The role of vascularization on changes in ligamentum flavum mechanical properties and development of hypertrophy in patients with lumbar spinal stenosis.
Chondroid metaplasia
Inflammatory
Ligamentum flavum vascularization
Mechanical properties
Structure of ligamentum flavum
Vascular density
Journal
The spine journal : official journal of the North American Spine Society
ISSN: 1878-1632
Titre abrégé: Spine J
Pays: United States
ID NLM: 101130732
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
13
11
2019
revised:
03
03
2020
accepted:
04
03
2020
pubmed:
18
3
2020
medline:
1
7
2021
entrez:
18
3
2020
Statut:
ppublish
Résumé
Ligamentum flavum (LF) induced lumbar spinal stenosis (LSS) is conditioned not only by its "gathering" but especially by hypertrophy. Previous studies have examined the pathophysiology and biochemical changes that cause the hypertrophy. Some studies have described a link between chronic LF inflammation and neovascularization but others have reported highly hypovascular LF tissue in LSS patients. Currently, there is no practical application for our knowledge of the pathophysiology of the LF hypertrophy. Considerations for future treatment include influencing this hypertrophy at the level of tissue mediators, which may slow the development of LSS. To our knowledge, there is no study of micromechanical properties of native LF to date. (1) To clarify the changes in vascularization, chondroid metaplasia, and the presence of inflammatory cell infiltration in LF associated with LSS. (2) To quantify changes in the micromechanical properties associated with LF degenerative processes. Vascular density analysis of degenerated and healthy human LF combined with measurement of micromechanical properties. The study involved 35 patients who underwent surgery between November 1, 2015 and October 1, 2016. The LSS group consisted of 20 patients and the control group consisted of 15 patients. LF samples were obtained during the operation and were used for histopathological and nanoindentation examinations. Sample vascularization was examined as microvascular density (L Vascular density was significantly lower in the LSS group. However, after excluding the effect of age, the difference was not significant. There was high association between L This study showed that L Prevention of the loss of LF vascularization during aging may influence stiffness of LF which in turn may slow down the LF degenerative processes and delay onset of LSS.
Sections du résumé
BACKGROUND CONTEXT
Ligamentum flavum (LF) induced lumbar spinal stenosis (LSS) is conditioned not only by its "gathering" but especially by hypertrophy. Previous studies have examined the pathophysiology and biochemical changes that cause the hypertrophy. Some studies have described a link between chronic LF inflammation and neovascularization but others have reported highly hypovascular LF tissue in LSS patients. Currently, there is no practical application for our knowledge of the pathophysiology of the LF hypertrophy. Considerations for future treatment include influencing this hypertrophy at the level of tissue mediators, which may slow the development of LSS. To our knowledge, there is no study of micromechanical properties of native LF to date.
PURPOSE
(1) To clarify the changes in vascularization, chondroid metaplasia, and the presence of inflammatory cell infiltration in LF associated with LSS. (2) To quantify changes in the micromechanical properties associated with LF degenerative processes.
STUDY DESIGN/SETTING
Vascular density analysis of degenerated and healthy human LF combined with measurement of micromechanical properties.
METHODS
The study involved 35 patients who underwent surgery between November 1, 2015 and October 1, 2016. The LSS group consisted of 20 patients and the control group consisted of 15 patients. LF samples were obtained during the operation and were used for histopathological and nanoindentation examinations. Sample vascularization was examined as microvascular density (L
RESULTS
Vascular density was significantly lower in the LSS group. However, after excluding the effect of age, the difference was not significant. There was high association between L
CONCLUSION
This study showed that L
CLINICAL SIGNIFICANCE
Prevention of the loss of LF vascularization during aging may influence stiffness of LF which in turn may slow down the LF degenerative processes and delay onset of LSS.
Identifiants
pubmed: 32179155
pii: S1529-9430(20)30094-2
doi: 10.1016/j.spinee.2020.03.002
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1125-1133Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.