PerspectiveIntervertebral disc “dysgeneration”
Section snippets
Acknowledgments
This work was supported by grants from the Hong Kong Theme-Based Research Scheme (T12-708/12N) and the International Society for the Study of the Lumbar Spine MacNab/LaRocca Award.
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Intervertebral disc degeneration
2022, Spine PhenotypesLumbar high-intensity zones on MRI: imaging biomarkers for severe, prolonged low back pain and sciatica in a population-based cohort
2020, Spine JournalCitation Excerpt :Furthermore, inappropriate decision-making based on the lack of understanding of lumbar MRI phenotypes (e.g. black disc, end plate abnormalities, and Modic changes) may explain the relatively high incidence of failed spinal surgeries and poor outcomes in LBP patients [5,8]. Such lumbar phenotypes have been reported to interact with pain pathways or be pain generators; thereby, having the potential to possess novel clinical utility in the decision-making process and further underscoring the importance of imaging phenotype profiling [8–14]. High-intensity zones (HIZs) are one such phenotype characterized as hyperintense regions of the intervertebral disc noted on T2-weighted (T2W) MRI (Fig. 1).
A population-based study identifies an association of THBS2 with intervertebral disc degeneration
2019, Osteoarthritis and CartilageCitation Excerpt :The MMPs degrade the extracellular matrix during tissue formation and repair23–25. Mutations in the MMP-binding region of THBS2 lead to the activation of MMPs24, which accelerates the proteolysis of proteoglycans and dehydration of the intervertebral disc, resulting in the change of MRI signal intensity26. The collagen fibers of the skin and tendon of Thbs2 knockout mice are disordered, resulting in kyphosis that slowly progresses with age27.
Progression, incidence, and risk factors for intervertebral disc degeneration in a longitudinal population-based cohort: the Wakayama Spine Study
2017, Osteoarthritis and CartilageCitation Excerpt :Over the past three decades, DD has been commonly thought to occur at a single level, predominantly in the lower lumbar spine, and that any further degeneration occurs consecutively in the adjacent intervertebral levels. However, “skipped” level DD and “dysgenerated” discs occur in the upper lumbar spine, with their occurrence being influenced by genetic, environmental, and endogenous factors in addition to aging and physical loading29–31. Furthermore, Battie et al. emphasized the importance of examining the upper and lower lumbar spine separately in the study of DD risk factors16,17.
Two subtypes of intervertebral disc degeneration distinguished by large-scale population-based study
2016, Spine JournalCitation Excerpt :Previous studies had proposed that ECs were associated with developmental deviance of the vertebrae during early life [42]. Luk and Samartzis [43] recently proposed the concept of intervertebral disc “dysgeneration,” in which some discs may have never fully developed. Our findings that ECs and upper level disc features are not related to age or BMI indicate that these features are often present from a young age and are not the result of aging or mechanical load, and support a developmental or dysgenerational origin for these features.
FDA device/drug status: Not applicable.
Author disclosures: KDKL: Endowments: Tam Sai Kit endowment Professorship (E US per annum, Paid directly to institution). DS: Grants: RGC Hong Kong AOSpine (F).
The disclosure key can be found on the Table of Contents and at www.TheSpineJournalOnline.com.
Disclosures: The authors have no financial or competing interests to disclose in relation to this work.