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1.
Int J Rheum Dis ; 25(4): 466-473, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35092627

RESUMO

OBJECTIVE: A relationship between spine osteoarthritis (OA) and metabolic syndrome has not been established. This study evaluated whether metabolic syndrome is associated with radiographic spine OA in the Korean population. METHODS: A total of 2252 subjects older than 50 years who underwent plain radiography of the lumbar spine during the Korea National Health and Nutrition Examination Survey (KNHANES) 2012 were enrolled. Radiographic grading of the lumbar spine was performed using the Kellgren-Lawrence (K-L) grading scale, ranging from grade 0 to grade 2. K-L grade 2 was defined as lumbar spine OA, while those of K-L grade 0 or 1 were defined as controls. RESULTS: The prevalence of spine OA was 28.1% (n = 689). The prevalence of metabolic syndrome in spine OA was not different from that among controls. The cumulative number of metabolic syndrome components was significantly different between spine OA and controls (P = .027). Subjects with K-L grade 1 or grade 2 showed higher proportion of metabolic syndrome and its cumulative components than those of K-L grade 0. Two or 3 or more metabolic syndrome components were significantly associated with spine OA (P = .012 and P = .010, respectively). Abnormal waist circumference was weakly associated with spine OA (odds ratio 1.233, 95% CI 1.000-1.520, P = .050). Multivariate logistic regression analysis showed that older age and female gender were linked with spine OA, but not metabolic syndrome. CONCLUSION: This study found lack of association between metabolic syndrome and radiographic spine OA.


Assuntos
Síndrome Metabólica , Osteoartrite do Joelho , Osteoartrite da Coluna Vertebral , Estudos Transversais , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Síndrome Metabólica/diagnóstico por imagem , Síndrome Metabólica/epidemiologia , Inquéritos Nutricionais , Osteoartrite do Joelho/epidemiologia , Osteoartrite da Coluna Vertebral/diagnóstico por imagem , Osteoartrite da Coluna Vertebral/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-35055784

RESUMO

This case report speculates that the prolonged vibrations from enduro off-road sports are deleterious to the spine. The results of this case report may also aid sports physicians in better understanding this complex and relatively unknown phenomenon. No published data are present in the current literature that demonstrate the correlation between early spine osteoarthritis from enduro motorcycle overuse and the long-term management effects of a non-invasive kinesiological approach to reduce pain and inflammation and improve spine mobility and muscle strength.


Assuntos
Osteoartrite da Coluna Vertebral , Esportes , Humanos , Motocicletas , Dor , Vibração
3.
Medicina (Kaunas) ; 58(1)2022 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-35056434

RESUMO

Background and Objective: This study assessed comorbidities and health-related quality of life (HRQOL) in subjects with lumbar spine osteoarthritis (OA) in the Korean population. Materials and Methods: We analyzed 3256 subjects who were 50 years or older and underwent plain radiography of the lumbar spine as part of the Korea National Health and Nutrition Examination Survey (KNHANES) 2012. Radiographic assessment was based on Kellgren-Lawrence (K-L) grade ranging from 0 to 2, with K-L grade 2 defined as lumbar spine OA. HRQOL was assessed by EuroQol-5 dimensions (EQ-5D), which include the EQ-5D index and visual analogue scale (EQ-VAS) measurements. Results: Comorbidities such as hypertension, myocardial infarction, angina, cerebral infarction, and diabetes mellitus were more frequent in spine OA than in controls, while dyslipidemia was less common. Subjects with spine OA had higher mean number of comorbid conditions than controls (1.40 (SE 0.05) vs. 1.20 (SE 0.03), p = 0.001). Subjects with spine OA had much lower EQ-5D index than controls (p < 0.001) but not lower EQ-VAS score. Multivariate binary logistic analysis showed that hypertension and colon cancer were associated with spine OA compared to controls (OR 1.219, 95% CI 1.020-1.456, p = 0.030 and OR 0.200, 95% CI 0.079-0.505, p = 0.001, respectively) after adjustment for confounding factors. Lower EQ-5D index was related to spine OA (95% CI 0.256, 95% CI 0.110-0.595, p = 0.002) but not EQ-VAS score. Conclusion: In this study, we found that comorbidities such as hypertension and colon cancer as well as lower HRQOL were associated with spine OA.


Assuntos
Osteoartrite da Coluna Vertebral , Qualidade de Vida , Estudos Transversais , Humanos , Inquéritos Nutricionais , República da Coreia/epidemiologia
5.
Skeletal Radiol ; 51(6): 1261-1271, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34792625

RESUMO

OBJECTIVE: Obesity has been proposed as a risk factor for low back pain (LBP) and intervertebral disc degeneration (IVDD). Even though body mass index (BMI) is used as a parameter for obesity, it could not represent percentage and distribution of the body fat. Subcutaneous fat tissue thickness (SFTT) was proposed as one of the magnetic resonance imaging (MRI) parameters to evaluate the percentage of the body fat. In this study, we aimed to find out whether SFTT at lower back correlated with LBP and spine degeneration. MATERIALS AND METHODS: We retrospectively reviewed a database of the patients with LBP. Concomitantly, asymptomatic control subjects were retrieved. Patients and control subjects were evaluated in terms of IVDD and Modic changes at all lumbar levels on MRI. SFTT was measured both on MRI and computed tomography (CT) scans, where applicable. RESULTS: SFTT at the lumbar spine had moderate-to-strong correlations with BMI. SFTT at L1-L2 level was significantly associated with severe IVDD at L5-S1 level, and Modic changes at L4-L5 and L5-S1 levels. BMI had no significant association with severe IVDD and Modic changes at lumbar spine. BMI and mean SFTT of all lumbar levels had ORs of 0.735 (95% CI: 0.631-0.857, p < 0.001) and 1.389 (95% CI: 1.266-1.524, p < 0.001) in predicting symptomatic subjects with LBP. CONCLUSION: SFTT at upper lumbar levels could predict severe IVDD and Modic changes better than BMI, specifically in men. SFTT was better than BMI in predicting a symptomatic patient with LBP.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Osteoartrite da Coluna Vertebral , Tecido Adiposo/diagnóstico por imagem , Humanos , Degeneração do Disco Intervertebral/patologia , Dor Lombar/diagnóstico por imagem , Dor Lombar/patologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Região Lombossacral , Imageamento por Ressonância Magnética , Masculino , Obesidade/diagnóstico por imagem , Estudos Retrospectivos
6.
Ann Phys Rehabil Med ; 65(1): 101427, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32798770

RESUMO

BACKGROUND: Patients with back pain can show one or more features of spinal osteoarthritis (OA), such as morning stiffness, limited or painful range of motion (ROM), and lumbar disc degeneration (LDD). However, it has not been investigated whether these features are prognostic of long-term back pain. OBJECTIVES: This study assessed whether spinal morning stiffness, ROM and LDD are prognostic factors for back pain after 1 year in older adults with back pain. METHODS: This prospective observational study (BACE cohort) included patients aged>55 years visiting a general practitioner for a back-pain episode. Baseline patient-reported morning stiffness, physical examined ROM and radiographic LDD features (i.e., multilevel osteophytes and disc space narrowing) were analysed as potential prognostic factors in unadjusted and adjusted regression models with the outcomes of persistent back pain (yes/no) and back pain severity after 1-year follow-up. RESULTS: This study included 543 patients with mean (SD) age 67 (8) years, 59% female, and 62% reporting back pain at 1-year follow-up. When studied in separate adjusted models, persistent back pain was associated with morning stiffness>30min (OR 3.0, 95%CI 1.3; 5.5), restricted lateroflexion (OR 1.8, 95%CI 1.0; 3.2), pain during rotation (OR=1.7, 95%CI 1.0; 2.9), multilevel osteophytes (OR 2.4, 95%CI 1.4; 4.1), and multilevel disc space narrowing (OR 1.5, 95%CI 0.9; 2.4). When investigated in the same adjusted model, persistent back pain remained associated with only morning stiffness>30min (OR 2.4, 95%CI 1.0; 3.9), pain during rotation (OR 1.6, 95%CI 0.9; 2.8), and multilevel osteophytes (OR 2.1, 95%CI 1.2; 3.7). The same spinal OA-related features were associated with back pain severity. CONCLUSIONS: Spinal morning stiffness, painful rotation, and multilevel osteophytes are prognostic factors for persistent back pain and back pain severity after 1 year. Evaluating these clinical and radiographic features of spinal OA could help clinicians identify older patients who will experience long-term back pain.


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Osteoartrite da Coluna Vertebral , Idoso , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoartrite da Coluna Vertebral/diagnóstico por imagem
7.
World Neurosurg ; 159: e273-e284, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34929370

RESUMO

OBJECTIVE: The primary objective of the present study was to investigate the correlations among cervical paraspinal muscle morphology changes (fatty infiltration [FI] and muscle atrophy), cervical degeneration, and clinical features in patients with chronic nonspecific neck pain (CNSNP). METHODS: The magnetic resonance imaging data for 55 consecutive patients (average age, 35.80 years) with CNSNP were analyzed in the present cross-sectional study. The muscle morphology changes in 7 groups of paraspinal muscles, indicated by the adjusted cross-sectional area (aCSA) and FI ratio (FI%), were measured from C3/4 to C6/7. The correlations of these changes with disc degeneration, cervical balance (C2-C7 angle and cervical alignment), and clinical features (severity of neck pain and related disability and frequency of acute neck pain recurrence) were evaluated. RESULTS: Significant correlations between FI% and aCSA and the grade of disc degeneration were observed in specific muscle groups at each level (P < 0.05). Morphological changes in the deep extensors and superficial paraspinal muscles were significantly associated with the cervical balance parameters (P < 0.05). The FI% showed a significant positive correlation, and the aCSA showed a significant negative correlation with the severity of neck pain and related disability (P < 0.05). Correlations between the morphological changes and the frequency of acute neck pain recurrence were also present in specific muscles (P < 0.05). CONCLUSIONS: Correlations among the muscle morphology changes, cervical degeneration, and clinical features were established for patients with CNSNP. Muscle volume changes and FI might affect CNSNP diversely through different paraspinal muscle groups. These results imply a complex contribution of muscle morphological changes to cervical degeneration and the clinical course of CNSNP.


Assuntos
Dor Crônica , Degeneração do Disco Intervertebral , Osteoartrite da Coluna Vertebral , Adulto , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologia , Dor Crônica/diagnóstico por imagem , Dor Crônica/patologia , Estudos Transversais , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/patologia , Imageamento por Ressonância Magnética/métodos , Músculos , Cervicalgia/diagnóstico por imagem , Cervicalgia/patologia , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/patologia
8.
Medicine (Baltimore) ; 100(44): e27670, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34871243

RESUMO

ABSTRACT: The cortical bone trajectory screws technique (CBTT) is a popular minimally invasive spine surgery. Few studies have reported long-term outcomes. We aimed to evaluate the complication profile and long-term follow-up results of patients with lumbar degenerative disease treated with the CBTT.This retrospective analysis included the first 40 consecutive patients that underwent the CBTT. The indication for surgery was critical stenosis of the intervertebral foramen, which required removal of the entire intervertebral joint, on at least 1 side, during decompression.The last follow-up showed minimal clinically important differences in the numerical rating scale of leg pain, the numerical rating scale of back pain, and the Oswestry Disability Index, in 97%, 95%, and 95% of patients, respectively. Thirty-nine patients completed long-term radiological follow-up. Computed tomography demonstrated solid bone union on 47 (92%) operated levels, collapsed union on 2 (4%) levels, nonunion on 1 (2%) level, and 1 (2%) patient was lost to follow-up. Seven patients experienced complications (4 hardware-related). Three patients required 4 revision surgeries.The CBTT effectively achieved spinal fusion; over 90% of patients achieved clinical improvement at a mean follow-up of 4.4 years (range: 3-5.75 years).


Assuntos
Parafusos Ósseos , Osso Cortical , Vértebras Lombares/cirurgia , Fusão Vertebral , Espondilose/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Osso Cortical/diagnóstico por imagem , Osso Cortical/cirurgia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Osteoartrite da Coluna Vertebral , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Espondilose/diagnóstico por imagem , Resultado do Tratamento
9.
J Clin Endocrinol Metab ; 106(12): 3428-3438, 2021 11 19.
Artigo em Inglês | MEDLINE | ID: mdl-34375425

RESUMO

CONTEXT: Although homocysteine accumulation is a reported risk factor for several age-related disorders, little is known about its relationship with osteoarthritis (OA). OBJECTIVE: We investigated for associations of homocysteine and C677T polymorphism in methylenetetrahydrofolate reductase (MTHFR), which is involved in homocysteine clearance, with the development and progression of spinal OA through a combined cross-sectional and longitudinal cohort study. METHODS: A total of 1306 Japanese postmenopausal outpatients participating in the Nagano Cohort Study were followed for a mean 9.7-year period. Cross-sectional multiple logistic regression for spinal OA prevalence at registration by serum homocysteine level was performed with adjustment for confounders. In addition to Kaplan-Meier analysis, multivariate Cox regression was employed to examine the independent risk of MTHFR C677T variant for spinal OA progression. RESULTS: Multivariate regression analysis revealed a significant association between homocysteine and spinal OA prevalence (odds ratio 1.38; 95% CI 1.14-1.68). Kaplan-Meier curves showed a gene dosage effect of the T allele in MTHFR C677T polymorphism on the accelerated progression of spinal OA severity (P = 0.003). A statistically significant independent risk of the T allele for spinal OA advancement was validated by Cox regression analysis. Respective adjusted hazard ratios for the CT/TT and TT genotypes were 1.68 (95% CI, 1.16-2.42) and 1.67 (95% CI, 1.23-2.28). CONCLUSION: Circulating homocysteine and C677T variant in MTHFR are associated with the prevalence rate and ensuing progression, respectively, of spinal OA. These factors may represent potential interventional targets to prevent OA development and improve clinical outcomes.


Assuntos
Predisposição Genética para Doença , Homocisteína/metabolismo , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Osteoartrite da Coluna Vertebral/epidemiologia , Polimorfismo Genético , Pós-Menopausa , Idoso , Alelos , Estudos Transversais , Feminino , Seguimentos , Genótipo , Humanos , Japão/epidemiologia , Estudos Longitudinais , Pessoa de Meia-Idade , Osteoartrite da Coluna Vertebral/genética , Osteoartrite da Coluna Vertebral/metabolismo , Osteoartrite da Coluna Vertebral/patologia , Prognóstico , Fatores de Risco
10.
Exp Gerontol ; 149: 111311, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33744392

RESUMO

Naturally occurring spine osteoarthritis is clinically associated with the manifestation of chronic inflammatory muscle (myofascial) disease. The purpose of this study was to investigate the causal association between experimentally induced spine osteoarthritis and neurogenic inflammatory responses within neurosegmentally linked myotomes. Wistar Kyoto rats were randomly assigned to spine facet compression surgery (L4-L6) or sham surgery. Animals exposed to facet compression surgery demonstrated radiographic signs of facet-osteoarthritis (L4-L6 spinal levels) and sensory changes (allodynia, thermal hyperalgesia) at 7, 14 and 21 days post-intervention, consistent with the induction of central sensitization; no radiologic or sensory changes were observed after sham surgery. Increased levels of proinflammatory biomarkers including substance P (SP), calcitonin gene related peptide (CGRP), protease-activated receptor-2 (PAR2) and calcium/calmodulin dependent protein kinase II (CaMKII) were observed post-surgery within neurosegmentally-linked rectus femoris (L2-L5) muscle when compared to the non-segmentally linked biceps brachii (C4-C7) muscle; no differences were observed between muscles in the sham surgery group. These findings offer novel insight into the potential role of spine osteoarthritis and neurogenic inflammatory mechanisms in the pathophysiology of chronic inflammatory muscle (myofascial) disease.


Assuntos
Osteoartrite da Coluna Vertebral , Animais , Peptídeo Relacionado com Gene de Calcitonina , Hiperalgesia , Inflamação Neurogênica , Ratos , Ratos Sprague-Dawley , Substância P
11.
BMC Pulm Med ; 21(1): 59, 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33593334

RESUMO

BACKGROUND: Asthma and osteoarthritis (OA) are medical conditions that inhibit physical activity and adversely affect quality of life. Despite the high prevalence, there are limited studies focusing on the comorbid condition and association between asthma and OA. The aim of this study was to assess the prevalence of OA co-occurring with asthma and to identify the relevant clinical considerations. METHODS: Adult participants aged over 40 years who completed questionnaire assessments and spirometry tests were enrolled from the Korean National Health and Nutrition Examination Survey. Asthma and OA were defined based on the medical history of a diagnosis made by a doctor. Radiographic severities of OA were measured using the Kellgren-Lawrence grading system. Chronic obstructive pulmonary disease (COPD), as a comparative respiratory disease, was diagnosed based on the spirometric results. RESULTS: A total of 9344 subjects were enrolled, and the prevalence of asthma and COPD were 4.6% ± 0.3% and 12.0% ± 0.5%, respectively. The prevalence of OA in the asthma group was 31.9% ± 2.8%, which was significantly higher than that in the COPD (17.8% ± 1.5%) or control (16.2% ± 0.6%) groups. OA was more prevalent in patients with asthma after adjusting for age, sex, body mass index, and smoking status (OR 1.65; 95% CI 1.27-2.13). Furthermore, after adjustment of this model for the prescription of OA medication, OA remained independently associated with asthma (OR 1.56; 95% CI 1.10-2.20). Conversely, the relationship of OA medication with asthma was not significant (P = 0.64). This relationship was evident in patients with asthma without airflow limitation measured by spirometry (OR 1.97; 95% CI 1.32-2.93). Moreover, the radiographic severity of knee OA correlated with asthma (OR 1.10; 95% CI 1.0-||1.21). CONCLUSIONS: OA shows a high prevalence in patients with asthma, higher than in patients with COPD or the controls. The comorbid characteristics of these two conditions need to be considered in clinical practice.


Assuntos
Asma/epidemiologia , Osteoartrite/epidemiologia , Adulto , Idoso , Asma/fisiopatologia , Estudos de Casos e Controles , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite da Coluna Vertebral/epidemiologia , Prevalência , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , República da Coreia/epidemiologia , Fumar/epidemiologia , Espirometria , Capacidade Vital
12.
Mol Cell Biochem ; 476(4): 1929-1938, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33502650

RESUMO

Tumor necrosis factor receptor-associated factor 6 (TRAF6), a regulator of NF-κB signaling, has been discovered recently to be probably related to osteoarthritis, while the function of TRAF6 in lumbar facet joint osteoarthritis(FJOA)still remains unknown. The aim of this study was to probe the specific function of TRAF6 in chondrocytes and its connection with the pathophysiology of FJOA. We found upregulation of TRAF6 in FJOA cartilage by western blot analysis. In vitro, we stimulated immortalized human chondrocytes by LPS to establish the cells apoptosis model. Western blot analysis demonstrated that levels of TRAF6 and cleaved caspase-3/8 in the chondrocyte injury model increased significantly. Knockdown of TRAF6 suppressed the expression of matrix metallopeptidase-13 (MMP-13) and interleukin-6 (IL-6) induced by LPS, and alleviated cell apoptosis. Meanwhile, western blot and immunofluorescent staining demonstrated that IκBα degradation and p65 nuclear transportation were also inhibited, revealing that knockdown of TRAF6 suppressed activation of the NF-κB pathway in LPS-induced chondrocytes apoptosis model. Collectively, our findings suggest that TRAF6 plays a crucial role in FJOA development by regulating NF-κB signaling pathway. Knockdown of TRAF6 may supply a potential therapeutic strategy for FJOA.


Assuntos
Apoptose , Condrócitos/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/deficiência , Osteoartrite da Coluna Vertebral/metabolismo , Transdução de Sinais , Fator de Transcrição RelA/metabolismo , Articulação Zigapofisária/metabolismo , Linhagem Celular Transformada , Condrócitos/patologia , Técnicas de Silenciamento de Genes , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Osteoartrite da Coluna Vertebral/genética , Osteoartrite da Coluna Vertebral/patologia , Fator de Transcrição RelA/genética , Articulação Zigapofisária/patologia
13.
Spine J ; 21(1): 80-89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32805432

RESUMO

BACKGROUND CONTEXT: In the lumbar spine osteoarthritis (LS-OA) population having surgery for lumbar spinal stenosis (LSS) symptoms, a significant proportion of patients experience limited benefit following the intervention. Thus, identifying contributing factors to this is important. Individuals with OA often have multiple joint symptoms, yet this has received limited attention in this population. PURPOSE: Document the occurrence of joint symptoms among patients undergoing surgery for LS-OA, and investigate the influence of these symptoms on disability postsurgery. DESIGN: Prospective study of consecutive patients followed to 12-month postsurgery. PATIENT SAMPLE: Patients undergoing surgery (decompression surgery, with or without fusion) for neurogenic claudication with or without back pain due to LSS with a primary pathology diagnosis of LS-OA. OUTCOMES MEASURES: Patient self-reported: Oswestry Disability Index (ODI), completed pre- and 12-month postsurgery; and, completed presurgery, age, sex, education, smoking, comorbid conditions, opioid use, short/long-term disability, depression and anxiety symptoms, back and leg pain intensity, presence of spondylolisthesis, procedure, prior spine surgery, and joints with arthritis and "pain/stiffness/swelling most days of the month" indicated on a homunculus (a joint site count was derived). ASSESSMENTS: Height and weight, used to calculate body mass index; timed-up-and-go performance-based test. METHODS: Outcome of interest was achieving a clinically important improvement (CII) in ODI by 12-month postsurgery (yes/no). The association between joint site count and achieving a CII was examined by multivariable logistic regression analyses, adjusted for other measures. RESULTS: In all, 165 patients were included. The mean age was 67 years (range: 44-90) and 47% were female. Seventy-seven percent reported 1+ joint site other than the back, 62% reported 2+, and 25% reported 4+. Among those achieving a CII, 21% had 4+ joint sites, compared with 31% among those not achieving a CII. Adjusted analyses: Increasing joint site count was associated with increasing risk (odds ratio [OR]: 1.32, 95% confidence interval [CI]: 1.05, 1.66) of not achieving a CII; for those with 4+ joints, adjusted probability of not achieving a CII exceeded 50%. Also associated with an increased risk of not achieving a CII was presurgery anxiety (OR: 2.97, 95% CI: 1.02, 8.65), opioid use (OR: 2.89, 95% CI: 1.07, 7.82), and worse back pain intensity score (OR: 1.27, 95% CI: 1.05, 1.53). CONCLUSIONS: Multijoint involvement was highly prevalent in this LS-OA surgical sample. Its association with poorer postsurgery outcome supports a comprehensive approach to OA management and care. Knowledge of multijoint symptoms should inform patient education, shared decision-making, and recommendations for postsurgical rehabilitation and self-management strategies.


Assuntos
Osteoartrite da Coluna Vertebral , Estenose Espinal , Idoso , Descompressão Cirúrgica , Feminino , Humanos , Vértebras Lombares/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Estenose Espinal/cirurgia , Resultado do Tratamento
14.
Eur Spine J ; 30(2): 431-443, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33025192

RESUMO

PURPOSE: The aims of this study were (1) to determine the prevalence of radiographic cervical disc degeneration in a large population of patients aged from 18 to 97 years; (2) to investigate individually the prevalence and distribution of height loss, osteophyte formation, endplate sclerosis and spondylolisthesis; and (3) to describe the patterns of cervical disc degeneration. METHODS: A retrospective study was performed. Standard lateral cervical spine radiographs in standing, neutral position of 1581 consecutive patients (723 males, 858 females) with an average age of 41.2 ± 18.2 years were evaluated. Cervical disc degeneration was graded from C2/C3 to C6/C7 based on a validated quantitative grading system. The prevalence and distribution of radiographic findings were evaluated and associations with age were investigated. RESULTS: 53.9% of individuals had radiographic disc degeneration and the most affected level was C5/C6. The presence and severity of disc degeneration were found to be significantly associated with age both in male and female subjects. The most frequent and severe occurrences of height loss, osteophyte formation, and endplate sclerosis were at C5/C6, whereas spondylolisthesis was most observed at C4/C5. Age was significantly correlated with radiographic degenerative findings. Contiguous levels degeneration pattern was more likely found than skipped level degeneration. The number of degenerated levels was also associated with age. CONCLUSIONS: The presence and severity of radiographic disc degeneration increased with aging in the cervical spine. Older age was associated with greater number of degenerated disc levels. Furthermore, the correlations between age and the degree of degenerative findings were stronger at C5/C6 and C6/C7 than at other cervical spinal levels.


Assuntos
Degeneração do Disco Intervertebral , Osteoartrite da Coluna Vertebral , Espondilolistese , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/diagnóstico por imagem , Feminino , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
15.
Am J Phys Anthropol ; 174(3): 500-518, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33247981

RESUMO

OBJECTIVES: Degenerative joint disease in the spine is heavily influenced by genetic, environmental, and epigenetic factors, as well as exacerbated by physical activity and injury. The objective of this study was to investigate the multivariate relationship between known predictors of degenerative joint disease in the spine, such as age and sex, with mortuary indicators of economic access such as grave inclusions, burial location, and burial type. MATERIALS AND METHODS: The presence and severity of vertebral osteophytosis (VO) and vertebral osteoarthritis (VOA) was recorded for the vertebral columns of N = 106 adult individuals from the Late Medieval period at the rural monastery of San Pietro at Villamagna in Lazio, Italy (1300-1450 AD). Multiple skeletal indicators of degenerative joint disease, morphological sex, and age were compared with differences in mortuary treatment across four regions of the spine. RESULTS: There are marked differences in severe joint disease outcome between groups with more and less economic access. Relative risk ratios suggest that males and females with less economic access have elevated risk for VO and VOA in specific spine regions, although this effect is reduced among females. DISCUSSION: Current research on the consequences of economic and social inequality point to the important role of economic inequality in shaping disease outcomes. Our results suggest that biocultural effects of reduced economic access at the intraclass level may increase vulnerability to the downstream effects of risk exposure (e.g., biomechanical injure, physical activity, biochemical imbalance), and ultimately increase the risk and prevalence for severe degenerative disease outcomes in medieval Italy.


Assuntos
Sepultamento/história , Osteoartrite da Coluna Vertebral , Osteofitose Vertebral , Adolescente , Adulto , Fatores Etários , Arqueologia , Feminino , História Medieval , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Osteoartrite da Coluna Vertebral/economia , Osteoartrite da Coluna Vertebral/etnologia , Osteoartrite da Coluna Vertebral/patologia , Risco , Fatores Sexuais , Fatores Socioeconômicos , Osteofitose Vertebral/economia , Osteofitose Vertebral/etnologia , Osteofitose Vertebral/patologia , Coluna Vertebral/patologia , Adulto Jovem
16.
Osteoarthritis Cartilage ; 29(3): 372-379, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33347923

RESUMO

OBJECTIVES: To investigate the role of zinc finger protein 440 (ZNF440) in the pathophysiology of cartilage degeneration during facet joint (FJ) and knee osteoarthritis (OA). METHODS: Expression of ZNF440 in FJ and knee cartilage was determined by immunohistochemistry, quantitative (q)PCR, and Western blotting (WB). Human chondrocytes isolated from FJ and knee OA cartilage were cultured and transduced with ZNF440 or control plasmid, or transfected with ZNF440 or control small interfering RNA (siRNA), with/without interleukin (IL)-1ß. Gene and protein levels of catabolic, anabolic and apoptosis markers were determined by qPCR or WB, respectively. In silico analyses were performed to determine compounds with potential to inhibit expression of ZNF440. RESULTS: ZNF440 expression was increased in both FJ and knee OA cartilage compared to control cartilage. In vitro, overexpression of ZNF440 significantly increased expression of MMP13 and PARP p85, and decreased expression of COL2A1. Knockdown of ZNF440 with siRNA partially reversed the catabolic and cell death phenotype of human knee and FJ OA chondrocytes stimulated with IL-1ß. In silico analysis followed by validation assays identified scriptaid as a compound with potential to downregulate the expression of ZNF440. Validation experiments showed that scriptaid reduced the expression of ZNF440 in OA chondrocytes and concomitantly reduced the expression of MMP13 and PARP p85 in human knee OA chondrocytes overexpressing ZNF440. CONCLUSIONS: The expression of ZNF440 is significantly increased in human FJ and knee OA cartilage and may regulate cartilage degenerative mechanisms. Furthermore, scriptaid reduces the expression of ZNF440 and inhibits its destructive effects in OA chondrocytes.


Assuntos
Cartilagem Articular/metabolismo , Condrócitos/metabolismo , Proteínas de Ligação a DNA/fisiologia , Articulação do Joelho , Osteoartrite do Joelho/genética , Osteoartrite da Coluna Vertebral/genética , Dedos de Zinco/genética , Articulação Zigapofisária , Adulto , Idoso , Idoso de 80 Anos ou mais , Apoptose/efeitos dos fármacos , Apoptose/genética , Condrócitos/efeitos dos fármacos , Colágeno Tipo II/genética , Simulação por Computador , Proteínas de Ligação a DNA/genética , Feminino , Técnicas de Silenciamento de Genes , Inibidores de Histona Desacetilases/farmacologia , Humanos , Hidroxilaminas/farmacologia , Imuno-Histoquímica , Técnicas In Vitro , Inflamação/genética , Masculino , Metaloproteinase 13 da Matriz/genética , Metabolismo/efeitos dos fármacos , Metabolismo/genética , Pessoa de Meia-Idade , Osteoartrite do Joelho/metabolismo , Osteoartrite da Coluna Vertebral/metabolismo , Quinolinas/farmacologia , Adulto Jovem , Dedos de Zinco/efeitos dos fármacos
17.
PLoS One ; 15(11): e0242077, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180888

RESUMO

OBJECTIVES: This study aims to investigate the association between mental health and quality of life of osteoarthritis (OA) patients according to the site of pain. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Data of 22,948 participants of the sixth Korea National Health and Nutrition Examination Survey conducted from 2013-2015 were used. OUTCOME MEASURES: Participants were asked if they had OA pain in the hip joint, knee joint, and lower back (yes/no) and whether they experienced anxiety or depression. The EQ-5D questionnaire was used to determine the quality of life of patients with hip, knee, and lower back OA. Multiple logistic regression analysis was performed after adjusting. RESULTS: A total of 5,401 patients reported pain in the hip joint, knee joint, or lower back. The analysis showed significant relations between pain sites, mental health, and quality of life. First, more female patients with OA experienced stress and depression than males. Second, for males with OA, stress was reported in the order of: lower back > hip > knee, while pain and depression was reported in the order of: lower back > knee > hip (p < 0.05). For females with OA, stress was reported in the order of: knee > lower back > hip, while depression was reported in the order of: knee > lower back > hip. Third, considering quality of life, for males, hip joint pain had the greatest impact on quality of life and for females, knee joint pain had the largest impact (p < 0.001). CONCLUSIONS: For patients with OA, the effect on the mental health and quality of life differed according to sex and sites of pain. Therefore, this study confirms that pain sites, sex, mental health, and quality of life are independent risk factors when determining OA pain.


Assuntos
Osteoartrite do Quadril/complicações , Osteoartrite do Joelho/complicações , Osteoartrite da Coluna Vertebral/complicações , Dor/psicologia , Qualidade de Vida/psicologia , Distribuição por Idade , Idoso , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Osteoartrite do Quadril/psicologia , Osteoartrite do Joelho/psicologia , Osteoartrite da Coluna Vertebral/psicologia , Dor/etiologia , República da Coreia , Estudos Retrospectivos , Caracteres Sexuais
18.
Sci Rep ; 10(1): 19036, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33149177

RESUMO

We recently uncovered an association between spinal osteoarthritis and height loss that was independent of incident vertebral fracture. However, the optimal cut-off value of historical height loss (HHL) for discriminating spinal osteoarthritis has not been reported. This cross-sectional study aimed to evaluate the implications of HHL for prevalent vertebral fracture, spinal osteoarthritis, and other co-morbidities in postmenopausal women from the Nagano Cohort Study. In total, 942 Japanese postmenopausal outpatients (mean age: 66.7 years) were investigated. HHL was estimated by arm span - body height difference. Multiple logistic regression analysis revealed significant independent associations of HHL with prevalent vertebral fracture (odds ratio [OR] 1.89; 95% confidence interval [CI] 1.55-2.29), spinal osteoarthritis (OR 1.57; 95% CI 1.31-1.88), and gastroesophageal reflux disease (GERD) (OR 1.75; 95% CI 1.34-2.28) after adjustment for other confounders. Receiver operating characteristic curve analysis of HHL was conducted to discriminate the prevalence of co-morbidities. The optimal cut-off value as defined by the Youden index for prevalent vertebral fracture, spinal osteoarthritis, and GERD was 4.95 cm (area under the curve [AUC] 0.740; 95% CI 0.704-0.776), 2.75 cm (AUC 0.701; 95% CI 0.667-0.735), and 5.35 cm (AUC 0.692; 95% CI 0.629-0.754), respectively. Better understanding of the above relationships and proposed cut-off values will be useful for improving the diagnosis, care management, and quality of life in elderly patients.


Assuntos
Estatura , Refluxo Gastroesofágico/epidemiologia , Refluxo Gastroesofágico/etiologia , Osteoartrite da Coluna Vertebral/epidemiologia , Osteoartrite da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/epidemiologia , Fraturas da Coluna Vertebral/etiologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Pesos e Medidas Corporais , Comorbidade , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Curva ROC
19.
Spine (Phila Pa 1976) ; 45(21): E1400-E1404, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32796463

RESUMO

STUDY DESIGN: Retrospective observational study from the Nagano Cohort Study. OBJECTIVE: Clarify the association between spinal osteoarthritis and loss of stature in postmenopausal women. SUMMARY OF BACKGROUND DATA: Loss of stature with aging is known to deteriorate health-related quality of life and has been implicated with increased mortality. Although the association of vertebral fracture with height loss has been well documented, the relationship between stature loss and spinal osteoarthritis remains unclear. METHODS: We retrospectively investigated Japanese postmenopausal women recruited from the Nagano Cohort Study. The participants were outpatients at a primary care institute in Nagano prefecture, Japan. A total of 977 postmenopausal patients (mean age: 65.8 yr) completed a minimum of 1 year of follow-up, with an average observation period of 7.6 years. Quartile analysis on the prevalence of spinal osteoarthritis and occurrence of incident fracture was performed based on the rate of stature change per year (Δ cm/yr). Multiple regression analysis was also conducted to identify the determinants of stature change. RESULTS: The lower quartiles of stature change rate (i.e., more rapid stature loss) displayed a significantly higher prevalence of spinal osteoarthritis (P < 0.001) and incident vertebral fracture (P < 0.001). A statistically significant independent negative association for spinal osteoarthritis prevalence with change in stature was revealed by multiple regression analysis after adjusting for confounders including incident vertebral fracture. The partial regression coefficient for spinal osteoarthritis was -0.18 (95% confidence interval -0.33 to -0.03; P = 0.016). CONCLUSION: This study demonstrated an independent association of spinal osteoarthritis with stature loss in postmenopausal women. Adequate understanding of this relationship and appropriate treatment approaches will help improve health-related quality of life in elderly patients. LEVEL OF EVIDENCE: 3.


Assuntos
Estatura/fisiologia , Osteoartrite da Coluna Vertebral/diagnóstico por imagem , Osteoartrite da Coluna Vertebral/epidemiologia , Pós-Menopausa/fisiologia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/patologia , Envelhecimento/fisiologia , Densidade Óssea/fisiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/lesões , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Estudos Retrospectivos , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/lesões
20.
Curr Rheumatol Rep ; 22(10): 59, 2020 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-32808099

RESUMO

PURPOSE OF REVIEW: To discuss the challenges to early diagnosis of axial spondyloarthritis (axSpA) and present the impact an early inflammatory back pain service (EIBPS) had on diagnostic delay in the UK. RECENT FINDINGS: Diagnostic delay in axSpA varies greatly worldwide, and has continued in the UK at an average of 8.5 years. Education, public awareness, and accessibility to inflammatory back pain (IBP) pathways are some of the key barriers to achieving a prompt diagnosis. A recent national inquiry has highlighted insufficiencies in the availability of specialist axSpA services and limited provision of education and training to first contact practitioners and allied healthcare providers. We demonstrate diagnostic delay in axSpA can be successfully reduced to 3 years when an early inflammatory back pain service is embedded within a rheumatology department alongside a local educational and awareness campaign. Sharing these experiences and outcomes will enable other departments to engage in best practice and achieve similar results, facilitating a timely and accurate diagnosis.


Assuntos
Diagnóstico Tardio/prevenção & controle , Diagnóstico Precoce , Osteoartrite da Coluna Vertebral/diagnóstico , Adulto , Instituições de Assistência Ambulatorial , Dor nas Costas/etiologia , Dor Crônica/etiologia , Feminino , Promoção da Saúde , Acesso aos Serviços de Saúde , Humanos , Masculino , Osteoartrite da Coluna Vertebral/complicações , Encaminhamento e Consulta , Reumatologia/organização & administração
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