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3 results on '"nikamavälilevyn rappeuma"'

1. Isthmic Spondylolisthesis is Associated with Less Revisions for Adjacent Segment Disease After Lumbar Spine Fusion Than Degenerative Spinal Conditions : A 10-Year Follow-Up Study

Author

Heikki Mäntymäki, Marko H. Neva, Hannu Kautiainen, Arja Häkkinen, Leevi Toivonen, Tampere University, Department of Musculoskeletal Diseases, and Clinical Medicine

Subjects
medicine.medical_specialty, adjacent segment disease, Lumbar spine fusion, spondylolisteesi, nikamavälilevyn rappeuma, Isthmic spondylolisthesis, leikkaushoito, lanneranka, isthmic spondylolisthesis, selkäsairaudet, degenerative spinal disorders, Medicine, Orthopedics and Sports Medicine, revisions, spinal stenosis, business.industry, 10 year follow up, adjacent segment pathology, degenerative lumbar spine disorders, degenerative spondylolisthesis, 3126 Surgery, anesthesiology, intensive care, radiology, Surgery, hoitotulokset, Neurology (clinical), Adjacent segment disease, lumbar spine fusion, business
Abstract

Objective: We aim to compare the rate of revisions for adjacent segment disease (ASD) after lumbar spine fusion (LSF) surgery between patients with isthmic spondylolisthesis (IS) and degenerative lumbar spine disorders (DLSD). Summary of Background Data: ASD is a major reason for late reoperations after LSF surgery. Several risk factors are linked to the progression of ASD, but the understanding of the underlying mechanisms is imperfect. If IS infrequently becomes complicated with ASD, it would emphasize the role of the ongoing degenerative process in spine in the development of ASD. Methods: 365 consecutive patients that underwent elective LSF surgery were followed up for an average of 9.7 years. Surgical indications were classified into 1) IS (n=64), 2) DLSD (spinal stenosis with or without spondylolisthesis) (n=222), and 3) other reasons (deformities, postoperative conditions after decompression surgery, posttraumatic conditions) (n=79). All spinal reoperations were collected from hospital records. Rates of revisions for ASD were determined using Kaplan-Meier methods. Results: Altogether, 65 (17.8%) patients were reoperated for ASD. The incidences of revisions for ASD in subgroups were 1) 4.8% (95% CI: 1.6 to 22.1%); 2) 20.5% (95% CI: 15.6 to 26.7%); 3) 20.6% (95% CI: 12.9 to 31.9%). After adjusting the groups by age, sex, fusion length, and the level of the caudal end of fusion, when comparing with IS group, the other groups had significantly higher hazard ratios (HR) for the revision for ASD [2) HR (95% CI) 3.92 (1.10 to 13.96), p=0.035], [3) HR (95% CI) of 4.27 (1.11 to 15.54), p=0.036]. Conclusions: Among patients with IS, the incidence of revisions for ASD was less than a 4th of that with DLSD. Efforts to prevent the acceleration of the degenerative process at the adjacent level of fusion are most important with DLSD. peerReviewed

Published
2022

2. Association between severe lumbar disc degeneration and self-reported occupational physical loading

Author

Hurri, Heidi, Lääketieteen laitos, School of Medicine, Terveystieteiden tiedekunta, Lääketieteen laitos, Kliininen lääketiede, Faculty of Health Sciences, School of Medicine, Clinical Medicine, Terveystieteiden tiedekunta, and Faculty of Health Sciences

Subjects
kliininen lääketiede, smärta, kuormitus, nikamavälilevyn rappeuma, kipu, ryggsjukdomar, spinal diseases, load, ryggrad, spine, postmenopause, belastning, ammattitaudit, selkäranka, selkäsairaudet, degenerative disc disease, occupational diseases, intervertebraldiskdegeneration, yrkessjukdomar, clinical medicine, pain, lumbosacral region
Published
2022

3. The search for susceptibility genes in lumbar disc degeneration:focus on young individuals

Author

Männikkö, M. (Minna), Karppinen, J. (Jaro), Eskola, P. (Pasi), Männikkö, M. (Minna), Karppinen, J. (Jaro), and Eskola, P. (Pasi)

Abstract

Low back pain (LBP) is a truly enervating condition, presenting with considerable negative socioeconomic and health impacts on many levels. Although LBP may be attributed to many factors, there is increasing evidence that disc degeneration (DD) of the lumbar spine is a strong contributing factor, especially among young individuals. Understanding the aetiopathogenesis of DD has changed over the past few decades as numerous studies have indicated that inherited factors are largely responsible for the development of DD. Despite the many genetic associations in DD that have been reported, these associations have proven difficult to validate. The genetic component of DD is still unexplained for the most part. Previous studies have focused on adults, who have been exposed to environmental risk factors of DD, which may mask genetic associations. Thus, investigations among young individuals are well justified. The purpose of this study was to validate the associations between DD defined by magnetic resonance imaging (MRI) and genetic polymorphisms in two study populations of Finnish and Danish young individuals. New polymorphisms that have not been associated with DD were also included in the study. Associations with progression of DD were also investigated among Danish individuals. Furthermore, this study aimed to clarify the level of evidence of previously identified associations. Among Finnish individuals, polymorphisms in IL6, SKT and CILP were associated with moderate DD, but the association in CILP was significant only in women. Among Danish individuals, polymorphisms in IL6 and IL1A were associated with early DD and progression of DD. The genetic associations among the Danish teenagers were gender-specific as they were mainly observed in girls. Among both populations, the individuals with DD were significantly taller than individuals without DD. In the systematic analysis of previous reports, polymorphisms in GDF5, THBS2, MMP9, COL11A1, SKT and ASPN were fou, Tiivistelmä Alaselkäkipu on yksi merkittävimmistä toimintakykyyn vaikuttavista sairauksista. Alaselkäkivun riskitekijöitä tunnetaan useita, mutta näyttö siitä, että selän välilevyrappeuma on yksi tärkeimmistä riskitekijöistä, erityisesti nuorilla henkilöillä, lisääntyy jatkuvasti. Aiemmat tutkimukset ovat osoittaneet, että perintötekijöillä on merkittävä osuus välilevyjen rappeutumisessa. Useiden geenien on raportoitu vaikuttavan välilevyrappeumaan. Positiivisten tulosten toistaminen on kuitenkin osoittautunut vaikeaksi, ja kokonaiskuva on vielä suurelta osin epäselvä. Aikaisemmat tutkimukset aiheesta ovat keskittyneet aikuisiin, joilla nuoria pidempi altistus ympäristötekijöille saattaa peittää geneettisten tekijöiden yhteyttä. Tämän tutkimuksen tavoitteena oli varmentaa yhteyksiä magneettikuvauksella (MRI) määritetyn välilevyrappeuman ja geneettisten monimuotoisuuskohtien (polymorfioiden) välillä käyttäen yhtä suomalaisista ja yhtä tanskalaisista nuorista koostuvaa aineistoa. Työssä analysoitiin myös polymorfioita, joita ei ole aiemmin yhdistetty välilevyrappeumaan. Yhteyttä polymorfioiden ja välilevyrappeuman etenemisen välillä tutkittiin tanskalaisessa aineistossa. Lisäksi tutkimuksen tavoitteena oli selvittää aiemmin tunnistettujen geneettisten yhteyksien näytön aste. Suomalaisten nuorten aineistossa polymorfiat IL6-, SKT- ja CILP-geeneissä olivat yhteydessä kohtalaista astetta olevaan välilevyrappeumaan. Tanskalaisten nuorten aineistossa polymorfiat IL6- ja IL1A-geeneissä olivat yhteydessä varhaiseen välilevyrappeumaan ja sen etenemiseen. Tanskalaisten nuorten aineistossa nämä yhteydet olivat sukupuolesta riippuvaisia, koska yhteyksiä havaittiin pääasiassa tytöillä. Suomalaisten nuoren aineistossa yhteys CILP-geenissä havaittiin ainoastaan nuorilla naisilla. Kummassakin tutkimusaineistossa nuoret, joilla oli välilevyrappeuma, olivat pidempiä, kuin nuoret, joilla ei ollut välilevyrappeumaa. Aikaisempien tutkimusten systemaattinen analyysi osoitti, että tunniste

Published
2012

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