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Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes
Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in vari...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084054/ https://www.ncbi.nlm.nih.gov/pubmed/32211594 http://dx.doi.org/10.1002/jsp2.1083 |
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author | Zehra, Uruj Cheung, Jason P. Y. Bow, Cora Crawford, Rebecca J. Luk, Keith D. K. Lu, William Samartzis, Dino |
author_facet | Zehra, Uruj Cheung, Jason P. Y. Bow, Cora Crawford, Rebecca J. Luk, Keith D. K. Lu, William Samartzis, Dino |
author_sort | Zehra, Uruj |
collection | PubMed |
description | Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (PI) is “fixed parameter” since skeletal maturity. No study has addressed disc‐displacement, MCs and UDS in context of spinopelvic parameters. Therefore, the aim of study was to determine if spinopelvic parameters are associated and predict clinically‐relevant MRI‐phenotypes. One hundred and eight population‐based subjects (mean age: 52.3 years) were recruited. Spondylolisthesis and scoliosis individuals were excluded. Lumbar lordosis (LL), PI, sacral slope (SS), and pelvic tilt (PT) were assessed on lateral plain radiographs. Disc degeneration was assessed and summated, and presence or not of disc‐displacement and MCs were noted on T2W MRI. UDS was detected on UTE. Following exclusion criteria, 95 subjects were assessed. Disc‐displacement (82.1%), MCs (52.6%), and UDS (37.9%) were associated with lower PI, SS, LL, and LL/PI index. On multivariate analyses, lower PI was significantly related to development of these MRI phenotypes (adjusted OR range:0.95‐0.92; P < .05), with critical PI value of 42° or lower exhibiting fourfold increase risk of combined phenotypes (P = .020). Of UDS discs, 39.3% had adjacent MCs and 83.6% had disc‐displacement. 87.5% of MC had directly adjacent UDS. The first study to note that PI may “predict” the development of disc‐displacement, MCs and UDS, suggesting potential sub‐variants and mechanistic susceptibility that may be grounded in spinopelvic evolution. An “evolutionary etiological pathway” of spinal phenotype development is proposed. |
format | Online Article Text |
id | pubmed-7084054 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70840542020-03-24 Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes Zehra, Uruj Cheung, Jason P. Y. Bow, Cora Crawford, Rebecca J. Luk, Keith D. K. Lu, William Samartzis, Dino JOR Spine Research Articles Lumbar disc‐displacement, Modic changes (MCs), and UTE Disc Sign (UDS) on MRI are clinically relevant spinal phenotypes that can lead to sciatica/LBP. Not all degenerated discs result in disc‐displacement, MCs and UDS, suggesting varied etiologies. Spinopelvic parameters have been implicated in various spinal disorders. Pelvic incidence (PI) is “fixed parameter” since skeletal maturity. No study has addressed disc‐displacement, MCs and UDS in context of spinopelvic parameters. Therefore, the aim of study was to determine if spinopelvic parameters are associated and predict clinically‐relevant MRI‐phenotypes. One hundred and eight population‐based subjects (mean age: 52.3 years) were recruited. Spondylolisthesis and scoliosis individuals were excluded. Lumbar lordosis (LL), PI, sacral slope (SS), and pelvic tilt (PT) were assessed on lateral plain radiographs. Disc degeneration was assessed and summated, and presence or not of disc‐displacement and MCs were noted on T2W MRI. UDS was detected on UTE. Following exclusion criteria, 95 subjects were assessed. Disc‐displacement (82.1%), MCs (52.6%), and UDS (37.9%) were associated with lower PI, SS, LL, and LL/PI index. On multivariate analyses, lower PI was significantly related to development of these MRI phenotypes (adjusted OR range:0.95‐0.92; P < .05), with critical PI value of 42° or lower exhibiting fourfold increase risk of combined phenotypes (P = .020). Of UDS discs, 39.3% had adjacent MCs and 83.6% had disc‐displacement. 87.5% of MC had directly adjacent UDS. The first study to note that PI may “predict” the development of disc‐displacement, MCs and UDS, suggesting potential sub‐variants and mechanistic susceptibility that may be grounded in spinopelvic evolution. An “evolutionary etiological pathway” of spinal phenotype development is proposed. John Wiley & Sons, Inc. 2020-02-19 /pmc/articles/PMC7084054/ /pubmed/32211594 http://dx.doi.org/10.1002/jsp2.1083 Text en © 2020 The Authors. JOR Spine published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Zehra, Uruj Cheung, Jason P. Y. Bow, Cora Crawford, Rebecca J. Luk, Keith D. K. Lu, William Samartzis, Dino Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title | Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title_full | Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title_fullStr | Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title_full_unstemmed | Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title_short | Spinopelvic alignment predicts disc calcification, displacement, and Modic changes: Evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
title_sort | spinopelvic alignment predicts disc calcification, displacement, and modic changes: evidence of an evolutionary etiology for clinically‐relevant spinal phenotypes |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084054/ https://www.ncbi.nlm.nih.gov/pubmed/32211594 http://dx.doi.org/10.1002/jsp2.1083 |
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