Characteristics and mechanical mechanisms of intervertebral disc degeneration in old thoracolumbar fractures with kyphosis: clinical observations and finite element analyses.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2000-
    • Subject Terms:
      Finite Element Analysis* ; Thoracic Vertebrae*/injuries ; Thoracic Vertebrae*/diagnostic imaging ; Thoracic Vertebrae*/physiopathology ; Lumbar Vertebrae*/injuries ; Lumbar Vertebrae*/diagnostic imaging ; Lumbar Vertebrae*/physiopathology ; Kyphosis*/etiology ; Kyphosis*/physiopathology ; Kyphosis*/diagnostic imaging ; Spinal Fractures*/physiopathology ; Spinal Fractures*/etiology ; Spinal Fractures*/diagnostic imaging ; Spinal Fractures*/complications ; Intervertebral Disc Degeneration*/diagnostic imaging ; Intervertebral Disc Degeneration*/physiopathology ; Intervertebral Disc Degeneration*/complications; Humans ; Male ; Female ; Middle Aged ; Aged ; Biomechanical Phenomena ; Intervertebral Disc/physiopathology ; Intervertebral Disc/diagnostic imaging ; Intervertebral Disc/injuries ; Low Back Pain/etiology ; Low Back Pain/physiopathology ; Low Back Pain/diagnosis ; Case-Control Studies ; Range of Motion, Articular ; Adult
    • Abstract:
      Background: Low back pain is a common complication in patients with old thoracolumbar fractures with kyphosis (OTLFK), and intervertebral disc degeneration (IDD) is a major contributor. Mechanical abnormalities are believed to play a key role in the development to IDD. This study aimed to investigate the characteristics of lumbar disc degeneration and underlying mechanical mechanisms in patients with OTLFK.
      Methods: A total of 52 patients with OTLFK were included from February 2017 to March 2023 as the observation group (OG). A control group (CG) of individuals with chronic low back pain were matched for age, body mass index, and gender. The disc degeneration grades and distribution in both groups were observed. Intact, 20°, 30°, and 40° kyphotic finite element (FE) models were established. Intervertebral disc pressures (IDPs) were calculated under standing, flexion, extension, lateral bending, and axial rotation conditions.
      Results: The overall IDD in the OG was higher than that in the CG. The grades from T11 to L3 were higher in the OG (p < 0.05), while there was no significant difference from L4 to S1. Degeneration levels IV and V were concentrated in the T11-L3 segment in the OG; whereas, in the CG, this was in L4/5 and L5/S1 (p < 0.05). The FE analysis results showed that, in the kyphotic model, the IDP was higher than the intact model in the standing position, flexion, lateral bending, and rotation, but lower in extension.
      Conclusions: Patients with OTLFK exhibit higher-grade disc degeneration concentrated in the thoracolumbar segment. Abnormal mechanical stress may contribute to this degeneration, highlighting the importance of managing stress in kyphotic deformities.
      Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board and the Ethics Committee of Fuyang People’s Hospital Affiliated to Anhui Medical University. All the participants in the manuscript signed a written informed consent. All procedures were performed in accordance with relevant guidelines in the manuscript. Consent for publication: Written informed consent was provided by participant for images of the patients and techniques, clinical details and identifying information such as age, profession and gender to be included and published. Competing interests: The authors declare no competing interests.
      (© 2024. The Author(s).)
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    • Grant Information:
      AHJZJX-ZD-002 Medical Innovation Foundation from Spinal deformity clinical and research center of Anhui province
    • Contributed Indexing:
      Keywords: Finite element analysis; Intervertebral disc degeneration; Intervertebral disc pressure; Kyphosis; Old thoracolumbar fractures
    • Publication Date:
      Date Created: 20241220 Date Completed: 20241220 Latest Revision: 20250104
    • Publication Date:
      20250104
    • Accession Number:
      PMC11660776
    • Accession Number:
      10.1186/s12891-024-08157-8
    • Accession Number:
      39702090