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Residual lumbar curvature that developed during adolescence accelerates intervertebral disc degeneration in adulthood

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Abstract

Purpose

To elucidate the influence of spinal deformity in adolescent idiopathic scoliosis (AIS) on lumbar intervertebral disc (IVD) degeneration in adulthood using magnetic resonance imaging (MRI).

Methods

A total of 102 patients (8 men, 94 women; mean age, 31.4 years) who had developed idiopathic scoliosis at the age of 10–18 years and underwent preoperative lumbar spine MRI at the age of ≥ 20 were included in the study. Twenty volunteers (3 men, 17 women; mean age, 33.6 years) without scoliosis were assessed as controls. We divided the adult scoliosis patients into two groups: Group A consisted of patients with lumbar modifier A, and Group BC consisted of those with modifiers B and C. IVD degeneration from L1/2 to L5/S1 was assessed by MRI. The Scoliosis Research Society-22 (SRS-22) patient questionnaire was used in the patients’ clinical assessment.

Results

There were 40 patients in the Group A and 62 in the Group BC. Compared to the control groups, significant IVD degeneration was observed at L2/3 and L3/4 in Group A, and at all levels except for L5/S1 in Group BC. The proportion of degenerated IVDs patients (Grades 1c and 2) was significantly higher in Group BC than those in Group A at L3/L4 and L4/L5. Furthermore, the severity of IVD degeneration was significantly greater in the group BC than in the group A at all levels, except for L5/S1, especially in patients aged > 30 years. The mean scores of all subdomains in the SRS-22 questionnaire were comparable between the two groups.

Conclusion

Our study showed that the residual lumbar curvature from AIS may have accelerated IVD degeneration in adulthood, especially in patients aged > 30 years.

Level of evidence

III.

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Data availability

The datasets that support the findings of this study are available from the corresponding author on reasonable request.

References

  1. de Schepper EI, Damen J, van Meurs JB et al (2010) The association between lumbar disc degeneration and low back pain: the influence of age, gender, and individual radiographic features. Spine 35(5):531–536

    Article  Google Scholar 

  2. Luoma K, Riihimaki H, Luukkonen R et al (2011) Low back pain in relation to lumbar disc degeneration. Spine 25(4):487–492

    Article  Google Scholar 

  3. Samartzis D, Karppinen J, Mok F et al (2011) A population-based study of juvenile disc degeneration and its association with overweight and obesity, low back pain, and diminished functional status. J Bone Jt Surg Am 93(7):662–670

    Article  Google Scholar 

  4. Sambrook PN, MacGregor AJ, Spector TD (1999) Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins. Arthritis Rheum 42(2):366–372

    Article  CAS  Google Scholar 

  5. Suzuki S, Fujita N, Hosogane N et al (2015) Excessive reactive oxygen species are therapeutic targets for intervertebral disc degeneration. Arthritis Res Ther 17:316

    Article  Google Scholar 

  6. Lotz JC, Chin JR (2000) Intervertebral disc cell death is dependent on the magnitude and duration of spinal loading. Spine 25(12):1477–1483

    Article  CAS  Google Scholar 

  7. Takeda K, Kou I, Hosogane N (2019) Association of susceptibility genes for adolescent idiopathic scoliosis and intervertebral disc degeneration with adult spinal deformity. Spine 44(23):1623–1629

    Article  Google Scholar 

  8. Yurube T, Takada T, Suzuki T (2012) Rat tail static compression model mimics extracellular matrix metabolic imbalances of matrix metalloproteinases, aggrecanases, and tissue inhibitors of metalloproteinases in intervertebral disc degeneration. Arthritis Res Ther 14(2):R51

    Article  CAS  Google Scholar 

  9. Zaleske DJ, Ehrlich MG, Hall JE (1980) Association of glycosaminoglycan depletion and degradative enzyme activity in scoliosis. Clin Orthop Relat Res 148:177–181

    Google Scholar 

  10. Bertram H, Steck E, Zimmerman G et al (2006) Accelerated intervertebral disc degeneration in scoliosis versus physiological ageing develops against a background of enhanced anabolic gene expression. Biochem Biophys Res Commun 342(3):963–972

    Article  CAS  Google Scholar 

  11. Roberts S, Menage J, Eisenstein SM (1993) The cartilage end-plate and intervertebral disc in scoliosis: calcification and other sequelae. J Orthopaedic Res Off Publ Orthopaedic Res Soc 11(5):747–757

    Article  CAS  Google Scholar 

  12. Urban JP, Roberts S (2003) Degeneration of the intervertebral disc. Arthritis Res Ther 5(3):120–130

    Article  Google Scholar 

  13. Rajasekaran S, Vidyadhara S, Subbiah M et al (2010) ISSLS prize winner: a study of effects of in vivo mechanical forces on human lumbar discs with scoliotic disc as a biological model: results from serial postcontrast diffusion studies, histopathology and biochemical analysis of twenty-one human lumbar scoliotic discs. Spine 35(21):1930–1943

    Article  CAS  Google Scholar 

  14. Urban MR, Fairbank JC, Bibby SR et al (2001) Intervertebral disc composition in neuromuscular scoliosis: changes in cell density and glycosaminoglycan concentration at the curve apex. Spine 26(6):610–617

    Article  CAS  Google Scholar 

  15. Sitte I, Kathrein A, Pfaller K et al (2013) Morphological differences in adolescent idiopathic scoliosis: a histological and ultrastructural investigation. Spine 38(19):1672–1680

    Article  Google Scholar 

  16. Yu J, Fairbank JC, Roberts S et al (2005) The elastic fiber network of the anulus fibrosus of the normal and scoliotic human intervertebral disc. Spine 30(16):1815–1820

    Article  Google Scholar 

  17. Duance VC, Crean JK, Sims TJ et al (1998) Changes in collagen cross-linking in degenerative disc disease and scoliosis. Spine 23(23):2545–2551

    Article  CAS  Google Scholar 

  18. Fong DY, Cheung KM, Wong YW et al (2015) A population-based cohort study of 394,401 children followed for 10 years exhibits sustained effectiveness of scoliosis screening. Spine J Off J N Am Spine Soc 15(5):825–833

    Article  Google Scholar 

  19. Daruwalla JS, Balasubramaniam P, Chay SO et al (1985) Idiopathic scoliosis. Prevalence and ethnic distribution in Singapore schoolchildren. J Bone Jt Surg Br 67(2):182–184

    Article  CAS  Google Scholar 

  20. Hengwei F, Zifang H, Qifei W et al (2016) Prevalence of idiopathic scoliosis in Chinese schoolchildren: a Large. Popul Based Study Spine 41(3):259–264

    Google Scholar 

  21. Michelsson JE (1965) The development of spinal deformity in experimental scoliosis. Acta Orthop Scand Suppl 1965(Suppl 81):81–91

    Google Scholar 

  22. Aulisa L, Papaleo P, Pola E et al (2007) Association between IL-6 and MMP-3 gene polymorphisms and adolescent idiopathic scoliosis: a case–control study. Spine 32(24):2700–2702

    Article  Google Scholar 

  23. Lonner BS, Ren Y, Upasani VV et al (2018) Disc degeneration in unfused caudal motion segments ten years following surgery for adolescent idiopathic scoliosis. Spine Deform 6(6):684–690

    Article  Google Scholar 

  24. Nohara A, Kawakami N, Seki K et al (2015) The effects of spinal fusion on lumbar disc degeneration in patients with adolescent idiopathic scoliosis: a minimum 10-year follow-up. Spine Deform 3(5):462–468

    Article  Google Scholar 

  25. Matsumoto M, Okada E, Ichihara D et al (2010) Age-related changes of thoracic and cervical intervertebral discs in asymptomatic subjects. Spine 35(14):1359–1364

    Article  Google Scholar 

  26. Matsumoto M, Okada E, Toyama Y et al (2013) Tandem age-related lumbar and cervical intervertebral disc changes in asymptomatic subjects. Eur Spine J 22(4):708–713

    Article  Google Scholar 

  27. Lenke LG, Betz RR, Harms J et al (2001) Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Jt Surg Am 83(8):1169–1181

    Article  CAS  Google Scholar 

  28. Pfirrmann CW, Metzdorf A, Zanetti M et al (2001) Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine 26(17):1873–1878

    Article  CAS  Google Scholar 

  29. Lowe T, Berven SH, Schwab FJ et al (2006) The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems. Spine 31(19 Suppl):S119-125

    Article  Google Scholar 

  30. Meir AR, Fairbank JC, Jones DA et al (2007) High pressures and asymmetrical stresses in the scoliotic disc in the absence of muscle loading. Scoliosis 2:4

    Article  Google Scholar 

  31. Bibby SR, Fairbank JC, Urban MR et al (2002) Cell viability in scoliotic discs in relation to disc deformity and nutrient levels. Spine 27(20):2220–2228 (discussion 2227–2228)

    Article  Google Scholar 

  32. Lee CS, Ha JK, Kim DG et al (2015) The clinical importance of lumbosacral transitional vertebra in patients with adolescent idiopathic scoliosis. Spine 40(17):E964-970

    Article  Google Scholar 

  33. Glassman SD, Berven S, Bridwell K et al (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine 30(6):682–688

    Article  Google Scholar 

  34. Mac-Thiong JM, Transfeldt EE, Mehbod AA et al (2009) Can c7 plumbline and gravity line predict health related quality of life in adult scoliosis? Spine 34(15):E519-527

    Article  Google Scholar 

  35. Jackson RP, Simmons EH, Stripinis D (1989) Coronal and sagittal plane spinal deformities correlating with back pain and pulmonary function in adult idiopathic scoliosis. Spine 14(12):1391–1397

    Article  CAS  Google Scholar 

  36. Marty-Poumarat C, Scattin L, Marpeau M et al (2007) Natural history of progressive adult scoliosis. Spine 32(11):1227–1234 (discussion 1235)

    Article  Google Scholar 

  37. Abelin-Genevois K, Estivalezes E, Briot J et al (2015) Spino-pelvic alignment influences disc hydration properties after AIS surgery: a prospective MRI-based study. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 24(6):1183–1190

    Article  Google Scholar 

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Funding

This work had no support from funds or grants.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan

    Satoshi Suzuki, Satoshi Nori, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Mitsuru Yagi, Masaya Nakamura, Morio Matsumoto & Kota Watanabe

  2. Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan

    Hirokazu Fujiwara

  3. Department of Orthopaedic Surgery, Fujita Health University, Aichi, Japan

    Nobuyuki Fujita

  4. Department of Spine Surgery, Japan Community Healthcare Organization Tokyo Shinjuku Medical Center, Tokyo, Japan

    Ayato Nohara

  5. Department of Orthopaedic Surgery and Spine Center, Meijo Hospital, Nagoya, Japan

    Noriaki Kawakami

  6. Department of Orthopaedic Surgery, Ichinomiyanishi Hospital, Aichi, Japan

    Noriaki Kawakami

  7. Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan

    Takehiro Michikawa

Authors
  1. Satoshi Suzuki
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Contributions

SS: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting of the manuscript. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HF, SN, OT, NN, EO, NF, MY, MN, MM: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AN, NK, TM: Substantial contributions to the acquisition, analysis, or interpretation of data for the work. Revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KW: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work. Drafting of the manuscript and revising it critically for important intellectual content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Kota Watanabe.

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Conflict of interest

Satoshi Suzuki, Hirokazu Fujiwara, Satoshi Nori, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Nobuyuki Fujita, Mitsuru Yagi, Ayato Nohara, Takehiro Michikawa, Masaya Nakamura and Kowa Watanabe have no conflicts of interest. Morio Matsumoto reports receiving grants from Medtronic and Nu Vasive that are outside the scope of the submitted work. Noriaki Kawakami also reports receiving grant from Health and Labor Science Research Grant Japan, and non-financial support from EOS Imaging that are outside the scope of the submitted work.

Ethical approval

Approval was obtained from the ethics committee of Keio University School of Medicine. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Suzuki, S., Fujiwara, H., Nori, S. et al. Residual lumbar curvature that developed during adolescence accelerates intervertebral disc degeneration in adulthood. Spine Deform 9, 711–720 (2021). https://doi.org/10.1007/s43390-020-00252-9

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  • DOI: https://doi.org/10.1007/s43390-020-00252-9

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