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Medicina
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New Advances in Intervertebral Disc Degeneration
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New Advances in Intervertebral Disc Degeneration

A special issue of Medicina (ISSN 1648-9144).

Deadline for manuscript submissions: closed (25 November 2022) | Viewed by 12011

Special Issue Editors

Dr. Koji Akeda

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Guest Editor
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Mie 514-8507, Japan
Interests: adult spinal deformity; lateral lumbar interbody fusion (LLIF); minimally invasive spinal treatment (MIST); degenerative disc diseases; intervertebral disc therapy
Special Issues, Collections and Topics in MDPI journals
Dr. Daisuke Sakai

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Guest Editor
Department Orthopaedic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
Interests: intervertebral disc regeneration
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Nobuyuki Fujita

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Guest Editor
Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Japan
Interests: intervertebral disc regeneration
Dr. Takashi Yurube

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Guest Editor
Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
Interests: minimally invasive reconstruction; spine surgery; regenerative medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Increasing evidence shows that intervertebral disc (IVD) degeneration is significantly associated with degenerative disc diseases, including low back pain, which is the leading cause of worldwide productivity loss and disability, with enormous socioeconomic and health impacts. Therefore, the biology, pathophysiology, preventive measures, and treatments against IVD degeneration are critical issues for future research.

The aim and scope of this Special Issue are to contribute to the progression of the research on IVD degeneration by collecting the latest evidence from basic science to clinical sciences. This special issue will consider the wide range of topics associated with IVD degeneration, including epidemiology, imaging and other diagnostic modalities, basic science (in vitro and animal study), clinical study (on discogenic low back pain, degenerative disc diseases, and disc herniation), and the recent advances in regenerative and/or reparative therapies.

Dr. Koji Akeda
Dr. Daisuke Sakai
Prof. Dr. Nobuyuki Fujita
Dr. Takashi Yurube
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • intervertebral disc
  • disc degeneration
  • degenerative disc disease
  • low back pain

Published Papers (4 papers)

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Research

12 pages, 1430 KiB  
Article
Clinical and Radiological Characteristics of Cervical Spondylotic Myelopathy in Young Adults: A Retrospective Case Series of Patients under Age 30
by Yoshiki Terashima, Takashi Yurube, Masatoshi Sumi, Aritetsu Kanemura, Koki Uno and Kenichiro Kakutani
Medicina 2023, 59(3), 539; https://doi.org/10.3390/medicina59030539 - 10 Mar 2023
Cited by 1 | Viewed by 3067
Abstract
Background and Objectives: Cervical spondylotic myelopathy (CSM) is a degenerative disease and occurs more frequently with age. In fact, the development of non-herniated CSM under age 30 is uncommon. Therefore, a retrospective case series was designed to clarify clinical and radiological characteristics of [...] Read more.
Background and Objectives: Cervical spondylotic myelopathy (CSM) is a degenerative disease and occurs more frequently with age. In fact, the development of non-herniated CSM under age 30 is uncommon. Therefore, a retrospective case series was designed to clarify clinical and radiological characteristics of young adult patients with CSM under age 30. Materials and Methods: A total of seven patients, all men, with non-herniated, degenerative CSM under age 30 were retrieved from the medical records of 2598 hospitalized CSM patients (0.27%). Patient demographics and backgrounds were assessed. The sagittal alignment, congenital canal stenosis, dynamic canal stenosis, and vertebral slips in the cervical spine were radiographically evaluated. The presence of degenerative discs, intramedullary high-signal intensity lesions, and sagittal spinal cord compression on T2-weighted magnetic resonance images (MRIs) and axial spinal cord deformity on T1-weighted MRIs was identified. Results: All patients (100.0%) had relatively high daily sports activities and/or jobs requiring frequent neck extension. Cervical spine radiographs revealed the sagittal alignment as the “reverse-sigmoid” type in 57.1% of patients and “straight” type in 28.6%. All patients (100.0%) presented congenital cervical stenosis with the canal diameter ≤12 mm and/or Torg–Pavlov ratio <0.80. Furthermore, all patients (100.0%) developed dynamic stenosis with the canal diameter ≤12 mm and/or posterior vertebral slip ≥2 mm at the neurologically responsible segment in full-extension position. In MRI examination, all discs at the neurologically responsible level (100.0%) were degenerative. Intramedullary abnormal intensity lesions were detected in 85.7% of patients, which were all at the neurologically responsible disc level. Conclusions: Patients with non-herniated, degenerative CSM under age 30 are rare but more common in men with mild sagittal “reverse-sigmoid” or “straight” deformity and congenital canal stenosis. Relatively high daily activities, accumulating neck stress, can cause an early development of intervertebral disc degeneration and dynamic canal stenosis, leading to CSM in young adults. Full article
(This article belongs to the Special Issue New Advances in Intervertebral Disc Degeneration)
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9 pages, 2892 KiB  
Article
Autologous Platelet-Rich Plasma Administration on the Intervertebral Disc in Low Back Pain Patients with Modic Type 1 Change: Report of Two Cases
by Soya Kawabata, Kurenai Hachiya, Sota Nagai, Hiroki Takeda, Mohd Zaim Mohd Rashid, Daiki Ikeda, Yusuke Kawano, Shinjiro Kaneko, Yoshiharu Ohno and Nobuyuki Fujita
Medicina 2023, 59(1), 112; https://doi.org/10.3390/medicina59010112 - 5 Jan 2023
Cited by 5 | Viewed by 3016
Abstract
Background and Objectives: Modic type 1 is known to be associated with lower back pain (LBP), but at present, a treatment has not been fully established. Meanwhile, platelet-rich plasma (PRP) has been used for tissue regeneration and repair in the clinical setting. [...] Read more.
Background and Objectives: Modic type 1 is known to be associated with lower back pain (LBP), but at present, a treatment has not been fully established. Meanwhile, platelet-rich plasma (PRP) has been used for tissue regeneration and repair in the clinical setting. There is no clinical PRP injection trial for the intervertebral disc of LBP patients with Modic type 1. Thus, this study aimed to verify PRP injection safety and efficacy in LBP patients with Modic type 1. As a preliminary experiment, two LBP cases with Modic type 1 are presented. Materials and Methods: PRP was administered intradiscally to two LBP patients with Modic type 1. PRP was obtained from the patients’ anticoagulated blood. Primary endpoints were physical condition, laboratory data, and X-ray for safety evaluation. Secondary endpoints were pain scores using the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Roland–Morris Disability Questionnaire (RDQ) to evaluate PRP efficacy. The observation period was 24 weeks after the PRP injection. In addition, changes in Modic type 1 using MRI were evaluated. Results: This study assessed two LBP patients with Modic type 1. There were no adverse events in physical condition, laboratory data, or lumbar X-rays after injection. Follow-up MRI showed a decrease of high signal intensity on T2WI compared to before PRP administration. The pain scores tended to improve after the injection. Conclusions: PRP injection into the intervertebral disc of LBP patients with Modic type 1 might be safe and effective. This analysis will be continued as a prospective study to establish the efficacy. Full article
(This article belongs to the Special Issue New Advances in Intervertebral Disc Degeneration)
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9 pages, 572 KiB  
Article
Influence of the Preoperative Duration of Symptoms on Patients’ Clinical Outcomes after Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion for Degenerative Lumbar Spinal Diseases
by Yoshiaki Hiranaka, Shingo Miyazaki, Takashi Yurube, Kohei Kuroshima, Masao Ryu, Shinichi Inoue, Kenichiro Kakutani and Ko Tadokoro
Medicina 2023, 59(1), 22; https://doi.org/10.3390/medicina59010022 - 22 Dec 2022
Viewed by 1731
Abstract
Background and Objectives: The impact of the duration of symptoms (DOS) on postoperative clinical outcomes of patients with degenerative lumbar spinal diseases is important for determining the optimal timing of surgical intervention; however, the timing remains controversial. This prospective case–control study aimed [...] Read more.
Background and Objectives: The impact of the duration of symptoms (DOS) on postoperative clinical outcomes of patients with degenerative lumbar spinal diseases is important for determining the optimal timing of surgical intervention; however, the timing remains controversial. This prospective case–control study aimed to investigate the influence of the preoperative DOS on surgical outcomes in minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF). Materials and Methods: Patients who underwent single-level TLIF for lumbar degenerative diseases between 2017 and 2018 were reviewed. Only patients with full clinical data during the 1-year follow-up period were included. The patients were divided into two groups (DOS < 12 months, group S; DOS ≥ 12 months, group L). The clinical outcomes, including the Oswestry disability index (ODI) and visual analog scale (VAS) for lower back pain, leg pain, and numbness, were investigated preoperatively and at 1, 3, and 6 months, as well as 1 year, after surgery. Furthermore, postoperative patient satisfaction 1 year after surgery was also surveyed. Results: A total of 163 patients were assessed: 60 in group S and 103 in group L. No differences in baseline characteristics and clinical outcomes were found. The ODI and VAS significantly improved from the baseline to each follow-up period (all p < 0.01). Group S had significantly lower ODI scores at 3 months (p = 0.019) and 6 months (p = 0.022). In addition, group S had significantly lower VAS scores for leg pain at 3 months (p = 0.027). In a comparison between both groups, only the patients with cauda equina symptoms showed that ODI and leg pain VAS scores at 3 months after surgery were significantly lower in group S (19.9 ± 9.1 vs. 14.1 ± 12.5; p = 0.037, 7.4 ± 13.9 vs. 14.7 ± 23.1; p = 0.032, respectively). However, the clinical outcomes were not significantly different between both groups 1 year after surgery. Patient satisfaction was also not significantly different between both groups. Conclusions: Patients with a shorter DOS tended to have a significantly slower recovery; however, clinical outcomes 1 year after surgery were good, regardless of the DOS. Full article
(This article belongs to the Special Issue New Advances in Intervertebral Disc Degeneration)
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14 pages, 59565 KiB  
Article
Multicenter Retrospective Analysis of Intradiscal Condoliase Injection Therapy for Lumbar Disc Herniation
by Yusuke Oshita, Daisuke Matsuyama, Daisuke Sakai, Jordy Schol, Eiki Shirasawa, Haruka Emori, Kazuyuki Segami, Shu Takahashi, Kazumichi Yagura, Masayuki Miyagi, Wataru Saito, Takayuki Imura, Toshiyuki Nakazawa, Gen Inoue, Akihiko Hiyama, Hiroyuki Katoh, Tsutomu Akazawa, Koji Kanzaki, Masato Sato, Masashi Takaso and Masahiko Watanabeadd Show full author list remove Hide full author list
Medicina 2022, 58(9), 1284; https://doi.org/10.3390/medicina58091284 - 15 Sep 2022
Cited by 7 | Viewed by 3160
Abstract
Background and Objectives: Intradiscal injection of Condoliase (chondroitin sulfate ABC endolyase), a glycosaminoglycan-degrading enzyme, is employed as a minimally invasive treatment for lumbar disc herniation (LDH) and represents a promising option between conservative treatment and surgical intervention. Since its 2018 approval in [...] Read more.
Background and Objectives: Intradiscal injection of Condoliase (chondroitin sulfate ABC endolyase), a glycosaminoglycan-degrading enzyme, is employed as a minimally invasive treatment for lumbar disc herniation (LDH) and represents a promising option between conservative treatment and surgical intervention. Since its 2018 approval in Japan, multiple single-site trails have highlighted its effectiveness, however, the effect of LDH types, and influences of patient age, sex, etc., on treatment success remains unclear. Moreover, data on teenagers and elderly patients has not been reported. In this retrospective multi-center study, we sought to classify prognostic factors for successful condoliase treatment for LDH and assess its effect on patients < 20 and ≥70 years old. Materials and Methods: We reviewed the records of 137 LDH patients treated through condoliase at four Japanese institutions and assessed its effectiveness among different age categories on alleviation of visual analog scale (VAS) of leg pain, low back pain and numbness, as well as ODI and JOA scores. Moreover, we divided them into either a “group-A” category if a ≥50% improvement in baseline leg pain VAS was observed or “group-N” if VAS leg pain improved <50%. Next, we assessed the differences in clinical and demographic distribution between group-A and group-N. Results: Fifty-five patients were classified as group-A (77.5%) and 16 patients were allocated to group-N (22.5%). A significant difference in Pfirrmann classification was found between both cohorts, with grade IV suggested to be most receptive. A posterior disc angle > 5° was also found to approach statical significance. In all age groups, average VAS scores showed improvement. However, 75% of adolescent patients showed deterioration in Pfirrmann classification following treatment. Conclusions: Intradiscal condoliase injection is an effective treatment for LDH, even in patients with large vertebral translation and posterior disc angles, regardless of age. However, since condoliase imposes a risk of progressing disc degeneration, its indication for younger patients remains controversial. Full article
(This article belongs to the Special Issue New Advances in Intervertebral Disc Degeneration)
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