that includes the stretching of nerve roots as it relates to radiculopathy. Careful anatomical assessment can help distinguish the mechanical strategies to relieve sciatica.
In this randomized controlled trial, researchers compared mind-body interventions and the usual medical treatment approach to chronic low back pain. There is growing evidence that stress reduction is important, but the mechanics should never be dismissed.
Aging is a natural tendency of the the human spine. The intervertebral disc can develop annular fissures as early as the first decade of life. Teaching this concept to the young and old can be helpful in the discussions of the mechanisms related to aging.
A review on Lumbar Spinal Stenosis concluded that conservative treatment results in no side effects while surgical treatment did. Therefore, a course of conservative treatment should always be considered. A clinical clue is that lumbar flexion most often increases the spinal canal diametre.
These authors looked at clinical ways to determine if a patient will respond to exercises with spinal instability. They use four variables with one being the prone instability test to predict the probability of success.
In this study, they believe that resistance extension exercise can impart regeneration to the intervertebral discs if done in a high load, low volume, and low frequency manner. Share with patients that the disc has the ability to self heal itself, if the right motions are induced.
In this histochemical study, they eloquently demonstrated the nerve distribution of the posterior longitudinal ligament in the lumbar region. Yes, it was done on rats but the detail is excellent. Many disc bulges and herniations have some impact on the PLL. Cited by 92 other researchers.
Disc height loss is often at the crux of many back pain sufferers. Here, researchers looked at the risk factors in the elderly as a longitudinal population based study. The results showed a gradual disc height loss of 5.8% over ten years. Our clinical strategies should focus on trying to slow this height loss down.
17 patients with chronic lumbar back pain were treated with intraosseous basivertebral nerve ablation. Significantly improved outcomes were seen in the early follow-up period, and these improvements lasted the entire 1 year study period.
As disc degeneration increases, stress gradients in the annulus increase too. This acts to sheer adjacent lamellae, potentially explaining annulus collapse.
Low rate loading enabled the rapid uptake and clearance of gadodiamide in discs. After 5 minutes of loading, an increase of 16.8% of transport into the nucleus was observed, compared to unloaded discs.
A twofold to threefold increase in the transport of antibodies was observed in cartilage plugs under mechanical cyclic compression. The highest transport was seen in areas with the highest interstitial fluid velocity
In a study of 1,043 patients, minimally invasive spine surgery significantly reduced infection rate. Non-instrumented minimally invasive spine surgery had no site infections at all.
In a study of 419 patients, ligamentum flavum thickness significantly increased in patients with severe disc degeneration. Increased ligament flavum thickness was also correlated with patient age and in more sagittalized facet joints.
In a meta analysis of 50 cell therapy animal studies, all reported some improvement in disc structure. Two reported attenuation of local inflammation. A frequent problem with this therapy was cell leakage, but the early results are positive.
Patients who chose to receive physical therapy for lumbar intervertebral disc herniation saw no significant difference in pain or disability over one year.
In a 2016 free full text study, researchers looked to identify lumbar disc disease and lumbar disc herniation and found that in over 26,000 cases the prevalence was 44.23% and 14.18% respectively.
A study of twenty alpacas were rated according to the Pfirmann-grade for degeneration of the cervical intervertebral discs. Advanced disc degeneration was present in 47% of the older alpacas, while young alpacas were almost immune from such degeneration.
In this study, 558 young adults had MRI scans to assess their disc degeneration. Those who ran or swam at least twice a week were associated with lumbar disc degeneration.
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The models we build are informed by over 400 academic research articles with only a few below.